Abstract
Malaria is a global public health concern and its dynamic transmission is still a complex process. Malaria transmission largely depends on various factors, including demography, geography, vector dynamics, parasite reservoir, and climate. The dynamic behaviour of malaria transmission has been explained using various statistical and mathematical methods. Of them, wavelet analysis is a powerful mathematical technique used in analysing rapidly changing time-series to understand disease processes in a more holistic way. The current study is aimed at identifying the pattern of malaria transmission and its variability with environmental factors in Kataragama, a malaria-endemic dry zone locality of Sri Lanka, using a wavelet approach. Monthly environmental data including total rainfall and mean water flow of the "Menik Ganga" river; mean temperature, mean minimum and maximum temperatures and mean relative humidity; and malaria cases in the Kataragama Medical Officer of Health (MOH) area were obtained from the Department of Irrigation, Department of Meteorology and Malaria Research Unit (MRU) of University of Colombo, respectively, for the period 1990 to 2005. Wavelet theory was applied to analyze these monthly time series data. There were two significant periodicities in malaria cases during the period of 1992-1995 and 1999-2000. The cross-wavelet power spectrums revealed an anti-phase correlation of malaria cases with mean temperature, minimum temperature, and water flow of "Menik Ganga" river during the period 1991-1995, while the in-phase correlation with rainfall is noticeable only during 1991-1992. Relative humidity was similarly associated with malaria cases between 1991-1992. It appears that environmental variables have contributed to a higher incidence of malaria cases in Kataragama in different time periods between 1990 and 2005.
Highlights
Malaria is a global public health concern
Environment variables were available from 1990 to 2013/2014, malaria case incidence was markedly decreased from year 2001 and remained zero since 2005
The total number of parasitologically confirmed malaria cases reported during the study period was 24,549 with a Malaria and environmental factors mean of 127.86 cases per month
Summary
According to the latest World Malaria Report 2018, an estimated 219 million malaria cases, two million more cases compared to 2016, and 435,000 deaths were estimated to have occurred globally in 2017 [1]. Sri Lanka was a malaria-endemic country in South Asia and has a long history of malaria pre-dating the colonial period [2]. By early 2000, there was a significant reduction in malaria cases and the country entered the pre-elimination phase in 2008 [8]. It was declared as a malaria-free in 2016. Sri Lanka has seen few imported malaria cases annually during the post-elimination period [9]
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