Last Updated: 07/11/2025

Can improved housing provide additional protection against clinical malaria over current best practice?

Objectives

In previous research, we have shown that closing the eaves (the gap between the top of the wall and the roof) and using screening can reduce dramatically the number of malaria mosquitoes entering a house. Here, we want to find out if we can protect children against malaria by modifying houses so that they have a metal roof, closed eaves, screened doors and windows and screened air bricks which allow the warm air to rise out of the house, but not let any mosquitoes indoors. We will see how successful these measures are by looking at how many children become infected in these houses compared to those living in houses with thatched roofs and open eaves. 

Principal Institution

Durham University, United Kingdom

Principal Investigators / Focal Persons

Steven W. Lindsay

Rationale and Abstract

Malaria is a life-threatening infection that people can get though bites by infected mosquitoes (malaria mosquitoes). It is one of the greatest threats to global public health; in 2012 there were 207 million cases of the condition resulting in 627,000 deaths with some 80% of those deaths occurring in Africa. Most cases of infection happens indoors at night, so it’s important to try and prevent, or at least reduce, the number of malaria mosquitoes entering people’s homes. In previous research, we have shown that closing the eaves (the gap between the top of the wall and the roof) and using screening can reduce dramatically the number of malaria mosquitoes entering a house. Here, we want to find out if we can protect children against malaria by modifying houses so that they have a metal roof, closed eaves, screened doors and windows and screened air bricks which allow the warm air to rise out of the house, but not let any mosquitoes indoors. We will see how successful these measures are by looking at how many children become infected in these houses compared to those living in houses with thatched roofs and open eaves. Over the past thirty years a silent revolution in house design has been happening across Africa. The traditional thatched-roofed houses are being replaced steadily by metal-roofed houses as the continent develops. We hope to ride this wave of cultural change and further improve the design of houses to make them healthier to live in. Improved housing has the potential to improve the lives of millions of people across sub-Saharan Africa.

Study Design

ISRCTN02622179

  • Study design: Two-armed household clustered-randomised controlled study
  • Primary study design: Interventional
  • Secondary study design: Cluster randomised trial
  • Study setting(s): Home
  • Study type: Prevention

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