Cargando…

House design and risk of malaria, acute respiratory infection and gastrointestinal illness in Uganda: A cohort study

House construction is rapidly modernizing across Africa but the potential benefits for human health are poorly understood. We hypothesised that improvements to housing would be associated with reductions in malaria, acute respiratory infection (ARI) and gastrointestinal illness in an area of low mal...

Descripción completa

Detalles Bibliográficos
Autores principales: Musiime, Alex K., Krezanoski, Paul J., Smith, David L., Kilama, Maxwell, Conrad, Melissa D., Otto, Geoffrey, Kyagamba, Patrick, Asiimwe, Jackson, Rek, John, Nankabirwa, Joaniter I., Arinaitwe, Emmanuel, Akol, Anne M., Kamya, Moses R., Staedke, Sarah G., Drakeley, Chris, Bousema, Teun, Lindsay, Steve W., Dorsey, Grant, Tusting, Lucy S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10022195/
https://www.ncbi.nlm.nih.gov/pubmed/36962263
http://dx.doi.org/10.1371/journal.pgph.0000063
_version_ 1784908676528603136
author Musiime, Alex K.
Krezanoski, Paul J.
Smith, David L.
Kilama, Maxwell
Conrad, Melissa D.
Otto, Geoffrey
Kyagamba, Patrick
Asiimwe, Jackson
Rek, John
Nankabirwa, Joaniter I.
Arinaitwe, Emmanuel
Akol, Anne M.
Kamya, Moses R.
Staedke, Sarah G.
Drakeley, Chris
Bousema, Teun
Lindsay, Steve W.
Dorsey, Grant
Tusting, Lucy S.
author_facet Musiime, Alex K.
Krezanoski, Paul J.
Smith, David L.
Kilama, Maxwell
Conrad, Melissa D.
Otto, Geoffrey
Kyagamba, Patrick
Asiimwe, Jackson
Rek, John
Nankabirwa, Joaniter I.
Arinaitwe, Emmanuel
Akol, Anne M.
Kamya, Moses R.
Staedke, Sarah G.
Drakeley, Chris
Bousema, Teun
Lindsay, Steve W.
Dorsey, Grant
Tusting, Lucy S.
author_sort Musiime, Alex K.
collection PubMed
description House construction is rapidly modernizing across Africa but the potential benefits for human health are poorly understood. We hypothesised that improvements to housing would be associated with reductions in malaria, acute respiratory infection (ARI) and gastrointestinal illness in an area of low malaria endemicity in Uganda. Data were analysed from a cohort study of male and female child and adult residents (n = 531) of 80 randomly-selected households in Nagongera sub-county, followed for 24 months (October 4, 2017 to October 31, 2019). Houses were classified as modern (brick walls, metal roof and closed eaves) or traditional (all other homes). Light trap collections of mosquitoes were done every two weeks in all sleeping rooms. Every four weeks, we measured malaria infection (using microscopy and qPCR to detect malaria parasites), incidence of malaria, ARI and gastrointestinal illness. We collected 15,780 adult female Anopheles over 7,631 nights. We collected 13,277 blood samples of which 10.2% (1,347) were positive for malaria parasites. Over 958 person years we diagnosed 38 episodes of uncomplicated malaria (incidence 0.04 episodes per person-year at risk), 2,553 episodes of ARI (incidence 2.7 episodes per person-year) and 387 episodes of gastrointestinal illness (incidence 0.4 episodes per person-year). Modern houses were associated with a 53% lower human biting rate compared to traditional houses (adjusted incidence rate ratio [aIRR] 0.47, 95% confidence interval [CI] 0.32–0.67, p<0.001) and a 24% lower incidence of gastrointestinal illness (aIRR 0.76, 95% CI 0.59–0.98, p = 0.04) but no changes in malaria prevalence, malaria incidence nor ARI incidence. House improvements may reduce mosquito-biting rates and gastrointestinal illness among children and adults. For the health sector to leverage Africa’s housing modernization, research is urgently needed to identify the healthiest house designs and to assess their effectiveness across a range of epidemiological settings in sub-Saharan Africa.
format Online
Article
Text
id pubmed-10022195
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Public Library of Science
record_format MEDLINE/PubMed
spelling pubmed-100221952023-03-17 House design and risk of malaria, acute respiratory infection and gastrointestinal illness in Uganda: A cohort study Musiime, Alex K. Krezanoski, Paul J. Smith, David L. Kilama, Maxwell Conrad, Melissa D. Otto, Geoffrey Kyagamba, Patrick Asiimwe, Jackson Rek, John Nankabirwa, Joaniter I. Arinaitwe, Emmanuel Akol, Anne M. Kamya, Moses R. Staedke, Sarah G. Drakeley, Chris Bousema, Teun Lindsay, Steve W. Dorsey, Grant Tusting, Lucy S. PLOS Glob Public Health Research Article House construction is rapidly modernizing across Africa but the potential benefits for human health are poorly understood. We hypothesised that improvements to housing would be associated with reductions in malaria, acute respiratory infection (ARI) and gastrointestinal illness in an area of low malaria endemicity in Uganda. Data were analysed from a cohort study of male and female child and adult residents (n = 531) of 80 randomly-selected households in Nagongera sub-county, followed for 24 months (October 4, 2017 to October 31, 2019). Houses were classified as modern (brick walls, metal roof and closed eaves) or traditional (all other homes). Light trap collections of mosquitoes were done every two weeks in all sleeping rooms. Every four weeks, we measured malaria infection (using microscopy and qPCR to detect malaria parasites), incidence of malaria, ARI and gastrointestinal illness. We collected 15,780 adult female Anopheles over 7,631 nights. We collected 13,277 blood samples of which 10.2% (1,347) were positive for malaria parasites. Over 958 person years we diagnosed 38 episodes of uncomplicated malaria (incidence 0.04 episodes per person-year at risk), 2,553 episodes of ARI (incidence 2.7 episodes per person-year) and 387 episodes of gastrointestinal illness (incidence 0.4 episodes per person-year). Modern houses were associated with a 53% lower human biting rate compared to traditional houses (adjusted incidence rate ratio [aIRR] 0.47, 95% confidence interval [CI] 0.32–0.67, p<0.001) and a 24% lower incidence of gastrointestinal illness (aIRR 0.76, 95% CI 0.59–0.98, p = 0.04) but no changes in malaria prevalence, malaria incidence nor ARI incidence. House improvements may reduce mosquito-biting rates and gastrointestinal illness among children and adults. For the health sector to leverage Africa’s housing modernization, research is urgently needed to identify the healthiest house designs and to assess their effectiveness across a range of epidemiological settings in sub-Saharan Africa. Public Library of Science 2022-03-03 /pmc/articles/PMC10022195/ /pubmed/36962263 http://dx.doi.org/10.1371/journal.pgph.0000063 Text en © 2022 Musiime et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Musiime, Alex K.
Krezanoski, Paul J.
Smith, David L.
Kilama, Maxwell
Conrad, Melissa D.
Otto, Geoffrey
Kyagamba, Patrick
Asiimwe, Jackson
Rek, John
Nankabirwa, Joaniter I.
Arinaitwe, Emmanuel
Akol, Anne M.
Kamya, Moses R.
Staedke, Sarah G.
Drakeley, Chris
Bousema, Teun
Lindsay, Steve W.
Dorsey, Grant
Tusting, Lucy S.
House design and risk of malaria, acute respiratory infection and gastrointestinal illness in Uganda: A cohort study
title House design and risk of malaria, acute respiratory infection and gastrointestinal illness in Uganda: A cohort study
title_full House design and risk of malaria, acute respiratory infection and gastrointestinal illness in Uganda: A cohort study
title_fullStr House design and risk of malaria, acute respiratory infection and gastrointestinal illness in Uganda: A cohort study
title_full_unstemmed House design and risk of malaria, acute respiratory infection and gastrointestinal illness in Uganda: A cohort study
title_short House design and risk of malaria, acute respiratory infection and gastrointestinal illness in Uganda: A cohort study
title_sort house design and risk of malaria, acute respiratory infection and gastrointestinal illness in uganda: a cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10022195/
https://www.ncbi.nlm.nih.gov/pubmed/36962263
http://dx.doi.org/10.1371/journal.pgph.0000063
work_keys_str_mv AT musiimealexk housedesignandriskofmalariaacuterespiratoryinfectionandgastrointestinalillnessinugandaacohortstudy
AT krezanoskipaulj housedesignandriskofmalariaacuterespiratoryinfectionandgastrointestinalillnessinugandaacohortstudy
AT smithdavidl housedesignandriskofmalariaacuterespiratoryinfectionandgastrointestinalillnessinugandaacohortstudy
AT kilamamaxwell housedesignandriskofmalariaacuterespiratoryinfectionandgastrointestinalillnessinugandaacohortstudy
AT conradmelissad housedesignandriskofmalariaacuterespiratoryinfectionandgastrointestinalillnessinugandaacohortstudy
AT ottogeoffrey housedesignandriskofmalariaacuterespiratoryinfectionandgastrointestinalillnessinugandaacohortstudy
AT kyagambapatrick housedesignandriskofmalariaacuterespiratoryinfectionandgastrointestinalillnessinugandaacohortstudy
AT asiimwejackson housedesignandriskofmalariaacuterespiratoryinfectionandgastrointestinalillnessinugandaacohortstudy
AT rekjohn housedesignandriskofmalariaacuterespiratoryinfectionandgastrointestinalillnessinugandaacohortstudy
AT nankabirwajoaniteri housedesignandriskofmalariaacuterespiratoryinfectionandgastrointestinalillnessinugandaacohortstudy
AT arinaitweemmanuel housedesignandriskofmalariaacuterespiratoryinfectionandgastrointestinalillnessinugandaacohortstudy
AT akolannem housedesignandriskofmalariaacuterespiratoryinfectionandgastrointestinalillnessinugandaacohortstudy
AT kamyamosesr housedesignandriskofmalariaacuterespiratoryinfectionandgastrointestinalillnessinugandaacohortstudy
AT staedkesarahg housedesignandriskofmalariaacuterespiratoryinfectionandgastrointestinalillnessinugandaacohortstudy
AT drakeleychris housedesignandriskofmalariaacuterespiratoryinfectionandgastrointestinalillnessinugandaacohortstudy
AT bousemateun housedesignandriskofmalariaacuterespiratoryinfectionandgastrointestinalillnessinugandaacohortstudy
AT lindsaystevew housedesignandriskofmalariaacuterespiratoryinfectionandgastrointestinalillnessinugandaacohortstudy
AT dorseygrant housedesignandriskofmalariaacuterespiratoryinfectionandgastrointestinalillnessinugandaacohortstudy
AT tustinglucys housedesignandriskofmalariaacuterespiratoryinfectionandgastrointestinalillnessinugandaacohortstudy