Abstract
Malaria is among the leading causes of mortality in the younger under-five group of children zero to four years of age. This study aims at describing the relationship between rainfall and temperature on under-five malaria or anaemia mortality in Kenya Medical Research Institute and United States Centers for Disease Control (KEMRI/CDC) Health and Demographic Surveillance System (HDSS). This study was conducted through the ongoing KEMRI and CDC collaboration. A general additive model with a Poisson link function was fit to model the weekly association of lagged cumulative rainfall and average temperature on malaria/anemia mortality in KEMRI/CDC HDSS for the period 2003 to 2008. A trend function was included in the model to control for time trends and seasonality not explained by weather fluctuations. 95% confidence intervals was presented with estimates. Malaria or anemia mortality was found to be associated with changes in temperature and rainfall in the KEMRI HDSS, with a delay up to 16 weeks. The empirical estimates of associations describe established biological relationships well. This information, and particularly, the strength of the relationships over longer lead times can highlight the possibility of developing a predictive forecast with lead times up to 16 weeks in order to enhance preparedness to high transmission episodes.
Highlights
Malaria is one of the leading causes of mortality among the under-five population with over 86% of the overall malaria mortality occurring in this age group [1]
40% of the Kenyan population is at high risk of malaria infection and most of the cases of malaria infection in Kenya are due to infection with the Plasmodium falciparum parasite [1]
We explored the relationship between rainfall and temperature with malaria and anemia mortality in children under five years of age using a general additive Poisson regression model employing smooth functions
Summary
Malaria is one of the leading causes of mortality among the under-five population with over 86% of the overall malaria mortality occurring in this age group [1]. The WHO reported over 655,000 malaria deaths in the world in 2010, 90% of which occurred in Africa [1]. According to the KEMRI/CDC HDSS 2008 annual report, 31% of the total deaths in Asembo, Gem and Karemo among the under-five population (excluding neonates) were due to malaria, and over 87% of pediatric admissions at Siaya District hospital were due to malaria [2]. Human malaria parasites are transmitted by mosquitoes of the genus anopheles; the most efficient are Anopheles gambiae and Anopheles arabiensis [3]. The most common malaria mosquito vectors in KEMRI/CDC HDSS study area are An. gambiae ss and funestus [4], but for many years the primary vector has been arabiensis [5]
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