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      Raised houses reduce mosquito bites

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          Abstract

          Background

          In many parts of continental Africa house construction does not appear to impede entry of malaria vectors and, given their generally late biting cycle, the great majority of transmission takes place indoors. In contrast, many houses in São Tomé, 140 km off the coast of Gabon, are raised on stilts and built of wooden planks. Building on stilts is a time-honoured, but largely untested, way of avoiding mosquito bites. Exposure may also be affected by mosquito activity times and age composition of host-seeking females. A study was therefore undertaken on the island of São Tomé to determine if exposure to Anopheles gambiae, the only vector on the island, varied with house construction or time of the night.

          Methods

          A series of all-night landing collections were undertaken out of doors at ground level, inside houses at ground level, on the verandas of, and inside houses built on stilts. The gonotrophic age of an unselected sample of insects from the first three hours of landing collection (18:00–21:00) was determined by dissection. In addition, 1,149 miniature light-trap collections were obtained from 125 houses in the study area. Numbers collected were related to house construction.

          Results

          Biting of An. gambiae took place primarily outside at ground level. Less than one third of biting occurred inside houses. Houses built on stilts had half the number of An. gambiae in them compared to those built at ground level. Conversely houses with an eaves gap had more An. gambiae in them than houses without such a gap. Gonotrophic age did not affect house entry rates in An. gambiae. House construction affected Culex quinquefasciatus less than An. gambiae. Mean density per house, derived from a series of 1,490 randomly assigned light-trap collections, was over-dispersed with 18% of houses having 70% of the vectors.

          Conclusion

          House construction plays an important role in determining exposure to malaria vectors in São Tomé. Neighbours can have very different exposure levels. Recommendations for improvement in control are given.

          Related collections

          Most cited references21

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          Changes in house design reduce exposure to malaria mosquitoes.

          House design may affect an individual's exposure to malaria parasites, and hence to disease. We conducted a randomized-controlled study using experimental huts in rural Gambia, to determine whether installing a ceiling or closing the eaves could protect people from malaria mosquitoes. Five treatments were tested against a control hut: plywood ceiling; synthetic-netting ceiling; insecticide-treated synthetic-netting ceiling (deltamethrin 12.5 mg/m2); plastic insect-screen ceiling; or the eaves closed with mud. The acceptability of such interventions was investigated by discussions with local communities. House entry by Anopheles gambiae, the principal African malaria vector, was reduced by the presence of a ceiling: plywood (59% reduction), synthetic-netting (79%), insecticide-treated synthetic-netting (78%), plastic insect-screen (80%, P < 0.001 in all cases) and closed eaves (37%, ns). Similar reductions were also seen with Mansonia spp., vectors of lymphatic filariasis and numerous arboviruses. Netting and insect-screen ceilings probably work as decoy traps attracting mosquitoes into the roof space, but not the room. Ceilings are likely to be well accepted and may be of greatest benefit in areas of low to moderate transmission and when used in combination with other malaria control strategies.
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            Reducing malaria by mosquito-proofing houses.

            Sometimes, valuable lessons from history are forgotten, remain unknown, or worse, are ignored. This article reminds us of the pioneering work of Angelo Celli at the end of the 19th century, who demonstrated that people could be protected from malaria by screening their homes against mosquitoes. Since then, public health scientists have continued to show that simple changes in house design have the potential for protecting people against this life-threatening disease. Yet today, this type of intervention remains virtually ignored. The literature reviewed here demonstrates the enormous potential of these methods to reduce malaria, in the hope that it will stimulate scientific debate and further research.
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              Clustering of malaria infections within an endemic population: risk of malaria associated with the type of housing construction.

              The occurrence of malaria infections due to Plasmodium vivax and P. falciparum was monitored in a population of 3,023 people living in six contiguous villages in Kataragama, an area of endemic malaria in southern Sri Lanka, over a period of 17 months. The annual incidence of malaria in this population during the study period was 25.8%. Malaria attacks were clustered, occurring more frequently than expected in certain individuals and housing groups and less frequently than expected in others. In one of these villages, the distribution of cases was examined in relation to locality and to the type of house construction. There was a strong association between the malaria incidence and house construction, independent of location. The risk of getting malaria was greater for inhabitants of the poorest type of house construction (incomplete, mud, or cadjan (palm) walls, and cadjan thatched roofs) compared to houses with complete brick and plaster walls and tiled roofs. Houses that were better constructed had a significantly lower malaria incidence rate (10.5%) than those that were poorly constructed (21.2%; P less than 0.01, by Student's t-test). There was also a significantly higher number of indoor resting mosquitoes collected from the poorly constructed houses than from those better constructed; the average (geometric mean) of mosquito densities found in houses of better versus poor construction were 0.97 and 1.89 per collection in the dry season, and 1.95 and 3.42 per collection in the wet season, respectively (P less than 0.05 in both seasons). This indicated that the higher malaria risk associated with poorly constructed houses was at least partly due to higher human-mosquito contact among their inhabitants.
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                Author and article information

                Journal
                Malar J
                Malaria Journal
                BioMed Central (London )
                1475-2875
                2003
                10 December 2003
                : 2
                : 45
                Affiliations
                [1 ]Danish Bilharziasis Laboratories, Jaergersborg Allé 1-D, Charlottenlund, DK 2920, Denmark
                [2 ]Centro de Malária e Outras Doenças Tropicais, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Rua da Junqueira 96, 1349-008 Lisbon, Portugal
                [3 ]SIMA Project, c/o Technoserve, Rua Bas N'Tchinga 509, Bairro da Coop, Maputo, Mozambique
                [4 ]Unidade de Entomologia Médica Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Rua da Junqueira 96, 1349-008 Lisbon, Portugal
                [5 ]Centro Nacional de Endemias, Caixa Postal 218, São Tomé, Democratic Republic of São Tomé and Príncipe
                Article
                1475-2875-2-45
                10.1186/1475-2875-2-45
                317347
                14667242
                7c6a994c-a72b-4d81-82d7-44693effa1fd
                Copyright © 2003 Charlwood et al; licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL.
                History
                : 19 June 2003
                : 10 December 2003
                Categories
                Research

                Infectious disease & Microbiology
                Infectious disease & Microbiology

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