Florey, Lia, and Cameron Taylor. 2016. Using Household Survey Data to Explore the Effects of Improved Housing Conditions on Malaria Infection in Children in Sub-Saharan Africa. DHS Analytical Studies No. 61. Rockville, Maryland, USA: ICF International.
In the past decade, malaria control strategies in sub-Saharan Africa have focused on the use of insecticide-treated nets (ITNs), indoor residual spraying (IRS), and prompt diagnosis and treatment in combatting malaria. Improved housing can act as a barrier, preventing mosquito entry into homes, and thereby serving as a supplement to insecticides and antimalarial drugs. Evidence of the effectiveness of improved housing on malaria control in endemic tropical countries has been mounting; however, few studies have been attempted on a large scale or have produced findings likely to be generalizable to a broad population. This analysis examines data from 29 nationally representative Demographic and Health Surveys (DHS surveys) and Malaria Indicator Surveys (MIS surveys) from 21 malaria endemic countries in sub-Saharan Africa. Logistic regression was used in both survey-specific and pooled meta-analyses to assess whether improved flooring, wall, and roofing construction materials protected against malaria infection. The models were adjusted to control for potential confounders. This study shows that improved house construction may be an effective malaria control intervention, as it is associated with reduced risk of malaria infection in young children; however, the direction and strength of effect varied by household feature and by setting. Results corroborate findings from other studies that show improved housing as an important predictor of malaria. Findings suggest that investments in improved housing may contribute to sustainable development goals by conferring protection against malaria in addition to other socioeconomic benefits.