Housing Modifications Research Articles

An assessment framework for smart and sustainable housing for older adults using analytic hierarchy process (AHP)

IntroductionWhile there is a call for smart and sustainable housing in general and for older adults in particular, little attention is paid to identifying the determinants of such housing and their extent of influence on the quality of life (QoL) of older adults. This study addresses the above gap by re-defining the criteria for house quality assessment, taking into account new needs of older inhabitants, while concerning digital assistive technologies.MethodsThis research uses various methods to identify and validate housing-related criteria and metrics, resulting in a transparent multi-criteria evaluation framework that accounts for the spatial needs of older adults. These include recommendations for multi-criteria decision-making method (MCDM/A), expert workshop to develop new metrics and validate sub-criteria, expert survey to prioritize criteria and sub-criteria and interviews with three employees in the construction-services sector in the Netherlands, to gain knowledge on smart and healthy environments.Results and DiscussionThe results show that age-friendliness of housing function is the most significant criterion, while availability of housing modifications for seniors most important sub-criterion. Our findings can benefit architects in designing improved age- friendly spaces, older adults in evaluating their dwellings and researchers from the field of architecture in selecting most relevant method for their study.

The Uganda housing modification study - association between housing characteristics and malaria burden in a moderate to high transmission setting in Uganda

BackgroundScale up of proven malaria control interventions has not been sufficient to control malaria in Uganda, emphasizing the need to explore innovative new approaches. Improved housing is one such promising strategy. This paper describes housing characteristics and their association with malaria burden in a moderate to high transmission setting in Uganda.MethodsBetween October and November 2021, a household survey was conducted in 1500 randomly selected households in Jinja and Luuka districts. Information on demographics, housing characteristics, use of malaria prevention measures, and proxy indicators of wealth were collected for each household. A finger-prick blood sample was obtained for thick blood smears for malaria from all children aged 6 months to 14 years in the surveyed households. Febrile children had a malaria rapid diagnostics test (RDT) done; positive cases were managed according to national treatment guidelines. Haemoglobin was assessed in children aged < 5 years. Households were stratified as having modern houses (defined as having finished materials for roofs, walls, and floors and closed eaves) or traditional houses (those not meeting the definition of modern house). Associations between malaria burden and house type were estimated using mixed effects models and adjusted for age, wealth, and bed net use.ResultsMost (65.5%) of the households surveyed lived in traditional houses. Most of the houses had closed eaves (85.5%), however, the use of other protective features like window/vent screens and installed ceilings was limited (0.4% had screened windows, 2.8% had screened air vents, and 5.2% had ceiling). Overall, 3,443 children were included in the clinical survey, of which 31.4% had a positive smear. RDT test positivity rate was 56.6% among children with fever. Participants living in modern houses had a significantly lower parasite prevalence by microscopy (adjusted prevalence ratio [aPR = 0.80]; 95% confidence interval [CI] 0.71 – 0.90), RDT test positivity rate (aPR = 0.90, 95%CI 0.81 – 0.99), and anaemia (aPR = 0.80, 95%CI 0.65 – 0.97) compared to those in traditional houses.ConclusionThe study found that even after adjusting for wealth, higher quality housing had a moderate protective effect against malaria, on top of the protection already afforded by recently distributed nets.

Modification of Traditional Housing on the Example of Meskhuri Oda

Modification of Traditional Housing on the Example of Meskhuri Oda

Slow recovery rates and spatial aggregation of Triatoma infestans populations in an area with high pyrethroid resistance in the Argentine Chaco

BackgroundThe emergence of pyrethroid resistance has threatened the elimination of Triatoma infestans from the Gran Chaco ecoregion. We investigated the status and spatial distribution of house infestation with T. infestans and its main determinants in Castelli, a municipality of the Argentine Chaco with record levels of triatomine pyrethroid resistance, persistent infestation over 2005–2014, and limited or no control actions over 2015–2020.MethodsWe conducted a 2-year longitudinal survey to assess triatomine infestation by timed manual searches in a well-defined rural section of Castelli including 14 villages and 234 inhabited houses in 2018 (baseline) and 2020, collected housing and sociodemographic data by on-site inspection and a tailored questionnaire, and synthetized these data into three indices generated by multiple correspondence analysis.ResultsThe overall prevalence of house infestation in 2018 (33.8%) and 2020 (31.6%) virtually matched the historical estimates for the period 2005–2014 (33.7%) under recurrent pyrethroid sprays. While mean peridomestic infestation remained the same (26.4–26.7%) between 2018 and 2020, domestic infestation slightly decreased from 12.2 to 8.3%. Key triatomine habitats were storerooms, domiciles, kitchens, and structures occupied by chickens. Local spatial analysis showed significant aggregation of infestation and bug abundance in five villages, four of which had very high pyrethroid resistance approximately over 2010–2013, suggesting persistent infestations over space-time. House bug abundance within the hotspots consistently exceeded the estimates recorded in other villages. Multiple regression analysis revealed that the presence and relative abundance of T. infestans in domiciles were strongly and negatively associated with indices for household preventive practices (pesticide use) and housing quality. Questionnaire-derived information showed extensive use of pyrethroids associated with livestock raising and concomitant spillover treatment of dogs and (peri) domestic premises.ConclusionsTriatoma infestans populations in an area with high pyrethroid resistance showed slow recovery and propagation rates despite limited or marginal control actions over a 5-year period. Consistent with these patterns, independent experiments confirmed the lower fitness of pyrethroid-resistant triatomines in Castelli compared with susceptible conspecifics. Targeting hotspots and pyrethroid-resistant foci with appropriate house modification measures and judicious application of alternative insecticides with adequate toxicity profiles are needed to suppress resistant triatomine populations and prevent their eventual regional spread.Graphical

Innovative house structures for malaria vector control in Nampula district, Mozambique: assessing mosquito entry prevention, indoor comfort, and community acceptance.

Insecticide-treated mosquito bed nets and indoor residual spraying are widely used for malaria vector control. However, their effectiveness can be affected by household members' habits, requiring alternative approaches toward malaria vector control. To assess the effectiveness of modified houses in preventing mosquito entry; to assess the impact of house modifications on indoor air conditions and evaluate the acceptability of modified houses in the community where the study was conducted. Five traditional and five modified houses were constructed in Nampula district, Mozambique and underwent a 90-day overnight indoor mosquito collection using Centers for Disease Control and nitride ultraviolet light traps during the rainy season. Mosquitoes were identified morphologically. Indoor temperature, relative humidity, carbon dioxide levels and wind speed were also collected. The Student's t-test was used to compare the means of the number of mosquitos and environmental factors between both house types. A binomial form of the Generalized Linear Model identified the factors associated with the community volunteer's preference for house type. Modified houses reduced the number of Anopheles by an average of 14.97 mosquitos (95% CI, 11.38-18.56, p < 0.000) and non-Anopheles by 16.66 mosquitoes (95% CI, 8.23-25.09, p < 0.000). Although fewer mosquitoes were trapped in modified houses compared to traditional ones, the modifications were more effective against Anopheles (94% reduction) than for non-Anopheles (71% reduction). The average temperature increased at 0.25°C in modified houses but was not statistically significant (95% CI, -0.62 to 0.12, p = 0.181). Community volunteers preferred modified houses due to reduced mosquito buzzing. The efficacy of modified houses including its acceptability by community, highlight its potential to lower malaria risk. Effective integration of modified houses into the vector control strategy will require raising awareness among communities about malaria risks associated with house structure and training them to modify their houses.

Strategies for addressing exposure to extreme heat in a slum community

Climate change is resulting in higher temperatures and the problem of heat stress, which significantly affects urban population. Poor households living within low-income urban communities are disproportionately affected by these problems. This paper reports an investigation of coping strategies among residents in a low-income community within Lagos, Nigeria. The study utilised a mixed-method approach – community survey (sample size = 300 residents) and semi-structured interviews with 15 purposively selected residents. The survey data were analysed statistically, whereas content analysis was carried out on the interview transcripts. The findings indicate a range of personal/behavioural preventive and reactive strategies and building-related measures were utilised to address the challenge of increasing heat within the community. Notably, greening-related practices (for planting trees, cultivating gardens) did not rank high among the residents. They are willing to pay a modest amount towards greening and environmental features but not as much as housing modifications to enhance thermal comfort in the face of extreme heat. The study contributes to evidence of local coping strategies for heat exposure among disadvantaged urban residents, providing a pedestal on which heat adaptation initiatives can be developed.

House modifications as a malaria control tool: how does local context shape participants’ experience and interpretation in Uganda?

BackgroundEvidence that house design can provide protection from malaria is growing. Housing modifications such as screening windows, doors, and ceilings, and attaching insecticide-impregnated materials to the eaves (the gap between the top of the wall and bottom of the roof), can protect against malaria. To be effective at scale, however, these modifications must be adopted by household residents. There is evidence that housing modifications can be acceptable, but in-depth knowledge on the experiences and interpretation of modifications is lacking. This qualitative study was carried out to provide a holistic account of the relationship between experiences and interpretations of four types of piloted housing modifications and the local context in Jinja, Uganda.MethodsQualitative research was conducted between January to June 2021, before and during the installation of four types of housing modifications. The methods included nine weeks of participant observations in two study villages, nine focus group discussions with primary caregivers and heads of households (11–12 participants each), and nine key informant interviews with stakeholders and study team members.ResultsMost residents supported the modifications. Experiences and interpretation of the housing modifications were shaped by the different types of housing in the area and the processes through which residents finished their houses, local forms of land and property ownership, and cultural and spiritual beliefs about houses.ConclusionsTo maximize the uptake and benefit of housing modifications against malaria, programme development needs to take local context into account. Forms of local land and house ownership, preferences, the social significance of housing types, and religious and spiritual ideas shape the responses to housing modifications in Jinja. These factors may be important in other setting.Trial registration Trial registration number is NCT04622241. The first draft was posted on November 9th 2020.

Assessing housing exposures and interventions that impact healthy cities: a systematic overview of reviews.

There are direct links between housing and health. However, there is a lack of systematic reviews that bring together the evidence to outline the health impacts of exposures in housing and housing interventions. This article aims to address this gap by synthesising systematic reviews on the themes of housing exposures and interventions. We searched four databases: Scopus (Elsevier), PsycINFO (OvidSP), Science Citation Index and Social Science Citation Index (Web of Science Core Collection), and the Sociology Collection (Proquest). We used keywords related to 'health' and 'city*' and included all types of reviews. We extracted data into a predesigned extraction form and synthesised information narratively. 745 articles were identified and screened, of which 256 reviews were included and 16 (6%) related to housing. All reviews related to housing exposures found that poor housing, including crowding, coldness, dampness, mould, and indoor air pollution had a negative impact on health. Most reviews found that housing interventions such as housing refurbishment, heating, and energy efficiency interventions positively impacted health outcomes. An online toolkit was developed to disseminate and communicate this research: https://www.healthycitiescommission.org/toolkit/. Governments have a pivotal role in addressing health issues related to housing interventions and exposures in housing. This includes interventions through building regulations following international guidance and financial assistance to encourage housing modifications that will improve health.

Interventions against Aedes/dengue at the household level: a systematic review and meta-analysis.

Because the evidence for the role of structural housing and combinations of interventions (domestic or peri-domestic) against Aedes mosquitoes or dengue is still lacking, this systematic review and meta-analysis aimed to analyse and synthesize research focusing on the household as the unit of allocation. We searched MEDLINE, LILACS, and Web of Science databases until February 2023 using three general keyword categories: (1) "Aedes" or "dengue"; (2) structural housing interventions including "house", "water", or "drainage"; and (3) vector control interventions of potential relevance and their combinations. We performed a qualitative content analysis and a meta-analysis for 13 entries on dengue seroconversion data. 14,272 articles were screened by titles, 615 by abstracts, 79 by full-text. 61 were selected. Satisfactory data quality allowed for detailed content analysis. Interventions at the household level against the immature mosquito stages (21 studies, 34%) showed positive or mixed results in entomological and epidemiological outcomes (86% and 75% respectively). Combined interventions against immature and adult stages (11 studies, 18%) performed similarly (91% and 67%) while those against the adult mosquitoes (29 studies, 48%) performed less well (79%, 22%). A meta-analysis on seroconversion outcomes showed a not-statistically significant reduction for interventions (log odds-ratio:-0.18 [-0.51, 0.14 95% CI]). No basic research on housing structure or modification was eligible for this systematic review but many interventions with clear impact on vector indices and, to a lesser extent, on dengue were described. The small and not-statistically significant effect size of the meta-analysis highlights the difficulty of proving effectiveness against this highly-clustered disease and of overcoming practical implementation obstacles (e.g. efficacy loss, compliance). The long-term success of interventions depends on suitability, community commitment and official support and promotion. The choice of a specific vector control package needs to take all these context-specific aspects into consideration. This work was funded by a grant from the World Health Organization (2021/1121668-0, PO 202678425, NTD/VVE).

Housing modification for malaria control: impact of a “lethal house lure” intervention on malaria infection prevalence in a cluster randomised control trial in Côte d’Ivoire

BackgroundIn recent years, the downward trajectory of malaria transmission has slowed and, in some places, reversed. New tools are needed to further reduce malaria transmission. One approach that has received recent attention is a novel house-based intervention comprising window screening (S) and general house repairs to make the house more mosquito proof, together with EaveTubes (ET) that provide an innovative way of targeting mosquitoes with insecticides as they search for human hosts at night. The combined approach of Screening + EaveTubes (SET) essentially turns the house into a ‘lure and kill’ device.MethodsThis study evaluated the impact of SET on malaria infection prevalence in Côte d’Ivoire and compares the result in the primary outcome, malaria case incidence. Malaria infection prevalence was measured in a cross-sectional survey in 40 villages, as part of a cluster-randomised trial evaluating the impact of SET on malaria case incidence.ResultsInfection prevalence, measured by rapid diagnostic test (RDT), was 50.4% and 36.7% in the control arm and intervention arm, respectively, corresponding to an odds ratio of 0.57 (0.45–0.71), p < 0.0001). There was moderate agreement between RDT and microscopy results, with a reduction in odds of infection of 36% recorded when infection was measured by microscopy. Prevalence measured by RDT correlated strongly with incidence at a cluster level.ConclusionsIn addition to reducing malaria case incidence, house screening and EaveTubes substantially reduced malaria infection prevalence 18 months after installation. Infection prevalence may be a good metric to use for evaluating malaria interventions in areas of similar transmission levels to this setting.Trial registrationISRCTN18145556, registered 1 February 2017.

Home Modification Status and Needs of Older Adults Households for Sustainable Living in the Community - Focused on the Korea Housing Survey 2020 -

This study aims to provide implications as basic data for seeking spatial alternatives for sustainable home-based elderly housing in the community and establishing policies by identifying the reality of housing modification and improvement needs of older adults households. The analysis data used the micro-data of Korea housing survey 2020, and the older adults household owners aged 65 or older who responded that they had experience in housing modification were targeted. As a result, older adults households of ‘female’ and ‘over 85 years of age’ were found to be the most in need of support as both the awareness and use rate of home modification installation and housing support programs were lower than others. Most of the home modification items were repaired in the kitchen and toilet-related facilities, ‘lever-type faucet (faucet)’, and ‘a kitchen workbench of appropriate height’ was the highest in order. The necessary home modification was ‘safe flooring for anti-slip’, ‘a toilet or bathroom support handles’, ‘emergency bells in the house’, and ‘removal of steps such as thresholds and stairs in the house’ were higher than others. ‘Male’ older adults households were more aware of the housing support program than ‘female’ older adults. Even though home modification was the preferred program, it showed a low utilization rate.

Exploring alternative insecticide delivery options in a “lethal house lure” for malaria vector control

The In2Care EaveTube is a house modification designed to block and kill malaria mosquitoes using an electrostatic netting treated with insecticide powder. A previous study demonstrated prolonged duration of effective action of insecticide-treated electrostatic netting in a semi-field setting. As part of a cluster randomized controlled trial (CRT) of the EaveTube intervention in Côte d’Ivoire, we investigated the residual efficacy of a pyrethroid insecticide deployed in EaveTubes under village conditions of use. We also explored the scope of using existing malaria control technologies including LLINs and IRS as alternative methods to deliver insecticides in the lethal house lure. The efficacy of beta-cyfluthrin was monitored over time using the “eave tube bioassay” method. Mortality of beta-cyfluthrin exposed pyrethroid resistant Anopheles gambiae mosquitoes was > 80% after 4 months. The impact (mosquito mortality) of PVC tubes coated with pirimiphos methyl was similar to that of beta-cyfluthrin treated insert (66.8 vs. 62.8%) in release-recapture experiments in experimental huts. Efficacy was significantly lower with all the LLINs tested; however, the roof of PermaNet 3.0 induced significantly higher mosquito mortality (50.4%) compared to Olyset Plus (25.9%) and Interceptor G2 (21.6%) LLINs. The efficacy of the alternative delivery methods was short-lived with mortality decreasing below 50% within 2 months in residual activity bioassays. None of the products tested appeared superior to the powder treatments. Further research is therefore required to identify suitable insecticide delivery options in EaveTube for malaria vector control.

Comparison of environment quality measurements between 3 types of calf housing in the United Kingdom

Preweaning calves are kept in a range of housing types that offer variable protection against the weather and provide differing internal environments. This cross-sectional observational study assessed the effect of housing type (shed, polytunnel, or hutches) on internal environmental parameters, using 2 blocks of 8-wk measurements from 10 commercial dairy farms in the south of England, covering both summer and winter periods. Continuous measurements for internal and external temperature and humidity were recorded by data logger placed within the calf housing and used to calculate the temperature-humidity index (THI). Weekly point readings were also taken for temperature, humidity, light, air speed, ammonia level, and airborne particulate matter. Airborne bacterial levels were determined at wk 2, 5, and 8 by incubating air samples at 35°C for 24 h in aerobic conditions. Data were analyzed using linear mixed models. Housing type influenced THI significantly in both seasons. In summer, calves were exposed to heat stress conditions (THI ≥72) for 39, 31, and 14 of 46 d in polytunnel housing, hutches, and sheds, respectively. The maximum summer temperature (37.0°C) was recorded in both hutch and polytunnel housing, with sheds remaining consistently cooler (maximum 31.0°C). In winter, the lowest minimum internal temperature recorded was in hutches at -4.5°C, with both the sheds and polytunnel, but not hutches, providing a significant increase in temperature compared with the external environment. Hutches remained ≤ 10°C for 86% of the winter study period. Light levels were reduced in all housing types compared with the external environment. The particulate matter in air that is capable of reaching the lungs (particulate matter <10 μm) was highest in sheds, intermediate in hutches, and lowest in polytunnel housing (0.97 ± 3.75, 0.37 ± 0.44, and 0.20 ± 0.24 mg/m3, respectively). This was mirrored by airborne bacterial numbers, which were also highest in sheds (8,017 ± 2,141 cfu/m3), intermediate in hutches (6,870 ± 2,084 cfu/m3), and lowest in the polytunnel (3,357 ± 2,572 cfu/m3). Round, white, catalase-positive, and oxidase-negative colonies were most prevalent, likely indicating Staphylococcus species. This study demonstrated that UK calves are routinely exposed to either heat or cold stress, especially when housed in hutches or polytunnels. Sheds had the highest levels of particulate matter and airborne bacteria, both known contributory factors for respiratory disease. These findings demonstrate that all calf housing systems result in environmental compromises that could have long-term impacts on calf health and growth; therefore, further studies should identify husbandry and housing modifications to mitigate these factors.

Home Indoor Environmental Quality and Attention Deficit Hyperactivity Disorder

Indoor environmental quality (IEQ) has been found to influence children’s health and behaviour, particularly conditions, such as attention deficit hyperactivity disorder (ADHD). This research aimed to ascertain whether housing IEQ impacted the symptoms of ADHD and its related behaviours. This study involved 435 parents of children and adolescents (aged 5–17) with ADHD residing in Australia. We utilised an online survey tool comprising the home version of the ADHD Rating Scale for Children and Adolescents and the Housing Environmental Quality Assessment Tool. The findings revealed that all the housing IEQ factors were associated with both the diagnosis and the severity of the symptoms. The results indicated that, for over one in ten children with ADHD (13.3%), the diagnosis was impacted by a collective contribution of air quality, acoustic quality, lighting quality, and the thermal comfort within their home. The air quality and the thermal comfort predicted a 4% variance in the severity of inattention. Additionally, air and lighting qualities predicted a 9.7% variance in the severity of hyperactivity-impulsivity, and all the factors of air quality, acoustic quality, lighting quality, and thermal comfort predicted a 10.9% variance in the severity of combined ADHD. In conclusion, this research provided insights into the importance of housing features and suggests that improving the housing indoor environmental quality, mainly thermal comfort, air, and lighting quality, could positively correlate with alleviating ADHD symptoms and severity among children and adolescents. Therefore, ensuring an appropriate indoor environmental quality should be prioritised in housing design, modification, and building, especially for those with ADHD.

How Accommodative Are Houses in Trinidad? Implications for Older Persons With Disabilities

ABSTRACT This paper examines the accommodation in houses in Trinidad in the context of older persons with disabilities. An exploratory sequential mixed-methods research design was used. In the qualitative phase, a list of accommodation items was identified via interviews. This information was used to develop a questionnaire to measure accommodation items of a large nationally representative sample of houses in Trinidad. Only physical accessibility items were identified, and data from 768 houses indicated that no house had all identified items. There is a need for urgent adoption and implementation of accessibility standards. Findings also indicate modification cost is a challenge and that responses targeted to low-income and rural households are needed. Lastly, the social care context, specifically the family care potential, is an important consideration in housing policy debates, and community homes for the aged and programs involving multiple experts to identify and support housing modification are recommended.

Interdisciplinary Cooperation in Technical, Medical, and Social Sciences: A Focus on Creating Accessibility.

Accessibility and Universal Design (UD) is an area of professional interest for architects and occupational therapists, but college curricula rarely include both broader and collaborative education in this area. This article presents the experience of the inter-university, interdisciplinary project "Joint Architecture Initiative" (JAI), with the participation of students from the University of Science and Technology, University of Health and Sport Science, and Academy of Fine Arts in Wroclaw (Poland). The JAI project is a response of the university community of Wroclaw to the social-urban campaign "Life Without Barriers" and the needs of residents-the elderly and people with disabilities-for adaptation and modification of housing. The paper presents the theoretical background of the problem, the stages of implementation of the JAI project from the perspective of the model-human-environment-occupation-the tasks of project team members, and the justification for the need to create interdisciplinary teams from the area of technical and health sciences, with particular emphasis on occupational therapy practice (OTP).

Screening eaves of houses reduces indoor mosquito density in rural, western Kenya

Despite the scale-up of insecticide-treated nets and indoor residual spraying, the bulk of malaria transmission in western Kenya still occurs indoors, late at night. House improvement is a potential long-term solution to further reduce malaria transmission in the region. The impact of eave screening on mosquito densities was evaluated in two rural villages in western Kenya. One-hundred-and-twenty pairs of structurally similar, neighbouring houses were used in the study. In each pair, one house was randomly selected to receive eave screening at the beginning of the study while the other remained unscreened until the end of the sampling period. Mosquito sampling was performed monthly by motorized aspiration method for 4 months. The collected mosquitoes were analysed for species identification. Compared to unscreened houses, significantly fewer female Anopheles funestus (RR = 0.40, 95% CI 0.29-0.55), Anopheles gambiae Complex (RR = 0.46, 95% CI 0.34-0.62) and Culex species (RR = 0.53, 95% CI 0.45-0.61) were collected in screened houses. No significant differences in the densities of the mosquitoes were detected in outdoor collections. Significantly fewer Anopheles funestus were collected indoors from houses with painted walls (RR = 0.05, 95% CI 0.01-0.38) while cooking in the house was associated with significantly lower numbers of Anopheles gambiae Complex indoors (RR = 0.60, 95% CI 0.45-0.79). Nearly all house owners (99.6%) wanted their houses permanently screened, including 97.7% that indicated a willingness to use their own resources. However, 99.2% required training on house screening. The cost of screening a single house was estimated at KES6,162.38 (US$61.62). Simple house modification by eave screening has the potential to reduce the indoor occurrence of both Anopheles and Culex mosquito species. Community acceptance was very high although education and mobilization may be needed for community uptake of house modification for vector control. Intersectoral collaboration and favourable government policies on housing are important links towards the adoption of house improvements for malaria control.

What are the effects of house modifications including screening potential dwelling entry points for preventing malaria?

What are the effects of house modifications including screening potential dwelling entry points for preventing malaria?

Participatory development of practical, affordable, insecticide-treated mosquito proofing for a range of housing designs in rural southern Tanzania

BackgroundInsecticidal mosquito-proof netting screens could combine the best features of insecticide-treated nets (ITNs) and indoor residual spraying (IRS), the two most important front line vector control interventions in Africa today, and also overcome the most important limitations of these methods. This study engaged members of a rural Tanzanian community in developing and evaluating simple, affordable and scalable procedures for installing readily available screening materials on eave gaps and windows of their own houses, and then treating those screens with a widely used IRS formulation of the organophosphate insecticide pirimiphos-methyl (PM).MethodsA cohort of 54 households recruited upon consent, following which the structural features and occupant demographics of their houses were surveyed. Indoor mosquito densities were surveyed longitudinally, for approximately 3 months before and over 5 months after participatory house modification and screening using locally available materials. Each house was randomly assigned to one of three study arms: (1) No screens installed until the end of the study (negative control), (2) untreated screens installed, and (3) screened installed and then treated with PM, the insecticidal activity of which was subsequently assessed using standard cone assays.ResultsAlmost all (52) recruited households participated until the end, at which point all houses had been successfully screened. In most cases, screening was only installed after making enabling structural modifications that were accepted by the enrolled households. Compared to unscreened houses, houses with either treated or untreated screens both almost entirely excluded Anopheles arabiensis (Relative reduction (RR) ≥ 98%, P < < 0.0001), the most abundant local malaria vector. However, screens were far less effective against Culex quinquefasciatus (RR ≤ 46%, P < < 0.0001), a non-malaria vector causing considerable biting nuisance, regardless of their treatment status. While PM did not augment household level protection by screens against either mosquito species (P = 0.676 and 0.831, respectively), 8 months after treatment it still caused 73% and 89% mortality among susceptible insectary-reared Anopheles gambiae following exposures of 3 and 30 min, respectively.ConclusionsParticipatory approaches to mosquito proofing houses may be acceptable and effective, and installed screens may be suitable targets for residual insecticide treatments.

Home Modification for Older Adults Aging in Place: Evidence from the American Housing Survey

What is the impact of housing adequacy on recent home modification, controlling for demographics and housing characteristics? This study examined home modifications of households with a member aged 65 or older, focusing on relationships between selected demographic and housing variables and home modification. Binary logistic regression analysis was used on a sample of 6,627 homeowners from the newly released 2019 American Housing Survey (AHS) dataset. This analysis of the 2019 AHS data is important because of its pre-COVID pandemic era perspective in terms of home modifications and older adults aging in place. Results showed that recent housing modifications were significantly affected by select demographic and housing factors.