Housing modifications for heat adaptation, thermal comfort and malaria vector control in rural African settlements.

The rapid increase in global temperatures coupled with persistent malaria transmission presents substantial health burdens in sub-Saharan Africa. Here this randomized pilot field study assessed the feasibility of sustainable housing modifications via passive cooling approaches and vector proofing. Forty houses were randomly allocated to four arms: cool-roof, cross-ventilation, mat-ceiling or control. Doors, windows and eaves of the intervention houses (not control) were screened for malaria mosquito vectors. Indoor temperature and humidity were monitored continuously to assess Heat Index (HI), predicted mean value and psychrometric charts. The HI in cool-roof houses was the lowest (daytime -3.3 °C, P < 0.001; nighttime -2.4 °C, P < 0.01). Mat-ceiling houses lowered daytime HI but increased nighttime HI compared to control. No differences in HI were observed for cross-ventilation houses. Screening reduced the number of female Anopheles funestus mosquitoes by 77% and the number of Culex mosquitoes by 58% compared to control houses. Eighty-five percent of the households expressed willingness to use their resources for housing intervention. Cool-roofs combined with vector proofing is an effective, practical and sustainable housing modification for heat adaptation and for reducing indoor mosquito numbers in rural African households.