Uganda Housing Modification Study
UHMS
Impact of Housing Modifications Combined With Piperonyl Butoxide (PBO) Long-lasting Insecticidal Nets (LLINs) on the Malaria Burden in Uganda: a Cluster-randomised Trial
1 other identifier
interventional
2,422
1 country
1
Brief Summary
To explore housing modification as a malaria control intervention, and to assess the degree to which it may offer protection in moderate to high malaria endemicity settings, we propose a two-phase study evaluating epidemiological and entomological effectiveness, cost-effectiveness, feasibility, and acceptability of housing modification in Uganda. The first phase will be a pilot implementation assessing the feasibility of candidate housing modification interventions, followed by a cluster randomised control trial of the most effective, scalable, and cost-effective interventions.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for not_applicable
Started Jan 2021
Typical duration for not_applicable
1 active site
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
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Study Timeline
Key milestones and dates
First Submitted
Initial submission to the registry
November 4, 2020
CompletedFirst Posted
Study publicly available on registry
November 9, 2020
CompletedStudy Start
First participant enrolled
January 29, 2021
CompletedPrimary Completion
Last participant's last visit for primary outcome
May 1, 2023
CompletedStudy Completion
Last participant's last visit for all outcomes
July 1, 2023
CompletedAugust 4, 2022
August 1, 2022
2.3 years
November 4, 2020
August 2, 2022
Conditions
Keywords
Outcome Measures
Primary Outcomes (1)
Incidence of malaria
Number of incident episodes of clinical malaria per time of observation. Incident episodes of malaria defined as any treatment for malaria \> 14 days after any prior treatment for malaria
12 months following housing modification
Secondary Outcomes (20)
Parasite prevalence
12 months following housing modification
Prevalence of anaemia
12 months following housing modification
Vector density
12 months following housing modification
Sporozoite rate
12 months following housing modification
Annual entomological inoculation rate
12 months following housing modification
- +15 more secondary outcomes
Study Arms (10)
Eave Tubes - Traditional House
EXPERIMENTALInstallation of eave tubes in traditional homes.
Eave Tubes - Modern House
EXPERIMENTALInstallation of eave tubes in modern homes.
Eave Ribbons - Traditional House
EXPERIMENTALInstallation of eave ribbons in traditional homes.
Eave Ribbons - Modern House
EXPERIMENTALInstallation of eave ribbons in modern homes.
Full House Screening - Traditional House
EXPERIMENTALInstallation of full house screening, includes screening eaves and windows, in traditional homes.
Full House Screening - Modern House
EXPERIMENTALInstallation of full house screening, includes screening eaves and windows, in modern homes.
Partial House Screening - Traditional House
EXPERIMENTALInstallation of partial screening, includee either screening of the eaves or installing a screened ceiling, in traditional homes.
Partial House Screening - Modern House
EXPERIMENTALInstallation of partial screening, includee either screening of the eaves or installing a screened ceiling, in modern homes.
Control - Traditional House
NO INTERVENTIONControl group with no intervention in traditional homes
Control - Modern House
NO INTERVENTIONControl group with no intervention in modern homes.
Interventions
The eave tubes are PVC tubes with a diameter of 15 cm installed in the outer wall of occupied rooms (e.g. bedrooms and living rooms but not storage rooms) at 1.5-2 m intervals, fitted with electrostatic mesh inserts coated with insecticides. No additional screening will be done. All households will be provided with piperonyl butoxide (PBO) long-lasting insecticidal nets (LLINs) - one for every two residents.
Eave ribbons are 15 cm-wide triple-layered hessian fabrics (burlap-line fabric woven from sisal fibres, procured locally), in lengths starting 1 m that can be attached to houses using nails, adhesives or Velcro, without completely closing eave-spaces. The eave ribbons will be treated by study staff with a commonly used spatial repellent, transfluthrin. Eave ribbons will be retreated by study staff after 6 months (only in Phase II, if selected for inclusion in the cluster-randomised trial). All households will be provided with piperonyl butoxide (PBO) long-lasting insecticidal nets (LLINs) - one for every two residents.
Full house screening includes screening eaves/ceilings, ventilation openings, and windows. Eaves/ceiling, air vents, and windows of eligible houses will be screened with wire mesh or other locally available screening materials. or ceilings, if eaves are closed" and ventilation openings. We are also filling in any gaps in the walls. All households will be provided with piperonyl butoxide (PBO) long-lasting insecticidal nets (LLINs) - one for every two residents.
Partial screening will include either screening of the eaves or installing a screened ceiling, where no ceiling is present. In traditional houses, a netting (either insecticide-impregnated or untreated) may be either fixed in multiple places in the rafters or by hanging from a single central point and attached to the walls. No other screening or filling of the gaps will be done in partially screened houses.All households will be provided with piperonyl butoxide (PBO) long-lasting insecticidal nets (LLINs) - one for every two residents.
Eligibility Criteria
You may qualify if:
- At least one adult aged 18 years or older present
- Agreement of the adult resident to provide informed consent for the pilot study
- Phase II
- Cohort Study
- Household considered their primary residence
- Child aged less than 59 months
- Agreement to come to the study clinic for any febrile illness
- Agreement to avoid antimalarial medications outside the study
- Provision of written informed consent (for parent or guardian in case of children)
- Cross-sectional Community Survey - Household Survey
- At least one household resident between 6 months and 14 years of age present (with an adult caregiver willing to provide informed consent for the clinical survey)
- At least one adult aged 18 years or older present
- Adult is a usual resident who slept in the sampled household on the night before the survey
- Agreement of the adult resident to provide informed consent for the household survey
You may not qualify if:
- Dwelling destroyed or not found
- Household vacant
- No adult resident home on more than 3 occasions
- Cross-sectional Community Survey - Clinical Survey
- Child aged 6 months to 14 years
- Usual resident who was present in the sampled household on the night before the survey
- Agreement of parent/guardian to provide informed consent
- Agreement of child aged 8 years or older to provide assent
- Child not home on day of survey
- Recruitment of Field Workers for entomology activities (human landing catches).
- Willingness to take chemoprophylaxis for malaria
- Willingness to abstain from alcohol during working hours
- No significant past medical history.
Contact the study team to confirm eligibility.
Sponsors & Collaborators
Study Sites (1)
Infectious Diseases Research Collaboration
Kampala, Central Region, Uganda
Related Publications (2)
Snyman K, Ochieng W, Gonahasa S, Aber J, Katureebe A, Staedke SG, Kamya MR, Westercamp N, Pitt C. Housing modification to prevent malaria in Uganda: an analysis of costs, willingness to pay, and equity. Malar J. 2025 Dec 24. doi: 10.1186/s12936-025-05757-0. Online ahead of print.
PMID: 41444546DERIVEDKayendeke M, Nabirye C, Nayiga S, Westercamp N, Gonahasa S, Katureebe A, Kamya MR, Staedke SG, Hutchinson E. House modifications as a malaria control tool: how does local context shape participants' experience and interpretation in Uganda? Malar J. 2023 Aug 25;22(1):244. doi: 10.1186/s12936-023-04669-1.
PMID: 37626312DERIVED
MeSH Terms
Conditions
Condition Hierarchy (Ancestors)
Study Officials
- PRINCIPAL INVESTIGATOR
Nelli Westercamp, PhD MBA
Centers for Disease Control and Prevention
- PRINCIPAL INVESTIGATOR
Moses Kamya, MBChB PhD
Infectious Diseases Research Collaboration
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- RANDOMIZED
- Masking
- NONE
- Masking Details
- Masking is not possible due to the nature of the intervention.
- Purpose
- PREVENTION
- Intervention Model
- PARALLEL
- Sponsor Type
- OTHER
- Responsible Party
- SPONSOR
Study Record Dates
First Submitted
November 4, 2020
First Posted
November 9, 2020
Study Start
January 29, 2021
Primary Completion
May 1, 2023
Study Completion
July 1, 2023
Last Updated
August 4, 2022
Record last verified: 2022-08
Data Sharing
- IPD Sharing
- Will not share