{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T22:20:22Z","timestamp":1790893222610,"version":"4.1.0"},"reference-count":0,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,6,2]]},"abstract":"<jats:title>Abstract.<\/jats:title><jats:p>Since the late nineteenth century, the importance of house structure as a determinant of malaria risk has been recognized. Few studies to date have examined the association of housing and malaria in clinical populations. We conducted a cross-sectional study of febrile patients (<jats:italic>n<\/jats:italic> = 282) at two rural health clinics in a high malaria-transmission area of northern Zambia. Participants underwent testing for <jats:italic>Plasmodium falciparum<\/jats:italic> infection by PCR. Demographic and other risk factors including house structure, indoor residual spraying (IRS), bed net use, education level, and household income were collected. Data were fitted to logistic regression models for relational and mediation analyses. Residing in a house with a thatch roof was associated with higher odds of malaria than residing in a house with corrugated metal (odds ratio: 2.6; 95% CI: 1.0\u20136.3, <jats:italic>P<\/jats:italic> = 0.04). Lower income and educational attainment were also associated with greater odds of malaria. Living under a thatch roof accounted for 24% (95% CI: 14\u201382) of the effect of household income on malaria risk, and income accounted for 11% (95% CI: 8\u201319) of the effect of education. Neither IRS nor bed net use was associated with malaria risk despite large, local investments in these vector control interventions. The findings testify to malaria as a disease of rural poverty and contribute further evidence to the utility of housing improvements in vector control programs.<\/jats:p>","DOI":"10.4269\/ajtmh.20-1378","type":"journal-article","created":{"date-parts":[[2021,4,28]],"date-time":"2021-04-28T13:38:25Z","timestamp":1619617105000},"page":"2131-2138","source":"Crossref","is-referenced-by-count":13,"title":["House Structure Is Associated with Malaria among Febrile Patients in a High-Transmission Region of Zambia"],"prefix":"10.4269","volume":"104","author":[{"given":"Jay","family":"Sikalima","sequence":"first","affiliation":[{"name":"1Tropical Diseases Research Centre, Ndola, Zambia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica L.","family":"Schue","sequence":"additional","affiliation":[{"name":"2Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;"},{"name":"3Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah E.","family":"Hill","sequence":"additional","affiliation":[{"name":"4Johns Hopkins University School of Medicine, Baltimore, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Modest","family":"Mulenga","sequence":"additional","affiliation":[{"name":"5Department of Public Health, Michael Chilufya Sata School of Medicine, Copperbelt University, Kitwe, Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ray","family":"Handema","sequence":"additional","affiliation":[{"name":"1Tropical Diseases Research Centre, Ndola, Zambia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Daka","sequence":"additional","affiliation":[{"name":"5Department of Public Health, Michael Chilufya Sata School of Medicine, Copperbelt University, Kitwe, Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Chileshe","sequence":"additional","affiliation":[{"name":"1Tropical Diseases Research Centre, Ndola, Zambia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Webster","family":"Kasongo","sequence":"additional","affiliation":[{"name":"1Tropical Diseases Research Centre, Ndola, Zambia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mike","family":"Chaponda","sequence":"additional","affiliation":[{"name":"1Tropical Diseases Research Centre, Ndola, Zambia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Bertin","family":"Bukasa Kabuya","sequence":"additional","affiliation":[{"name":"1Tropical Diseases Research Centre, Ndola, Zambia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William J.","family":"Moss","sequence":"additional","affiliation":[{"name":"3Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew M.","family":"Ippolito","sequence":"additional","affiliation":[{"name":"3Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"_","family":"_","sequence":"additional","affiliation":[{"name":"1Tropical Diseases Research Centre, Ndola, Zambia;"},{"name":"2Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;"},{"name":"3Johns Hopkins Malaria Research Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;"},{"name":"4Johns Hopkins University School of Medicine, Baltimore, Maryland;"},{"name":"5Department of Public Health, Michael Chilufya Sata School of Medicine, Copperbelt University, Kitwe, Zambia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","container-title":["The American Journal of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/104\/6\/article-p2131.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/104\/6\/article-p2131.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,12]],"date-time":"2021-08-12T00:41:27Z","timestamp":1628728887000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/104\/6\/article-p2131.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,2]]},"references-count":0,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.20-1378","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,2]]}}}