肯尼亚西部扩大干预措施后气候变化对疟疾发病率的相对影响：2008年至2019年月度发病率数据的时间序列分析

IF 2 Q3 INFECTIOUS DISEASES

Parasite Epidemiology and Control Pub Date : 2023-05-01 DOI:10.1016/j.parepi.2023.e00297

Bryan O. Nyawanda , Anton Beloconi , Sammy Khagayi , Godfrey Bigogo , David Obor , Nancy A. Otieno , Stefan Lange , Jonas Franke , Rainer Sauerborn , Jürg Utzinger , Simon Kariuki , Stephen Munga , Penelope Vounatsou

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Data pertaining to bed net use and socio-economic status (SES) were obtained from household surveys. Climatic proxy variables obtained from remote sensing were included as covariates in the models. Bayesian variable selection was used to determine the elapsing time between climate suitability and malaria incidence.</p></div><div><h3>Results</h3><p>Malaria incidence increased by 50% from 2008 to 2010, then declined by 73% until 2015. There was a resurgence of cases after 2016, despite high bed net use. Increase in daytime land surface temperature was associated with a decline in malaria incidence (incidence rate ratio [IRR] = 0.70, 95% Bayesian credible interval [BCI]: 0.59–0.82), while rainfall was associated with increased incidence (IRR = 1.27, 95% BCI: 1.10–1.44). 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引用次数: 1

摘要

背景尽管在过去20年中，在减轻全球疟疾负担方面取得了相当大的进展，但疟疾仍然是一个主要的公共卫生问题，人们担心气候变化可能会扩大适宜的传播区域。这项研究调查了肯尼亚西部扩大干预措施后气候变化对疟疾发病率的相对影响。方法将贝叶斯负二项模型拟合到每月疟疾发病率数据中，这些数据是从2008年至2019年间访问Lwak Mission医院的发热性疾病患者记录中提取的。与净床使用和社会经济地位（SES）有关的数据是从家庭调查中获得的。从遥感中获得的气候代理变量被作为协变量纳入模型中。贝叶斯变量选择用于确定气候适宜性和疟疾发病率之间的消逝时间。结果2008年至2010年，疟疾发病率上升了50%，2015年下降了73%。尽管使用了大量的蚊帐，但2016年之后病例再次出现。白天地表温度的升高与疟疾发病率的下降有关（发病率比率[IRR]=0.70，95%贝叶斯可信区间[BCI]:0.59–0.82），而降雨量与发病率增加有关（IRR=1.27，95%脑机接口：1.10-1.44）。在6至59个月的儿童中，使用蚊帐与疟疾发病率下降有关（IRD=0.78，95%脑电接口：0.70-0.87），但在老年组中没有，而SES与该人群中的疟疾发病率无关。结论气候因素的变异性对疟疾发病率的影响大于蚊帐的使用。然而，蚊帐的使用与疟疾发病率的降低有关，尤其是在适应气候影响后，6至59个月大的儿童中。为了维持疟疾发病率的下降趋势，本研究建议在规划未来的控制干预措施时，继续分发和使用蚊帐，并考虑基于气候的疟疾预警系统。

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The relative effect of climate variability on malaria incidence after scale-up of interventions in western Kenya: A time-series analysis of monthly incidence data from 2008 to 2019

Background

Despite considerable progress made over the past 20 years in reducing the global burden of malaria, the disease remains a major public health problem and there is concern that climate change might expand suitable areas for transmission. This study investigated the relative effect of climate variability on malaria incidence after scale-up of interventions in western Kenya.

Methods

Bayesian negative binomial models were fitted to monthly malaria incidence data, extracted from records of patients with febrile illnesses visiting the Lwak Mission Hospital between 2008 and 2019. Data pertaining to bed net use and socio-economic status (SES) were obtained from household surveys. Climatic proxy variables obtained from remote sensing were included as covariates in the models. Bayesian variable selection was used to determine the elapsing time between climate suitability and malaria incidence.

Results

Malaria incidence increased by 50% from 2008 to 2010, then declined by 73% until 2015. There was a resurgence of cases after 2016, despite high bed net use. Increase in daytime land surface temperature was associated with a decline in malaria incidence (incidence rate ratio [IRR] = 0.70, 95% Bayesian credible interval [BCI]: 0.59–0.82), while rainfall was associated with increased incidence (IRR = 1.27, 95% BCI: 1.10–1.44). Bed net use was associated with a decline in malaria incidence in children aged 6–59 months (IRR = 0.78, 95% BCI: 0.70–0.87) but not in older age groups, whereas SES was not associated with malaria incidence in this population.

Conclusions

Variability in climatic factors showed a stronger effect on malaria incidence than bed net use. Bed net use was, however, associated with a reduction in malaria incidence, especially among children aged 6–59 months after adjusting for climate effects. To sustain the downward trend in malaria incidence, this study recommends continued distribution and use of bed nets and consideration of climate-based malaria early warning systems when planning for future control interventions.

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来源期刊

Parasite Epidemiology and Control Medicine-Infectious Diseases

CiteScore

5.70

自引率

3.10%

发文量

审稿时长

17 weeks

期刊介绍： Parasite Epidemiology and Control is an Open Access journal. There is an increasing amount of research in the parasitology area that analyses the patterns, causes, and effects of health and disease conditions in defined populations. This epidemiology of parasite infectious diseases is predominantly studied in human populations but also spans other major hosts of parasitic infections and as such this journal will have a broad remit. We will focus on the major areas of epidemiological study including disease etiology, disease surveillance, drug resistance and geographical spread and screening, biomonitoring, and comparisons of treatment effects in clinical trials for both human and other animals. We will also look at the epidemiology and control of vector insects. The journal will also cover the use of geographic information systems (Epi-GIS) for epidemiological surveillance which is a rapidly growing area of research in infectious diseases. Molecular epidemiological approaches are also particularly encouraged.