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Poor Housing Construction Associated with Increased Malaria Incidence in a Cohort of Young Ugandan Children

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  • Department of Medicine, San Francisco General Hospital, University of California, San Francisco, California; Infectious Diseases Research Collaboration, Kampala, Uganda; Department of Epidemiology and Biostatistics, University of California, San Francisco, California

Despite the use of accepted interventions to combat malaria, such as insecticide-treated bed nets and artemisinin-based combination therapy, malaria remains a leading cause of morbidity and mortality in Uganda. We investigated associations between household factors and malaria incidence in a cohort of children living in a highly endemic region of Uganda. Living in a modern house, defined as the use of non-earth floors, non-thatched roofs, and non-mud walls, was associated with approximately half malaria incidence compared with living in a traditional home (incidence rate ratio [IRR] = 0.54, P = 0.001). Other factors found to be associated with a lower incidence of malaria included living in town versus rural setting; sleeping in a room with openings to the outside (windows, eaves, and airbricks); and having an older and more educated primary caregiver. This study adds to the growing body of evidence that improved house construction may be associated with a lower risk of malaria.

Author Notes

* Address correspondence to Katherine Snyman, Department of Medicine, Division of HIV/AIDS, San Francisco General Hospital, University of California San Francisco, 1001 Potrero Avenue, Building 30, Room 3420, San Francisco, CA 94110. E-mail: katherine.snyman@ucsf.edu

Financial support: This study was funded by the National Institutes of Health (HD059454) and the University of California, Berkeley Center for Global Public Health.

Authors' addresses: Katherine Snyman, Tamara D. Clark, Bryan Greenhouse, and Grant Dorsey, Department of Medicine, San Francisco General Hospital, University of California, San Francisco, CA, E-mails: katherine.snyman@ucsf.edu, tclark@medsfgh.ucsf.edu, bgreenhouse@medsfgh.ucsf.edu, and gdorsey@medsfgh.ucsf.edu. Florence Mwangwa, Infectious Diseases Research Collaboration, Kampala, Uganda, E-mail: fmwangwa@idrc-uganda.org. Victor Bigira, Clinton Health Access Initiative, Kampala, Uganda, E-mail: vbigira@gmail.com. James Kapisi, Department of Medicine, Makerere University, Kampala, Uganda, E-mail: kapisij@gmail.com. Beth Osterbauer, Children's Hospital Los Angeles, Los Angeles, CA, E-mail: b.osterbauer@gmail.com. Hugh Sturrock, Roly Gosling, and Jenny Liu, Department of Global Health Sciences, University of California, San Francisco, CA, E-mails: hugh.sturrock@ucsf.edu, goslingr@globalhealth.ucsf.edu, and jenny.liu2@ucsf.edu.

Reprint requests: Grant Dorsey, San Francisco General Hospital, 1001 Portrero Avenue, Building 30, Room 3420, San Francisco, CA 94110, E-mail: gdorsey@medsfgh.ucsf.edu.

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