Housing construction for malaria control in the Lake Victoria Basin region

In sub-Saharan Africa, over 80% of malaria is transmitted indoors at night. High-quality housing has been shown to limit entry of Anopheles vectors and is gaining momentum as a malaria control tool. Recent studies have demonstrated that houses with improved construction are associated with reduced risk of malaria in individuals and households, but little evidence is available on the community-level impact of better housing and malaria burden. Further research is needed to understand the mechanisms of protection provided by different house features, and to explore the interaction between house design, long-lasting insecticidal nets (LLINs), and other malaria control interventions, within individual households and in communities.

This project will involve analysis of household survey data collected through ongoing trials of vector control interventions in Uganda and western Kenya.  The project is flexible, allowing the student to develop their own research questions and objectives, and to focus the analysis. Initially, we propose that associations between housing construction and malaria outcomes (clinical and entomological) be explored at the level of the household and community, controlling for other factors (environmental, urbanicity, household wealth, age). Modelling could be used to explore the potential benefits of improved housing in different settings, and the overall impact of housing construction on malaria in the Lake Victoria basin region. 

T2 Human / Clinical Research

T2 Human / Clinical Research & T3 Evidence into Practice & T4 Practice to Policy / Population

Expected Outputs

The aims of this PhD project are to generate high-quality research outputs and provide the training and skills needed for the student to build a career as an independent scientist.  Funding for the ongoing trials has been secured. The outputs of the project would include at least 3-4 REF returnable publications with the student as first or second author, and research presentations at academic conferences. Results of this project will also be shared with the WHO’s Vector Control Advisory Group (VCAG) and technical working groups, and with policymakers in Uganda and Kenya to discuss the impact on programmes and policies.

Training Opportunities

The student will gain skills in epidemiology, statistical analysis, geospatial analysis, mapping, and academic writing.

Skills Required

MSc in Epidemiology, Public Health, or similar

Skills with data analysis using STATA, R, or similar package

Experience working on trials of malaria control interventions in Africa

Experience working with policy-makers in Africa

Key Publications associated with this project

Rek JC, Alegana V, Arinaitwe E, Cameron E, Kamya MR, Katureebe A, Lindsay SW, Kilama M, Staedke SG, Todd J, Dorsey G, Tusting LS. Rapid improvements to rural Ugandan housing and their association with malaria from intense to reduced transmission: a cohort study. Lancet Planet Health 2018; 2(2): e83-e94; PMC5887083; doi: 10.1016/S2542-5196(18)30010-X.

Tusting LS, Bottomley C, Gibson H, Kleinschmidt I, Tatem AJ, Lindsay SW, Gething PW. Housing Improvements and Malaria Risk in Sub-Saharan Africa: A Multi-Country Analysis of Survey Data. PLoS Med 2017; 14(2): e1002234; PMC5319641; doi: 10.1371/journal.pmed.1002234.

Staedke SG, Gonahasa S, Dorsey G, Kamya MR, Maiteki-Sebuguzi C, Lynd A, Katureebe A, Kyohere M, Mutungi P, Kigozi SP, Opigo J, Hemingway J, Donnelly MJ. Effect of long-lasting insecticidal nets with and without piperonyl butoxide on malaria indicators in Uganda (LLINEUP): a pragmatic, cluster-randomised trial embedded in a national LLIN distribution campaign. Lancet 2020; 395(10232): 1292-303; PMC7181182; doi: 10.1016/S0140-6736(20)30214-2

Musiime AK, Krezanoski PJ, Smith DL, Kilama M, Conrad MD, Otto G, Kyagamba P, Asiimwe J, Rek J, Nankabirwa JI, Arinaitwe E, Akol AM, Kamya MR, Staedke SG, Drakeley C, Bousema T, Lindsay SW, Dorsey G, Tusting LS. House design and risk of malaria, acute respiratory infection and gastrointestinal illness in Uganda: A cohort study. PLOS Global Public Health 2022; doi: 10.1371/journal.pgph.0000063.

Fox T, Furnival-Adams J, Chaplin M, Napier M, Olanga EA. House modifications for preventing malaria. Cochrane Database Syst Rev 2022; 10(10): Cd013398; PMC9536247; doi: 10.1002/14651858.CD013398.pub4

LSTM Themes and Topics – Key Words

Malaria and other vector-borne diseases, Maternal, newborn and child health