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Association between climate variability and malaria epidemics in the East African highlands
Open accessAbstract
The causes of the recent reemergence of Plasmodium falciparum epidemic malaria in the East African highlands are controversial. Regional climate changes have been invoked as a major factor; however, assessing the impact of climate in malaria resurgence is difficult due to high spatial and temporal climate variability and the lack of long-term data series on malaria cases from different sites. Climate variability, defined as short-term fluctuations around the mean climate state, may be epidemiologically more relevant than mean temperature change, but its effects on malaria epidemics have not been rigorously examined. Here we used nonlinear mixed-regression model to investigate the association between autoregression (number of malaria outpatients during the previous time period), seasonality and climate variability, and the number of monthly malaria outpatients of the past 10–20 years in seven highland sites in East Africa. The model explained 65–81% of the variance in the number of monthly malaria outpatients. Nonlinear and synergistic effects of temperature and rainfall on the number of malaria outpatients were found in all seven sites. The net variance in the number of monthly malaria outpatients caused by autoregression and seasonality varied among sites and ranged from 18 to 63% (mean = 38.6%), whereas 12–63% (mean = 36.1%) of variance is attributed to climate variability. Our results suggest that there was a high spatial variation in the sensitivity of malaria outpatient number to climate fluctuations in the highlands, and that climate variability played an important role in initiating malaria epidemics in the East African highlands.
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“Individual or a combined influence of factors, including habitat formation, vector development, infectivity, and emergence of signs and symptoms in humans during the lag’s periods, affects malaria transmission dynamics [48,49,50].”
From A Bayesian Spatio-Temporal Analysis of Malaria in the Greater Accra Region of Ghana from 2015 to 2019 (2021) · cites this paper as [50]
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“Studies in East Africa have shown that rainfall significantly correlates with malaria transmission with a lag time of 1–2 months (Loevinsohn, 1994; Zhou et al., 2004).”
From Investigating the Impact of Irrigation on Malaria Vector Larval Habitats and Transmission Using a Hydrology‐Based Model (2023) · cites this paper as Zhou et al., 2004
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“Malaria transmission within the region may have been mediated by multiple factors apart from the climatic covariates assessed, including vector characteristics and environmental and human population dynamics [48,50].”
From A Bayesian Spatio-Temporal Analysis of Malaria in the Greater Accra Region of Ghana from 2015 to 2019 (2021) · cites this paper as [50]
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Cited by
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Bates, B. C., Kundzewicz, Z. W., & Wu, S. (2008) · TaCCIRe Repository (Sokoine University of Agriculture) · Cited by 2,641
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Metadata
- Authors
- Zhou, G., Minakawa, N., Githeko, A. K., & Yan, G.
- Affiliations
- Kenya Medical Research Institute (KE)
- Corresponding author
- Yan, Guiyun
- Venue
- Proceedings of the National Academy of Sciences
- Publisher
- National Academy of Sciences
- Published
- 2004-02-17
- Volume
- 101
- Issue
- 8
- Pages
- 2375-2380
- ISSN
- 0027-8424 (ISSN-L)
- 1091-6490
- PMC
- PMC356958
- OpenAlex
- W1990791331
- Cited by
- 498
- References
- 50
- Citations by year
- 2026: 13 · 2025: 23 · 2024: 12 · 2023: 14 · 2022: 14 · 2021: 16 · 2020: 27 · 2019: 10 · 2018: 24 · 2017: 26 · 2016: 29 · 2015: 29 · 2014: 32 · 2013: 33 · 2012: 30
- FWCI
- 19.10
- Type
- journal article
- Language
- en
- Update notices
- correction (2004-09-14)
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Proceedings of the National Academy of Sciences (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institutes of Health
- National Institute of Allergy and Infectious Diseases (R01AI050243, R01 AI 50243)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Malaria Research and Control
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Climate Change and Health Impacts
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Mosquito-borne diseases and control
- Keywords
- climate variability, malaria epidemic, Plasmodium falciparum, East African highlands, malaria resurgence, temperature, rainfall, seasonal variation, autoregression
- MeSH terms
- Africa, Eastern, Climate, Disease Outbreaks, Ethiopia, Humans, Kenya, Malaria, Seasons, Temperature, Uganda, Incidence
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