Poor housing construction associated with increased malaria incidence in a cohort of young Ugandan children

Abstract

Despite the use of accepted interventions to combat malaria, such as insecticide-treated bed nets and artemisinin-based combination therapy, malaria remains a leading cause of morbidity and mortality in Uganda. We investigated associations between household factors and malaria incidence in a cohort of children living in a highly endemic region of Uganda. Living in a modern house, defined as the use of non-earth floors, non-thatched roofs, and non-mud walls, was associated with approximately half malaria incidence compared with living in a traditional home (incidence rate ratio [IRR] = 0.54, P = 0.001). Other factors found to be associated with a lower incidence of malaria included living in town versus rural setting; sleeping in a room with openings to the outside (windows, eaves, and airbricks); and having an older and more educated primary caregiver. This study adds to the growing body of evidence that improved house construction may be associated with a lower risk of malaria.

© The American Society of Tropical Medicine and Hygiene.

Figures

Figure 1.

Relationship between materials used for household construction. Incidence is defined as cases/person/person-year at risk. Traditional floors are defined as earth floors, whereas modern floors are defined as cement, stone, or brick floors. Traditional walls are defined as mud and sticks or mud brick walls, whereas modern walls are defined as cement bricks or plaster. Traditional roofs are defined as thatched roofs, whereas modern roofs are defined as iron sheets or cement.

Figure 2.

Spatial distribution of household construction type variable. Incidence is defined as cases/person/person-year at risk. Modern homes defined as structure where nontraditional materials are used for floor, walls, and roof. Traditional homes defined as structure where any traditional materials are used.