von Seidlein Lorenz, Ikonomidis Konstantin, Mshamu Salum, Nkya Theresia E, Mukaka Mavuto, Pell Christopher, Lindsay Steven W, Deen Jacqueline L, Kisinza William N, Knudsen Jakob B
Mahidol-Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
Ingvartsen Arkitekter, København K, Denmark.
Lancet Planet Health. 2017 Aug;1(5):e188-e199. doi: 10.1016/S2542-5196(17)30078-5. Epub 2017 Aug 4.
The population of sub-Saharan Africa is currently estimated to be 1245 million and is expected to quadruple by the end of the century, necessitating the building of millions of homes. Malaria remains a substantial problem in this region and efforts to minimise transmission should be considered in future house planning. We studied how building elements, which have been successfully employed in southeast Asia to prevent mosquitos from entering and cooling the house, could be integrated in a more sustainable house design in rural northeastern Tanzania, Africa, to decrease mosquito density and regulate indoor climate.
In this field study, six prototype houses of southeast Asian design were built in in the village of Magoda in Muheza District, Tanga Region, Tanzania, and compared with modified and unmodified, traditional, sub-Saharan African houses. Prototype houses were built with walls made of lightweight permeable materials (bamboo, shade net, or timber) with bedrooms elevated from the ground and with screened windows. Modified and unmodified traditional African houses, wattle-daub or mud-block constructions, built on the ground with poor ventilation served as controls. In the modified houses, major structural problems such as leaking roofs were repaired, windows screened, open eaves blocked with bricks and mortar, cement floors repaired or constructed, and rain gutters and a tank for water storage added. Prototype houses were randomly allocated to village households through a free, fair, and transparent lottery. The lottery tickets were deposited in a bucket made of transparent plastic. Each participant could draw one ticket. Hourly measurements of indoor temperature and humidity were recorded in all study houses with data loggers and mosquitoes were collected indoors and outdoors using Furvela tent traps and were identified with standard taxonomic keys. Mosquitoes of the Anopheles gambiae complex were identified to species using PCR. Attitudes towards the new house design were assessed 6-9 months after the residents moved into their new or modified homes through 15 in-depth interviews with household heads of the new houses and five focus group discussions including neighbours of each group of prototype housing.
Between July, 2014, and July, 2015, six prototype houses were constructed; one single and one double storey building with each of the following claddings: bamboo, shade net, and timber. The overall reduction of all mosquitoes caught was highest in the double-storey buildings (96%; 95% CI 92-98) followed closely by the reduction found in single-storey buildings (77%; 72-82) and lowest in the modified reference houses (43%; 36-50) and unmodified reference houses (23%; 18-29). The indoor temperature in the new design houses was 2·3°C (95% CI 2·2-2·4) cooler than in the reference houses. While both single and two-storey buildings provided a cooler indoor climate than did traditional housing, two-story buildings provided the biggest reduction in mosquito densities (96%, 95% CI 89-100). Seven people who moved into the prototype houses and seven of their neighbours (three of whom had their houses modified) participated in in-depth interviews. After living in their new prototype houses for 6-9 months, residents expressed satisfaction with the new design, especially the second-storey sleeping area because of the privacy and security of upstairs bedrooms.
The new design houses had fewer mosquitoes and were cooler than modified and unmodified traditional homes. New house designs are an underused intervention and hold promise to reduce malaria transmission in sub-Saharan Africa and keep areas malaria-free after elimination.
Ruth W Jensens Foundation, Copenhagen and Hanako Foundation, Singapore.
目前估计撒哈拉以南非洲的人口为12.45亿，预计到本世纪末将增至四倍，这就需要建造数百万套住房。疟疾在该地区仍然是一个严重问题，未来的房屋规划应考虑采取措施尽量减少疟疾传播。我们研究了在东南亚已成功用于防止蚊子进入和使房屋凉爽的建筑构件，如何能融入非洲坦桑尼亚东北部农村更具可持续性的房屋设计中，以降低蚊子密度并调节室内气候。
在这项实地研究中，在坦桑尼亚坦噶地区穆赫扎区的马戈达村建造了六座东南亚设计的样板房，并与经过改造和未改造的传统撒哈拉以南非洲房屋进行比较。样板房的墙壁由轻质可渗透材料（竹子、遮阳网或木材）制成，卧室高于地面，窗户装有纱窗。经过改造和未改造的传统非洲房屋，即柳条涂抹泥墙或土坯建筑，建在地面上，通风不良，用作对照。在改造后的房屋中，修复了诸如屋顶漏水等主要结构问题，安装了纱窗，用砖灰堵塞了敞开的屋檐，修复或建造了水泥地面，并增加了雨水槽和一个储水箱。样板房通过免费、公平和透明的抽签随机分配给村民。彩票放在一个透明塑料桶中。每个参与者可以抽取一张彩票。使用数据记录器记录所有研究房屋内每小时的温度和湿度测量值，并使用富韦拉帐篷诱捕器在室内和室外收集蚊子，并用标准分类学钥匙进行鉴定。使用聚合酶链反应（PCR）将冈比亚按蚊复合体的蚊子鉴定到物种。在居民搬进新的或改造后的房屋6 - 9个月后，通过对新房户主进行15次深入访谈以及包括每组样板房邻居在内的五次焦点小组讨论，评估他们对新房屋设计的态度。
在2014年7月至2015年7月期间，建造了六座样板房；一座单层和一座双层建筑，每种建筑分别采用以下覆面材料：竹子、遮阳网和木材。捕获的所有蚊子的总体减少率在双层建筑中最高（96%；95%置信区间92 - 98），紧随其后的是单层建筑中的减少率（77%；72 - 82），在改造后的参照房屋中最低（43%；36 - 50），在未改造的参照房屋中最低（23%；18 - 29）。新设计房屋的室内温度比参照房屋低2.3°C（95%置信区间2.2 - 2.4）。虽然单层和双层建筑都比传统房屋提供了更凉爽的室内气候，但两层建筑对蚊子密度的降低幅度最大（96%，95%置信区间89 - 100）。七名搬进样板房的人和他们的七名邻居（其中三人的房屋经过了改造）参与了深入访谈。在新样板房中居住6 - 9个月后，居民对新设计表示满意，特别是二楼的睡眠区，因为楼上卧室具有隐私性和安全性。
新设计的房屋蚊子较少，且比经过改造和未改造的传统房屋更凉爽。新的房屋设计是一种未得到充分利用的干预措施，有望在撒哈拉以南非洲减少疟疾传播，并在疟疾消除后保持地区无疟疾状态。
哥本哈根的露丝·W·詹森斯基金会和新加坡的花王基金会。
