Tanser Frank C, Sharp Brian, le Sueur David
Malaria Research Lead Programme, Medical Research Council, Overport, Durban, South Africa.
Lancet. 2003 Nov 29;362(9398):1792-8. doi: 10.1016/S0140-6736(03)14898-2.
Climate change is likely to affect transmission of vector-borne diseases such as malaria. We quantitatively estimated current malaria exposure and assessed the potential effect of projected climate scenarios on malaria transmission.
We produced a spatiotemporally validated (against 3791 parasite surveys) model of Plasmodium falciparum malaria transmission in Africa. Using different climate scenarios from the Hadley Centre global climate model (HAD CM3) climate experiments, we projected the potential effect of climate change on transmission patterns.
Our model showed sensitivity and specificity of 63% and 96%, respectively (within 1 month temporal accuracy), when compared with the parasite surveys. We estimate that on average there are 3.1 billion person-months of exposure (445 million people exposed) in Africa per year. The projected scenarios would estimate a 5-7% potential increase (mainly altitudinal) in malaria distribution with surprisingly little increase in the latitudinal extents of the disease by 2100. Of the overall potential increase (although transmission will decrease in some countries) of 16-28% in person-months of exposure (assuming a constant population), a large proportion will be seen in areas of existing transmission.
The effect of projected climate change indicates that a prolonged transmission season is as important as geographical expansion in correct assessment of the effect of changes in transmission patterns. Our model constitutes a valid baseline against which climate scenarios can be assessed and interventions planned.
气候变化可能会影响疟疾等媒介传播疾病的传播。我们定量估计了当前疟疾暴露情况,并评估了预测的气候情景对疟疾传播的潜在影响。
我们建立了一个在时空上经过验证(与3791次寄生虫调查对比)的非洲恶性疟原虫疟疾传播模型。利用来自哈德利中心全球气候模型(HAD CM3)气候实验的不同气候情景,我们预测了气候变化对传播模式的潜在影响。
与寄生虫调查相比,我们的模型显示敏感性和特异性分别为63%和96%(时间精度在1个月内)。我们估计,非洲每年平均有31亿人月的暴露(4.45亿人暴露)。预测情景估计到2100年疟疾分布可能增加5 - 7%(主要是海拔高度上的增加),而疾病在纬度范围上的增加惊人地少。在暴露的人月数总体潜在增加16 - 28%中(假设人口不变,尽管在一些国家传播会减少),很大一部分将出现在现有传播地区。
预测的气候变化影响表明,在正确评估传播模式变化的影响方面,延长传播季节与地理范围扩大同样重要。我们的模型构成了一个有效的基线,可据此评估气候情景并规划干预措施。