Table 4.

Customary Household Practices as Health-EDRM Primary Prevention Approaches against VBDs.

Parametre	Minimise Household Entry Points		Cover Exposed Foodstuffs
	Wall Cracks	Door and Window Openings
Risk	Household entry points such as wall cracks as well as open doors and windows provide opportunities for vector entrance, contributing to the risk of indoor infestation.		Common vectors such as flies are attracted to odours and chemicals released by exposed foodstuffs, such as the volatile fermentation products [136] of ripe fruits associated with the breeding of yeast in the fruit [137]. Disease vectors may contaminate exposed foodstuffs in open containers via direct contact or droppings, which contribute to health hazards such as a high incidence of diarrhoea in children under six [138]. If uncooked food with pathogens such as Salmonella and E. Coli are left uncovered, houseflies may serve as vectors and expose humans to the risk of food-borne pathogenic infections [139].
	A significant number of vectors may accumulate in the cracks if they remain unrepaired [140].	Entry points through open doors and windows have large surface areas and are more prone to the entrance of disease vectors [141].
Behavioural Change	Household improvements to minimise entry points are effective in reducing infestation from vectors such as Aedes aegypti, which transmit the Zika and chikungunya viruses [142]. The risk of malaria transmission from the Anopheles mosquito is similarly reduced [143].		Practice the covering of exposed foodstuffs with food covers or nets to prevent food contamination by flies [111], especially in contexts without refrigerators.
	Repair cracks to seal potential vector entry points [21].	Install door and window screens and close windows in the early evening to reduce indoor disease vector density [21,36,144,145].
Co-benefit(s)	Protects individuals from household pests such as rodents [146,147] and cockroaches [148].		Protects exposed foodstuffs from household pests such as rodents [149].
	Reduces water leakage [150], such as during heavy rainfall.	Enhances household safety, such as decreasing the risk of theft or burglary [151].
Enabling Factor(s)	Availability and affordability of crack-repairing materials. Knowledge about crack-repairing, or accessibility to professional services.	Availability and affordability of door and window screens. Knowledge about door and window screen installation, or accessibility to professional services.	Availability and affordability of food covers.
Limiting Factor(s) and/or Alternative(s)	Contextual limitations: Household modifications do not apply to the homeless and the impoverished living in open, unstable shelters. Universal applicability: Household modification recommendations may not apply to all settings due to housing differences [152]. Professional requirement: Crack-repairing and door and window screen installation using modern methods often require professional tools and skills as well as long-term maintenance strategies.		Lack of access to quality food covers: In resource-deprived areas, clean pieces of cloth, lids, or any materials that can serve as physical barriers should be used as alternatives for covering exposed foodstuffs.
	Lack of access to modern crack-repairing materials: In resource-deprived areas, mud and lime mixtures may serve as alternatives, although they may be more costly in the long-term [153]. Less well-off populations that cannot afford modern building materials [154] may use other locally-available alternatives.	Lack of access to door and window screen installation services: The installation of door and window screens involves significant renovation work that is often costly and unaffordable for impoverished populations [155].
Strength of Evidence	While there is available evidence on the effects of crack-repairing on VBD risk reduction, studies on the detailed evaluation of different crack-repairing methods remain limited. Materials such as cement, modern crack-fillers, and a mixture of mud and lime are scientifically proven to be efficacious in reducing indoor vector density. There are few studies on other more cost-effective alternatives for populations in resource-deprived areas. Mud is a locally-available alternative, but there are limited studies on whether crack-repairing with mud alone is potentially correlated with an increased risk of vector entrance [156].	A comparatively large amount of evidence on the efficacy of proper door and window screen installation, as well as the closing of windows, in reducing indoor vector density is available. Given that variations exist in screening designs, further research on their specific efficacies is necessary [141].	A comparatively large amount of evidence of the potential health risks associated with disease vectors if foodstuffs are exposed and not covered or stored well is available. Research on the efficacy of the use of food covers, and that of potential alternatives in resource-deprived areas, is limited.