House modifications for preventing malaria
Joanna Furnival-Adams1, Evelyn A Olanga2, Mark Napier3,4
1Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.
The Cochrane Database of Systematic Reviews
|October 15, 2020
Summary
House screening may reduce malaria transmission and infection, offering a potential new tool as malaria control efforts plateau. Further research is ongoing to confirm these promising findings for public health.
Area of Science:
- Public Health
- Infectious Diseases
- Vector Control
Background:
- Malaria remains a significant global health challenge, with progress in control efforts stagnating.
- Novel and supplementary vector control strategies are urgently needed.
- Modifying houses to prevent mosquito entry is a revisited approach with potential to reduce malaria transmission.
Purpose of the Study:
- To evaluate the impact of house modifications on malaria incidence and transmission.
- To synthesize evidence from various study designs assessing house screening interventions.
Main Methods:
- Systematic search of multiple databases and clinical trial registries up to November 2019.
- Inclusion of randomized controlled trials (RCTs), cluster-RCTs, and quasi-experimental studies reporting malaria outcomes.
- Data extraction and risk of bias assessment by two independent reviewers, with evidence certainty evaluated using the GRADE approach.
Main Results:
- Six cluster-RCTs conducted in sub-Saharan Africa met inclusion criteria, focusing on screening various house entry points.
- Screening showed potential to reduce clinical malaria incidence (low-certainty evidence) and malaria parasite prevalence (moderate-certainty evidence).
- Reduced entomological inoculation rates (EIR) were observed in screened houses, suggesting decreased malaria transmission.
Conclusions:
- Current evidence suggests house screening may effectively reduce malaria transmission and infection.
- Further trials are expected to strengthen the evidence base.
- House modification represents a promising supplementary tool for malaria control.
