Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2021 Jan 8;16(1):e0244284.
doi: 10.1371/journal.pone.0244284. eCollection 2021.

Randomized trials of housing interventions to prevent malaria and Aedes-transmitted diseases: A systematic review and meta-analysis

Kok Pim Kua  1 , Shaun Wen Huey Lee  2   3   4   5
Affiliations
Meta-Analysis

Randomized trials of housing interventions to prevent malaria and Aedes-transmitted diseases: A systematic review and meta-analysis

Kok Pim Kua et al. PLoS One. .

Abstract

Background: Mosquito-borne diseases remain a significant public health problem in tropical regions. Housing improvements such as screening of doors and windows may be effective in reducing disease transmission, but the impact remains unclear.

Objectives: To examine whether housing interventions were effective in reducing mosquito densities in homes and the impact on the incidence of mosquito-borne diseases.

Methods: In this systematic review and meta-analysis, we searched 16 online databases, including NIH PubMed, CINAHL Complete, LILACS, Ovid MEDLINE, and Cochrane Central Register of Controlled Trials for randomized trials published from database inception to June 30, 2020. The primary outcome was the incidence of any mosquito-borne diseases. Secondary outcomes encompassed entomological indicators of the disease transmission. I2 values were used to explore heterogeneity between studies. A random-effects meta-analysis was used to assess the primary and secondary outcomes, with sub-group analyses for type of interventions on home environment, study settings (rural, urban, or mixed), and overall house type (traditional or modern housing).

Results: The literature search yielded 4,869 articles. After screening, 18 studies were included in the qualitative review, of which nine were included in the meta-analysis. The studies enrolled 7,200 households in Africa and South America, reporting on malaria or dengue only. The type of home environmental interventions included modification to ceilings and ribbons to close eaves, screening doors and windows with nets, insecticide-treated wall linings in homes, nettings over gables and eaves openings, mosquito trapping systems, metal-roofed houses with mosquito screening, gable windows and closed eaves, and prototype houses using southeast Asian designs. Pooled analysis depicted a lower risk of mosquito-borne diseases in the housing intervention group (OR = 0.68; 95% CI = 0.48 to 0.95; P = 0.03). Subgroup analysis depicted housing intervention reduced the risk of malaria in all settings (OR = 0.63; 95% CI = 0.39 to 1.01; P = 0.05). In urban environment, housing intervention was found to decrease the risk of both malaria and dengue infections (OR = 0.52; 95% CI = 0.27 to 0.99; P = 0.05).Meta-analysis of pooled odds ratio showed a significant benefit of improved housing in reducing indoor vector densities of both Aedes and Anopheles (OR = 0.35; 95% CI = 0.23 to 0.54; P<0.001).

Conclusions: Housing intervention could reduce transmission of malaria and dengue among people living in the homes. Future research should evaluate the protective effect of specific house features and housing improvements associated with urban development.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow diagram of study selection.
Fig 2
Fig 2. Pooled odds ratio for the effect of housing intervention in reducing mosquito vector densities.
Fig 3
Fig 3. Effect of housing intervention on the risk of mosquito-borne diseases stratified by type of mosquito-borne diseases.
Fig 4
Fig 4. Effect of housing intervention on the risk of mosquito-borne diseases stratified by type of housing interventions.
Fig 5
Fig 5. Effect of housing intervention on the risk of mosquito-borne diseases stratified by urbanicity.
Fig 6
Fig 6. Effect of housing intervention on the risk of mosquito-borne diseases stratified by type of houses.
See this image and copyright information in PMC

References

    1. Chapter 2—Mosquito-borne siseases In: Qureshi AI, editor. Zika virus disease: Academic Press; 2018. p. 27–45.
    1. Paixão ES, Teixeira MG, Rodrigues LC. Zika, chikungunya and dengue: the causes and threats of new and re-emerging arboviral diseases. BMJ Glob Health. 2018;3(Suppl 1):e000530 Epub 2018/02/13. 10.1136/bmjgh-2017-000530 - DOI - PMC - PubMed
    1. Stanaway JD, Shepard DS, Undurraga EA, Halasa YA, Coffeng LE, Brady OJ, et al. The global burden of dengue: an analysis from the Global Burden of Disease Study 2013. Lancet Infect Dis. 2016;16(6):712–23. Epub 2016/02/15. 10.1016/S1473-3099(16)00026-8 - DOI - PMC - PubMed
    1. Grobbelaar AA, Weyer J, Moolla N, Jansen van Vuren P, Moises F, Paweska JT. Resurgence of yellow fever in Angola, 2015–2016. Emerg Infect Dis. 2016;22(10):1854–5. Epub 2016/08/19. 10.3201/eid2210.160818 - DOI - PMC - PubMed
    1. Franklinos LHV, Jones KE, Redding DW, Abubakar I. The effect of global change on mosquito-borne disease. Lancet Infect Dis. 2019;19(9):e302–e12. 10.1016/S1473-3099(19)30161-6 - DOI - PubMed