Swiss Tropical and Public Health Institute, Allschwil, Switzerland.
University of Basel, Basel, Switzerland.
Malar J. 2024 Sep 10;23(1):274. doi: 10.1186/s12936-024-05097-5.
Malaria remains an important public health problem, particularly in sub-Saharan Africa. In Rwanda, where malaria ranks among the leading causes of mortality and morbidity, disease transmission is influenced by climatic factors. However, there is a paucity of studies investigating the link between climate change and malaria dynamics, which hinders the development of effective national malaria response strategies. Addressing this critical gap, this study analyses how climatic factors influence malaria transmission across Rwanda, thereby informing tailored interventions and enhancing disease management frameworks.
The study analysed the potential impact of temperature and cumulative rainfall on malaria incidence in Rwanda from 2012 to 2021 using meteorological data from the Rwanda Meteorological Agency and malaria case records from the Rwanda Health Management and Information System. The analysis was performed in two stages. First, district-specific generalized linear models with a quasi-Poisson distribution were applied, which were enhanced by distributed lag non-linear models to explore non-linear and lagged effects. Second, random effects multivariate meta-analysis was employed to pool the estimates and to refine them through best linear unbiased predictions.
A 1-month lag with specific temperature and rainfall thresholds influenced malaria incidence across Rwanda. Average temperature of 18.5 °C was associated with higher malaria risk, while temperature above 23.9 °C reduced the risk. Rainfall demonstrated a dual effect on malaria risk: conditions of low (below 73 mm per month) and high (above 223 mm per month) precipitation correlated with lower risk, while moderate rainfall (87 to 223 mm per month) correlated with higher risk. Seasonal patterns showed increased malaria risk during the major rainy season, while the short dry season presented lower risk.
The study underscores the influence of temperature and rainfall on malaria transmission in Rwanda and calls for tailored interventions that are specific to location and season. The findings are crucial for informing policy that enhance preparedness and contribute to malaria elimination efforts. Future research should explore additional ecological and socioeconomic factors and their differential contribution to malaria transmission.
疟疾仍然是一个重要的公共卫生问题，特别是在撒哈拉以南非洲。在卢旺达，疟疾是导致死亡和发病的主要原因之一，疾病传播受到气候因素的影响。然而，关于气候变化与疟疾动态之间关系的研究很少，这阻碍了制定有效的国家疟疾应对策略。为了解决这一关键差距，本研究分析了气候因素如何影响卢旺达各地的疟疾传播，从而为有针对性的干预措施提供信息，并加强疾病管理框架。
本研究利用卢旺达气象局的气象数据和卢旺达卫生管理和信息系统的疟疾病例记录，分析了 2012 年至 2021 年期间温度和累积降雨量对卢旺达疟疾发病率的潜在影响。该分析分两个阶段进行。首先，应用具有拟泊松分布的特定地区广义线性模型，并通过分布式滞后非线性模型进行增强，以探索非线性和滞后效应。其次，采用随机效应多元荟萃分析来汇集估计值，并通过最佳线性无偏预测进行精炼。
卢旺达各地的疟疾发病率受到 1 个月滞后的特定温度和降雨量阈值的影响。平均温度为 18.5°C 与更高的疟疾风险相关，而温度高于 23.9°C 则降低了风险。降雨量对疟疾风险有双重影响：低降雨量（每月低于 73 毫米）和高降雨量（每月高于 223 毫米）条件与较低的风险相关，而中等降雨量（每月 87 至 223 毫米）与较高的风险相关。季节性模式显示主要雨季疟疾风险增加，而短暂的旱季风险较低。
本研究强调了温度和降雨量对卢旺达疟疾传播的影响，并呼吁采取针对特定地点和季节的有针对性的干预措施。研究结果对于制定增强准备工作和促进消除疟疾努力的政策至关重要。未来的研究应探索其他生态和社会经济因素及其对疟疾传播的差异贡献。
