Throughout the tropics a huge diversity in house design and use of building materials can be observed, based on centuries of local experience, customs, and availability of natural resources for construction. Consequently, these differences in building style affect indoor climate and comfort for occupants, which in turn affect occupants exposure to infectious diseases. The authors describe the architectural designs of rural houses in two countries in Asia (Thailand, Philippines) and two in Africa (The Gambia, Tanzania), and relate these factors to health, notably the risk of mosquito-borne infectious diseases such as malaria. Based on these findings they describe a series of house modifications that could enhance comfort whilst at the same time reduce health risks.