Reuters/Damir Sagolj
Anti-malaria kits are becoming less effective. Screens and gap-free walls can help.
SOLID THINKING

Modern housing can cut malaria infections nearly in half

By Steve Mollman

Keeping your children home safe at night is a good idea. But what if home is a deadly place?

For many people living in developing countries, traditional housing does little to keep out malaria-spreading mosquitoes. The infectious disease killed about 453,000 children under the age of five in 2013, according to the World Health Organization. And in sub-Saharan Africa, some 80-100% of malaria transmission occurs indoors at night.

Modern housing can help. New research published in Malaria Journal this week found that residents of modern housing were 47% less likely to be infected with malaria compared to those in traditional houses.

In traditional housing, mosquitoes easily get in through numerous points of entry—think thatched roofs, bamboo walls, and wooden floors. Modern housing does a far better job of keeping the insects out, thanks to closed eaves, ceilings, and screened doors and windows.

The new research looked at studies comparing cases in modern homes with cases in traditional homes. And it called for better and more such comparisons, noting they are now easier to conduct thanks to incrementally rising living and housing standards in sub-Saharan Africa.

Of course, many living in poverty cannot afford modern housing. But the research noted that even simple, relatively low-cost techniques, such as closing eaves (the gap between walls and the ceiling), can reduce infections. A Habitat for Humanity report (pdf) noted that “Many of the interventions are of very low cost or achievable with local materials. Using mud blocks to close eaves is almost free, and using locally made ceilings costs only 70 cents to $1.14…”

Better data could lead to more informed decisions in the future. For example, the new research noted that regional differences in traditional housing—between, say, Laos and Tanzania—affect how mosquitoes most commonly enter homes. That, in turn, could suggest what to prioritize when implementing modern construction techniques in a particular area.

In recent years insecticide-treated nets and other interventions have done much to protect people from malaria. Instances of the disease dropped by 30% between 2000 and 2013, according to the WHO. But an emerging mosquito resistance to insecticides, and microbial resistance to antimalarial medicines, threaten to trigger a rise in malaria-related deaths.

Artemisinin, the most powerful drug available to cure malaria, has failed in more and more people in Cambodia, Myanmar, Vietnam, Laos, and border regions of Thailand. Even countries that have done well in eradicating malaria, such as China and Brazil, could see their efforts unravel.

In coming years, modern housing could gain more prominence in the fight against malaria.