Abstract
BackgroundMalaria has recently re-emerged as a public health burden in Colombia. Although the problem seems to be climate-driven, there remain significant gaps of knowledge in the understanding of the complexity of malaria transmission, which have motivated attempts to develop a comprehensive model.MethodsThe mathematical tool was applied to represent Plasmodium falciparum malaria transmission in two endemic-areas. Entomological exogenous variables were estimated through field campaigns and laboratory experiments. Availability of breeding places was included towards representing fluctuations in vector densities. Diverse scenarios, sensitivity analyses and instabilities cases were considered during experimentation-validation process.ResultsCorrelation coefficients and mean square errors between observed and modelled incidences reached 0.897–0.668 (P > 0.95) and 0.0002–0.0005, respectively. Temperature became the most relevant climatic parameter driving the final incidence. Accordingly, malaria outbreaks are possible during the favourable epochs following the onset of El Niño warm events. Sporogonic and gonotrophic cycles showed to be the entomological key-variables controlling the transmission potential of mosquitoes' population. Simulation results also showed that seasonality of vector density becomes an important factor towards understanding disease transmission.ConclusionThe model constitutes a promising tool to deepen the understanding of the multiple interactions related to malaria transmission conducive to outbreaks. In the foreseeable future it could be implemented as a tool to diagnose possible dynamical patterns of malaria incidence under several scenarios, as well as a decision-making tool for the early detection and control of outbreaks. The model will be also able to be merged with forecasts of El Niño events to provide a National Malaria Early Warning System.
Highlights
Malaria has recently re-emerged as a public health burden in Colombia
We considered the collections of water as 'reservoirs' ranging from 10 to 60 mm in depth opened to observed rainfall, estimated actual evaporation, and assumed constant infiltration
Vector densities During a 1,800-day period assumed for the El Bagre region (January 3rd 1994 – December 7th 1998) mean daily temperatures ranged from 24.0 to 32.5°C, and at least 83% of the observed values were in the interval
Summary
Malaria has recently re-emerged as a public health burden in Colombia. the problem seems to be climate-driven, there remain significant gaps of knowledge in the understanding of the complexity of malaria transmission, which have motivated attempts to develop a comprehensive model. Forecasts from different models suggest that by the end of the 21st century ongoing warming will have enlarged the zone of potential malaria transmission from an area containing 45 percent of the world's population to an area containing about 60 percent [4]. This expansion certainly fits the predictions, the cause of that growth may not be attributed convincingly to global warming. The hypothesis for a climatic contribution becomes stronger: even though malaria is a highly complex multi-factorial disease, previous studies have identified environmental factors and climate variability as going a considerable way in helping to explain the fluctuations of disease incidence [5,6,7]
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