Tropical Health Matters

Being curious about AI and ChatGPT, I asked this question: How is climate change affecting malaria transmission. This is how it responded:

Climate change is significantly affecting malaria transmission by altering the environmental conditions that influence the life cycles of both Anopheles mosquitoes (the vectors) and the Plasmodium parasites they carry. Here’s how:

1. Temperature Rise: Faster parasite development: Warmer temperatures speed up the development of Plasmodium parasites inside mosquitoes (known as the extrinsic incubation period), increasing the chances of transmission. Mosquito lifespan: While extreme heat can be lethal, moderate warming may extend the geographical and seasonal range where mosquitoes can survive and transmit malaria. Altitude shifts: Warmer temperatures allow mosquitoes to survive at higher altitudes, leading to malaria transmission in previously malaria-free highland areas (e.g., parts of East Africa and South America).
2. Changes in Rainfall and Humidity: More breeding sites: Increased rainfall can create more standing water, ideal for mosquito breeding. However, excessive rain can also wash away larvae, so the impact depends on local conditions. Humidity: High humidity levels favor mosquito survival. Dry conditions reduce their lifespan and the chance of parasite development and transmission.
3. Changing Seasons: Longer transmission seasons: In some areas, the malaria transmission season is becoming longer due to prolonged warm and wet periods. Shifting malaria zones: Some regions may experience reduced risk (due to drought or high temperatures), while others become more suitable for transmission.
4. Extreme Weather Events: Floods and droughts: Climate variability increases the frequency of floods (which can boost mosquito breeding) and droughts (which can displace populations and lead to outbreaks in refugee camps or urban areas with poor sanitation).
5. Human Migration and Land Use: Climate-driven displacement can increase malaria risk by moving non-immune populations into endemic areas or overwhelming healthcare infrastructure.

The app also provided a summary table as attached. I next asked for reference articles on the topic and eight were provided. All checked out as coming from real journals/publications. Links are provided below. Without verifiable references the information could be suspect. This may be a useful tool to begin exploration on health and tropical disease topics if care is taken to verify information obtained.

1. **Influence of Future Climate Scenarios on Malaria Transmission in India.** This study utilized the VECTRI model to estimate malaria’s Entomological Inoculation Rate (EIR) under various climate scenarios (RCP 2.6, 4.5, and 8.5) for the period 2020–2029. The findings indicated a significant decline in malaria risk across all scenarios, with a decrease in EIR ranging from 0.3 to 2.6 EIR/person/day, attributed to reduced rainfall and moderate temperature increases. ([malariajournal.biomedcentral.com][1])
2. **Impact of Climate Change on Temperature Variations and Parasite Development in Chennai, India.** Research in Chennai revealed that global warming has increased atmospheric temperatures, leading to a decrease in the extrinsic incubation period (EIP) of *Plasmodium* parasites. Shorter EIP means faster parasite development, potentially enhancing transmission rates. However, extreme temperatures may still pose a risk to parasite development. [parasitesandvectors.biomedcentral.com][2])
3. **Predicting Malaria Risk Considering Vector Control Interventions Under Climate Change Scenarios.** This study modeled malaria risk in Uganda by integrating environmental variables (rainfall, humidity, temperature, vegetation) and vector control interventions (indoor residual spraying and long-lasting insecticidal nets). The results projected a 25% to 30% increase in annual malaria cases by the 2050s in the absence of interventions, underscoring the importance of maintaining control measures in the face of climate change. ([pmc.ncbi.nlm.nih.gov][3])
4. **Projected Impacts of Climate Change on Environmental Suitability for Malaria Transmission in West Africa.** This research assessed how climate change affects the environmental suitability for malaria transmission in West Africa. The findings suggest that increased rainfall and temperature could expand mosquito habitats, thereby increasing malaria transmission potential in certain regions. ([ehp.niehs.nih.gov][4])
5. **Climate Change Could Shift Disease Burden from Malaria to Arboviruses in Africa.** This study discusses how rising temperatures may reduce the suitability for malaria transmission while enhancing conditions for arboviruses like dengue and chikungunya. Such shifts could lead to a re-emergence of diseases in regions previously affected by malaria. ([pmc.ncbi.nlm.nih.gov][5])
6. **How climate change will affect malaria transmission | ScienceDaily**
7. **Malaria Transmission in Africa Shifts with the Climate—and Hydrology.** This article highlights how climate-induced changes in hydrology, such as altered river flows and evaporation rates, can impact malaria transmission patterns in Africa. The study emphasizes the need to consider hydrological factors in predicting and managing malaria risks. ([sciencedaily.com][6], [eos.org][7])
8. **Mapping Current and Future Thermal Limits to Suitability for Malaria Transmission by the Invasive Mosquito *Anopheles stephensi.*** This research mapped the thermal limits for malaria transmission by *Anopheles stephensi*, an invasive mosquito species. The findings indicate that climate change could expand the transmission season for *Plasmodium falciparum* in northern latitudes, including parts of North America and Europe. ([ncbi.nlm.nih.gov][8])

Mike Toso, Senior Program Officer at the Johns Hopkins Center for Communication Programs shares an update on visualizing malaria behaviors and determinants of malaria behaviors.

Breakthrough ACTION and the U.S. President’s Malaria Initiative are excited to announce the launch of the Malaria Behavior Survey (MBS) Dashboard, a new resource available on the MBS website.

The MBS Dashboard presents cross-sectional data collected from individuals and households in sub-Saharan African countries. This interactive dashboard allows users to explore MBS data on a single easy-to-explore platform. Currently, the dashboard includes data from six countries, and Breakthrough ACTION plans to add others as data points become available.

The dashboard shows a selection of the most important data points from the full MBS. It can be easily accessed on one’s smartphone if users are out in the field or at an informal meeting.

Additionally, the dashboard uses the collected data to make recommendations for program implementers to follow. These recommendations are generated dynamically, corresponding to the selected country’s data. National malaria programs and other partners working in malaria SBC can use MBS results to develop evidence-based malaria SBC programs and strategies.

The MBS is unique in that it gathers data on the behavioral factors that influence people’s use of malaria prevention and treatment interventions. Surveys in multiple countries often measure behaviors but do not assess the cognitive, emotional, or social factors associated with those behaviors. Such insights will help programs more fully address the needs of individuals and communities in combating malaria.

Link to blog post: https://ccp.jhu.edu/2023/04/24/malaria-dashboard-data-research/ “New Malaria Behavior Survey Dashboard “Like a Swiss Army Knife”

Link to Malaria Minute podcast: https://publichealth.jhu.edu/malaria-research-institute-1 (episode “How can Behavioral Science Improve Bed Net Use” 5/15/2023

 

 

 

 

 

Save the Children designs programs to protect children and families from malaria. An important aspect of the design process is learning about the factors that influence community members’ behaviors related to the prevention of the disease. Here we learn about behavioral factors that must be considered to design effective programs. This information is being presented at the 2021 American Society of Tropical Medicine and Hygiene Annual Meeting. See Author List below.

Understanding the drivers of malaria-related behavior helps national malaria control programs and implementing partners to plan national malaria strategies and to tailor interventions accordingly. This study examined the factors affecting adoption of malaria behaviors and those that drive or inhibit them among populations at high risk of malaria in Cote d’Ivoire.

This study was a multi-method, qualitative study with an exploratory approach using focus group discussions (FGDs), in-depth interviews (IDIs) and life stories. The study was conducted in 12 health districts across 10 health regions of Cote d’Ivoire in both urban and rural areas. FGDs and life stories were conducted with pregnant women and mothers of children under 5 and men (heads of household). IDIs were conducted with a number of stakeholders including: departmental district directors; midwives, nurses, community health workers, leaders of women’s groups, community leaders, and the local media.

The findings from this study show that incorrect knowledge about LLINs, LLIN dislike and discomfort, housing structure and size, sleeping arrangements for children under 5, and lack of LLIN recycling strategies were among the root causes for incorrect, non-use and/or inconsistent use of LLINs. In terms of ANC attendance, the main reported barriers were influence of their beliefs and norms, cost, perceived poor services provided, bad experiences from gynecological examinations, and the distance of health facilities in rural areas. Additionally, the lack of information on the benefits of SP for prevention of malaria in pregnancy and the use of traditional medicine were the main barriers for SP in pregnancy. Cost, poor services by health care providers and stock outs were the main barriers to diagnosis and treatment for children U5.  The main factor that influenced the adoption of preventive measures was free LLIN distribution through ANC viists and mass distribution campaigns.

Findings from this study are useful to inform the revision of the Social Behavior Change Communication Strategy in Cote d’Ivoire. Additionally, they can inform key messaging and the design of interventions in a context where malaria is the main cause of morbidity and mortality and children under 5 and pregnant women are the most affected.

AUTHOR LIST:

Jacob Y. Agniman1, Manasse N. Kassi1, Yssouf Ouattara1, Edouard C. Balogoun1, Serge B. Assi2, Philomène A. Beda1, Michel N’da-Ezoa3, Aristide E. Kouadio1, Joel Koffi1, Apollinaire N. Kouadio1, Paul Bouey4, Sara Canavati4, Eric Swedberg4 — 1Save the Children, Abidjan, Côte D’Ivoire, 2Le Programme Nationale de Lutte contre le Paludisme (PNLP), Abidjan, Côte D’Ivoire, 3Socio-Anthropologue de la Santé, Abidjan, Côte D’Ivoire, 4Save the Children, Washington, DC, United States