title: Is housing quality associated with malaria incidence among young children and mosquito vector numbers? Evidence from Korogwe, Tanzania.
abstract: BACKGROUND
  Several studies conducted in Northeast Tanzania have documented declines in malaria transmission even before interventions were scaled up. One explanation for these reductions may be the changes in socio-environmental conditions associated with economic development, and in particular improvements in housing construction.
  
  
  OBJECTIVE
  This analysis seeks to identify (1) risk factors for malaria incidence among young children and (2) household and environmental factors associated with mosquito vector numbers collected in the child's sleeping area. Both analyses focus on housing construction quality as a key determinant.
  
  
  METHODS
  For 435 children enrolled in a larger trial of intermittent preventive treatment for malaria in infants in the Korogwe District in Tanga, Northeastern Tanzania, detailed information on their dwelling characteristics were collected in the last year of the trial. Principal components analysis was used to construct an index of housing structure quality and converted to quintile units for regression analysis. Univariate and multivariate random effects negative binomial regressions were used to predict risk factors for child malaria incidence and the mean total number of indoor female Anopheles gambiae and funestus mosquitoes collected per household across three occasions.
  
  
  RESULTS
  Building materials have substantially improved in Korogwe over time. Multivariate regressions showed that residing in rural areas (versus urban) increased malaria incidence rates by over three-fold and mean indoor female A. gambiae and funestus numbers by nearly two-fold. Compared to those residing in the lowest quality houses, children residing in the highest quality houses had one-third lower malaria incidence rates, even when wealth and rural residence were controlled for. Living in the highest quality houses reduced vector numbers while having cattle near the house significantly increased them.
  
  
  CONCLUSIONS
  Results corroborate findings from other studies that show associations between malaria incidence and housing quality; associations were concentrated amongst the highest quality houses.
authors: Global Health Group, Global Health Sciences, University of California, San Francisco, San Francisco, California, United States of America.
authors: Jenny X
authors: JX
authors: Liu
authors: Department of Immunology & Infection, London School of Hygiene and Tropical Medicine, London, United Kingdom ; Department of Medical Microbiology, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands.
authors: Teun
authors: T
authors: Bousema
authors: Global Health Group, Global Health Sciences, University of California, San Francisco, San Francisco, California, United States of America.
authors: Brittany
authors: B
authors: Zelman
authors: Tanga Research Center, National Institute for Medical Research, Tanga, Tanzania.
authors: Samwel
authors: S
authors: Gesase
authors: Mwanza Interventions Trial Unit Center, National Institute for Medical Research, Mwanza, Tanzania.
authors: Ramadhan
authors: R
authors: Hashim
authors: Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
authors: Caroline
authors: C
authors: Maxwell
authors: Department of Immunology & Infection, London School of Hygiene and Tropical Medicine, London, United Kingdom.
authors: Daniel
authors: D
authors: Chandramohan
authors: Global Health Group, Global Health Sciences, University of California, San Francisco, San Francisco, California, United States of America ; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, United States of America.
authors: Roly
authors: R
authors: Gosling
mesh_terms: D000818:Animals; D000852:Anopheles; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006798:Housing; D006801:Humans; D015994:Incidence; D007223:Infant; D007303:Insect Vectors; D008288:Malaria / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission*; D008297:Male; D012959:Socioeconomic Factors; D013636:Tanzania / Q000453:epidemiology