Affordable house designs to improve health in rural Africa: a field study from northeastern Tanzania  Dr Lorenz von Seidlein, PhD, Konstantin Ikonomidis,

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Affordable house designs to improve health in rural Africa: a field study from northeastern Tanzania  Dr Lorenz von Seidlein, PhD, Konstantin Ikonomidis, Salum Mshamu, MSc, Theresia E Nkya, PhD, Mavuto Mukaka, PhD, Christopher Pell, PhD, Prof Steven W Lindsay, PhD, Jacqueline L Deen, MD, William N Kisinza, PhD, Jakob B Knudsen  The Lancet Planetary Health  Volume 1, Issue 5, Pages e188-e199 (August 2017) DOI: 10.1016/S2542-5196(17)30078-5 Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Terms and Conditions

Figure 1 The prototype houses (1) Porous wall materials (cladding) that are air permeable. (2) A concrete or timber floor that is elevated from the ground for sleeping areas. (3) A reinforced storage area that can be locked. (4) An outdoor cooking area with chimney connected to the main building and covered by a roof. (5) A water harvesting system that allows the collection of rain water through gutters and storage of water in a large plastic container. (6) An outdoor latrine. The Lancet Planetary Health 2017 1, e188-e199DOI: (10.1016/S2542-5196(17)30078-5) Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Terms and Conditions

Figure 2 Construction plan drawings (elevation, cross-section, and ground plan) of a single-storey and a double-storey prototype house The Lancet Planetary Health 2017 1, e188-e199DOI: (10.1016/S2542-5196(17)30078-5) Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Terms and Conditions

Figure 3 The study area and location of study houses The Lancet Planetary Health 2017 1, e188-e199DOI: (10.1016/S2542-5196(17)30078-5) Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Terms and Conditions

Figure 4 A single-storey, shade-net house at day (A) and evening (B) The Lancet Planetary Health 2017 1, e188-e199DOI: (10.1016/S2542-5196(17)30078-5) Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Terms and Conditions

Figure 5 The percentage reduction in mosquitoes caught by tent trap indoors and outdoors by house type The Lancet Planetary Health 2017 1, e188-e199DOI: (10.1016/S2542-5196(17)30078-5) Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Terms and Conditions

Figure 6 Mean indoor temperature at 2130 h between August, 2015, and July, 2016, by house type Reference house: a traditional house which was left unchanged and served as control. Modified house: major structural problems such as leaking roofs were repaired, windows screened, open eaves blocked with bricks and mortar, cement floors repaired or constructed, rain gutters and a tank for water storage added. Extra windows were installed in bedrooms with only one window to secure cross ventilation. The Lancet Planetary Health 2017 1, e188-e199DOI: (10.1016/S2542-5196(17)30078-5) Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Terms and Conditions

Figure 7 Summary of mean indoor temperature between August, 2015, and July, 2016, by house type The whiskers indicate 95% confidence interval. The Lancet Planetary Health 2017 1, e188-e199DOI: (10.1016/S2542-5196(17)30078-5) Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Terms and Conditions

Figure 8 Predicted mean vote using the example of group 1 houses (between Dec 1, 2015, and May 31, 2016, between 1900 h and 2200 h) The Lancet Planetary Health 2017 1, e188-e199DOI: (10.1016/S2542-5196(17)30078-5) Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Terms and Conditions