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

Autor: Musiime AK; Infectious Diseases Research Collaboration, Kampala, Uganda.; Department of Zoology, Entomology and Fisheries Sciences, College of Natural Sciences, Makerere University, Kampala, Uganda., Krezanoski PJ; Department of Medicine, San Francisco General Hospital, University of California, San Francisco, United States of America., Smith DL; Department of Health Metrics Sciences, University of Washington, Seattle, United States of America., Kilama M; Infectious Diseases Research Collaboration, Kampala, Uganda., Conrad MD; Department of Medicine, San Francisco General Hospital, University of California, San Francisco, United States of America., Otto G; Infectious Diseases Research Collaboration, Kampala, Uganda., Kyagamba P; Infectious Diseases Research Collaboration, Kampala, Uganda., Asiimwe J; Infectious Diseases Research Collaboration, Kampala, Uganda., Rek J; Infectious Diseases Research Collaboration, Kampala, Uganda., Nankabirwa JI; Infectious Diseases Research Collaboration, Kampala, Uganda.; Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda., Arinaitwe E; Infectious Diseases Research Collaboration, Kampala, Uganda., Akol AM; Department of Zoology, Entomology and Fisheries Sciences, College of Natural Sciences, Makerere University, Kampala, Uganda., Kamya MR; Infectious Diseases Research Collaboration, Kampala, Uganda.; Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda., Staedke SG; Faculty of Infectious and Tropical Diseases, Clinical Research Department, London School of Hygiene & Tropical Medicine, London, United Kingdom., Drakeley C; Faculty of Infectious and Tropical Diseases, Department of Infection Biology, London School of Hygiene & Tropical Medicine, London, United Kingdom., Bousema T; Department of Medical Microbiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands., Lindsay SW; Department of Biosciences, Durham University, Durham, United Kingdom., Dorsey G; Department of Medicine, San Francisco General Hospital, University of California, San Francisco, United States of America., Tusting LS; Faculty of Infectious and Tropical Diseases, Department of Disease Control, London School of Hygiene & Tropical Medicine, London, United Kingdom.; Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, United Kingdom.
Jazyk: angličtina
Zdroj: PLOS global public health [PLOS Glob Public Health] 2022 Mar 03; Vol. 2 (3), pp. e0000063. Date of Electronic Publication: 2022 Mar 03 (Print Publication: 2022).
DOI: 10.1371/journal.pgph.0000063
Abstrakt: 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.
Competing Interests: The authors declare that they have no competing interests.
(Copyright: © 2022 Musiime et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE