Standing Tall: the evolution of habitable room height limits in New Zealand building controls

Although it is often thought that the 3 February 1931 Napier earthquake led to the first New Zealand building codes, they have a far longer history. Often developed by the local town, city or borough engineer, these codes or by-laws covered a wide range of topics, not just structural safety. Two surveys of local government building bylaws undertaken to support the development of national building controls, have created digests of details from a number of these codes. The 1924 survey of 37 municipalities supported the development of the first national code for timber buildings, while the 1938 survey of 84 municipalities was used to develop NZSS 95 Model Building By-law during the 1930s and early 1940s. The digests provide an opportunity to explore the 1930s development of building by-laws by geographical and topic coverage, as well as the impact on building controls since that time.These local building bylaws often included requirements that affected the interior architecture of buildings, such as the requirement for minimum dwelling or bedroom room heights. In 1924 these minima ranged from 8 ft to 10 ft (2.4 m to 3.0 m) for either a dwelling or an attic room. However, by 1938 while the height range for dwelling rooms was unchanged for attic rooms the range was reduced by 1 foot (0.3 m) to 7 ft to 9 ft (2.1 to 2.9 m). Although the 1992 New Zealand Building Code does not specify minimum habitable room heights, the House Improvement Regulations 1947 are still in force. These initially set the habitable room height requirement to 2.1 m, increasing in 1975 to 2.4 m.The paper explores the development of minimum dwelling height requirements in New Zealand using these two surveys with analysis of Wellington and Dunedin City Councils from the 1870s to the 1930s. These requirements will be compared to UK codes, exploring both the international evolution of room height requirements and the relationship to New Zealand.

Cost of community-led larval source management and house improvement for malaria control: a cost analysis within a cluster-randomized trial in a rural district in Malawi

Background House improvement (HI) to prevent mosquito house entry, and larval source management (LSM) targeting aquatic mosquito stages to prevent development into adult forms, are promising complementary interventions to current malaria vector control strategies. Lack of evidence on costs and cost-effectiveness of community-led implementation of HI and LSM has hindered wide-scale adoption. This study presents an incremental cost analysis of community-led implementation of HI and LSM, in a cluster-randomized, factorial design trial, in addition to standard national malaria control interventions in a rural area (25,000 people), in southern Malawi. Methods In the trial, LSM comprised draining, filling, and Bacillus thuringiensis israelensis-based larviciding, while house improvement (henceforth HI) involved closing of eaves and gaps on walls, screening windows/ventilation spaces with wire mesh, and doorway modifications. Communities implemented all interventions. Costs were estimated retrospectively using the ‘ingredients approach’, combining ‘bottom-up’ and ‘top-down approaches’, from the societal perspective. To estimate the cost of independently implementing each intervention arm, resources shared between trial arms (e.g. overheads) were allocated to each consuming arm using proxies developed based on share of resource input quantities consumed. Incremental implementation costs (in 2017 US$) are presented for HI-only, LSM-only and HI + LSM arms. In sensitivity analyses, the effect of varying costs of important inputs on estimated costs was explored. Results The total economic programme costs of community-led HI and LSM implementation was $626,152. Incremental economic implementation costs of HI, LSM and HI + LSM were estimated as $27.04, $25.06 and $33.44, per person per year, respectively. Project staff, transport and labour costs, but not larvicide or screening material, were the major cost drivers across all interventions. Costs were sensitive to changes in staff costs and population covered. Conclusions In the trial, the incremental economic costs of community-led HI and LSM implementation were high compared to previous house improvement and LSM studies. Several factors, including intervention design, year-round LSM implementation and low human population density could explain the high costs. The factorial trial design necessitated use of proxies to allocate costs shared between trial arms, which limits generalizability where different designs are used. Nevertheless, costs may inform planners of similar intervention packages where cost-effectiveness is known. Trial registration Not applicable. The original trial was registered with The Pan African Clinical Trials Registry on 3 March 2016, trial number PACTR201604001501493

The effect of community-driven larval source management and house improvement on malaria transmission when added to the standard malaria control strategies in Malawi: a cluster-randomized controlled trial

Background Current standard interventions are not universally sufficient for malaria elimination. The effects of community-based house improvement (HI) and larval source management (LSM) as supplementary interventions to the Malawi National Malaria Control Programme (NMCP) interventions were assessed in the context of an intensive community engagement programme. Methods The study was a two-by-two factorial, cluster-randomized controlled trial in Malawi. Village clusters were randomly assigned to four arms: a control arm; HI; LSM; and HI + LSM. Malawi NMCP interventions and community engagement were used in all arms. Household-level, cross-sectional surveys were conducted on a rolling, 2-monthly basis to measure parasitological and entomological outcomes over 3 years, beginning with one baseline year. The primary outcome was the entomological inoculation rate (EIR). Secondary outcomes included mosquito density, Plasmodium falciparum prevalence, and haemoglobin levels. All outcomes were assessed based on intention to treat, and comparisons between trial arms were conducted at both cluster and household level. Results Eighteen clusters derived from 53 villages with 4558 households and 20,013 people were randomly assigned to the four trial arms. The mean nightly EIR fell from 0.010 infectious bites per person (95% CI 0.006–0.015) in the baseline year to 0.001 (0.000, 0.003) in the last year of the trial. Over the full trial period, the EIR did not differ between the four trial arms (p = 0.33). Similar results were observed for the other outcomes: mosquito density and P. falciparum prevalence decreased over 3 years of sampling, while haemoglobin levels increased; and there were minimal differences between the trial arms during the trial period. Conclusions In the context of high insecticide-treated bed net use, neither community-based HI, LSM, nor HI + LSM contributed to further reductions in malaria transmission or prevalence beyond the reductions observed over two years across all four trial arms. This was the first trial, as far as the authors are aware, to test the potential complementary impact of LSM and/or HI beyond levels achieved by standard interventions. The unexpectedly low EIR values following intervention implementation indicated a promising reduction in malaria transmission for the area, but also limited the usefulness of this outcome for measuring differences in malaria transmission among the trial arms. Trial registration PACTR, PACTR201604001501493, Registered 3 March 2016, https://pactr.samrc.ac.za/.

Housing Transformation in Kampala, Uganda: Causes and Opportunities

This paper discusses house transformation by owners in Kampala, the capital city of Uganda, examining the reasons for the phenomenon and highlighting its nature, opportunities it offers and what be done to formalise it and take advantage of some of these opportunities for the benefit of the community. The main objective of the study was to investigate the factors and processes leading to house transformation in Kampala’s owner-occupied houses. The study revealed that the processes of house development and transformation in Kampala are largely informal, excluding professionals and local authorities. House transformations were a means of expression of the changing needs of the owners, in terms of sizes, income, class and status. House transformations are characterised by phased alterations/modifications, which result in more space for the household needs, income generation and house improvement and status uplift. The process being widespread, almost inevitable and addressing the largely genuine concern. The research recommends formalisation of guided house transformation and phased construction by Kampala Capital City Authority (KCCA) under the consultation of house-owners and professionals.

Cost of Community-Led Larval Source Management and House Improvement for Malaria Control: A Cost Analysis Within A Cluster-Randomised Trial in A Rural District in Malawi

Background: House improvement (HI) to prevent mosquito house entry, and larval source management (LSM) targeting aquatic mosquito stages to prevent development into adult forms, are promising complementary interventions to current malaria vector control strategies. Lack of evidence on costs and cost-effectiveness of community-led implementation of HI and LSM has hindered wide scale adoption. This study presents an incremental cost analysis of community-led implementation of HI and LSM, in a factorial design trial, in addition to standard national malaria control interventions in Chikwawa district, southern Malawi.Methods: In the trial, LSM comprised draining, filling, and Bacillus thuringiensis israelensis larvicide application, while HI involved closing of eaves and gaps on walls, and screening windows and ventilation spaces with wire mesh. Communities implemented all interventions. Costs were estimated retrospectively using the ‘ingredients approach’, combining both ‘bottom-up’ and ‘top-down approaches’, from the societal perspective. To estimate the cost of independently implementing each intervention arm, resources shared between trial arms (e.g. overheads) were allocated to each consuming arm using proxies developed based on share of resource input quantities consumed. Incremental implementation costs (in 2017 US$) are presented for HI only, LSM only and HI+LSM arms. In sensitivity analyses, the effect of varying costs of important inputs on estimated costs was explored. Results: The total economic program costs of community-led HI and LSM implementation was $626,152. Economic implementation costs of HI, LSM and HI+LSM were estimated as $27.04, $25.06 and $33.44, per person per year, respectively. Staff, transport and labour costs, but not larvicide or screening material, were the major cost drivers across all interventions. Estimated costs were sensitive to changes in staff costs and population covered. Conclusions: In the context of the trial, the economic costs of community-led HI and LSM implementation were high compared to conventional vector control interventions. Several factors, including the year-round implementation of LSM and low human population density could explain the high costs. The factorial trial design necessitated use of proxies to allocate costs shared between trial arms, which may limit generalisability of estimated costs where different designs are used. Nevertheless, costs may inform planners of future similar intervention packages. Trial registration: Not applicable. The original trial was registered with The Pan African Clinical Trials Registry on 3 March 2016, trial number PACTR201604001501493.

Outdoor Transmission of Malaria

Recent assessments of controlling the vectors of malaria have shown that due to reliance of treatments inside houses, malaria transmission is still occurring as people are more active outdoors during the evening after sunset. During several visits to Cameroon, it was noticeable that, at least in the towns, there was considerable activity outdoors after sunset as people preferred to go shopping or socialise with friends when it was cooler. However, as in other countries in Africa, the emphasis has been put on the distribution of insecticide treated bednets while indoor residual spraying (IRS) has also been used. A pilot study in six villages in a malaria-endemic area examined different mosquito control interventions applied to entire villages to assess their impact on vectors, malaria incidence and the quality of life of the communities. One of the villages was left untreated during the year of the trial. One of the other villages which had been treated with IRS and bednets treated with ICON CS (lambda-cyhalothrin capsule suspension formulation) or another that had improved screening of houses combined with outdoor misting showed reduced numbers of mosquitoes collected from exit traps compared to the other treatments. More malaria sporozoites were detected in mosquitoes sampled in exit traps in the untreated village than in the treated villages. Malaria incidence several months after both IRS/ITN and screening/misting treatments was not significantly different from pre-treatment levels. In retrospect, the village with house improvement and outdoor misting was almost as effective as using both treated bed nets and IRS inside houses, indicating important transmission outdoors. A subsequent study showed that, as expected, the treated bed nets were of greater importance in protecting young children remaining under the nets throughout the night than adults.

Home-Based Enterprise and Its Impediment Factors to Self-Help House Improvement in Kampong Cikini, Jakarta

This research aims to embellish the existing literature on Home-Based Enterprise (HBE) to recuperate it as one of the effective solutions for self-help slum improvement programs in the future. Many experts have praised HBE as one of the plausible solutions for slum alleviation through income-generating activities that will enable the underprivileged to perform self-help house improvement. However, there is a vague establishment between HBE to self-help house improvement in Kampong Cikini, as one of the notable slum settlements in Central Jakarta. Through the employment of the case study method, this research established HBE’s contribution to self-help house improvement is less significant because of several impediments, which indicates the increment monthly income from HBE cannot automatically ignite the self-help house improvement. Both HBE and self-help house improvement are inseparable from socio-economy activities in the neighborhood and cannot be comprehended as an individual economy household’s activities. Therefore, specific solutions are required to overcome the mainly encountered impediments with considering the established interwoven domestic and economic activities, for increasing the impact of HBE to self-help house improvement.

Chagas disease

Trypanosoma cruzi, the protozoan parasite that causes Chagas disease, is a zoonotic infection with many mammal host and vector species. It is transmitted to humans by contamination of mucous membranes or abraded skin with infected faeces of bloodsucking triatomine bugs, also by blood transfusion, organ transplantation, transplacentally, and orally by food contaminated with infective forms. It multiplies intracellularly (pseudocysts) as amastigotes in mammalian cells, particularly heart and smooth muscle, from which flagellated trypomastigotes emerge to reinvade cells or circulate in blood. Around 10 million people are infected in Latin America; imported cases and congenital cases may occur elsewhere. Proven methods of controlling domestic triatomine bugs include insecticide spraying (with pyrethroids), health education, community support, and house improvement. Serological surveillance of children detects residual endemic foci or congenital transmission and is vital for monitoring the success of control programmes. There is no vaccine.