Bouma M J, Siraj A S, Rodo X, Pascual M
London School of Hygiene and Tropical Medicine, London, UK.
Catalan Institute of Climate Sciences, Barcelona, Spain.
Trop Med Int Health. 2016 Nov;21(11):1481-1488. doi: 10.1111/tmi.12776. Epub 2016 Oct 7.
Tropical highland malaria intensifies and shifts to higher altitudes during exceptionally warm years. Above-normal temperatures associated with El Niño during boreal winter months (December-March) may intensify malaria in East African highlands. We assessed the malaria risk for Oromia, the largest region of Ethiopia with around 30 million inhabitants.
Simple linear regression and spatial analyses were used to associate sea surface temperatures (SST) in the Pacific and surface temperatures in Ethiopia with annual malaria risk in Oromia, based on confirmed cases of malaria between 1982 and 2005.
A strong association (R = 0.6, P < 0.001) was identified between malaria and sea surface temperatures in the Pacific, anticipating a 70% increase in malaria risk for the period from August 2016 to July 2017. This forecast was quantitatively supported by elevated land surface temperatures (+1.6 °C) in December 2015. When more station data become available and mean March 2016 temperatures from meteorological stations can be taken into account, a more robust prediction can be issued.
An epidemic warning is issued for Oromia, Ethiopia, between August 2016 and July 2017 and may include the pre-July short malaria season. Similar relationships reported for Madagascar point to an epidemic risk for all East African highlands with around 150 million people. Preparedness for this high risk period would include pre-emptive intradomestic spraying with insecticides, adequate stocking of antimalarials, and spatial extension of diagnostic capacity and more frequent reporting to enable a rapid public health response when and where required.
在异常温暖的年份，热带高地疟疾会加剧并向更高海拔地区转移。北半球冬季月份（12月至3月）与厄尔尼诺现象相关的异常高温可能会加剧东非高地的疟疾疫情。我们评估了埃塞俄比亚最大的地区奥罗米亚的疟疾风险，该地区约有3000万居民。
基于1982年至2005年确诊的疟疾病例，采用简单线性回归和空间分析方法，将太平洋海表温度（SST）和埃塞俄比亚地表温度与奥罗米亚的年度疟疾风险关联起来。
发现疟疾与太平洋海表温度之间存在强关联（R = 0.6，P < 0.001），预计2016年8月至2017年7月期间疟疾风险将增加70%。2015年12月陆地表面温度升高（+1.6°C）为这一预测提供了定量支持。当有更多站点数据可用并能考虑到气象站2016年3月的平均温度时，可发布更可靠的预测。
已对埃塞俄比亚的奥罗米亚发布了2016年8月至2017年7月期间的疫情预警，可能包括7月前的短疟疾季节。马达加斯加报告的类似关系表明，约1.5亿人口的所有东非高地都存在疫情风险。针对这一高风险时期的准备工作将包括在国内预先喷洒杀虫剂、储备充足的抗疟药物、扩大诊断能力的空间范围以及更频繁地报告，以便在需要时能够迅速做出公共卫生应对。
