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Mitchell CL, Janko MM, Verity R, Kashamuka MM, Bailey JA, Tshefu AK, Parr JB, Juliano JJ. Close Proximity to Mining Is Associated with Increased Prevalence of the Drug Resistance-Associated Mutation dhps540E in Eastern Democratic Republic of the Congo. Am J Trop Med Hyg 2024; 111:361-364. [PMID: 38861981 PMCID: PMC11310628 DOI: 10.4269/ajtmh.23-0355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 03/07/2024] [Indexed: 06/13/2024] Open
Abstract
Increasing sulfadoxine-pyrimethamine (SP) resistance in the Democratic Republic of the Congo (DRC) has threatened its use for prevention of malaria in one of the most malarious countries in the world. Using geographic information on mining operations in the DRC and genetic data on SP drug resistance markers from the 2013-2014 Demographic and Health Surveys, we evaluated associations between close residence to mining and the presence of mutations conferring resistance to sulfadoxine. Close residential proximity to mining was associated with increased prevalence odds ratio (POR) of the dhps540E mutation (POR: 2.11, 95% uncertainty interval: 1.15-3.96) with adjustments for confounding variables and space. Our findings indicate that exposure to mining is associated with increased presence of an antimalarial drug resistance haplotype that threatens effective use of SP for vulnerable populations. Areas actively engaged in mining could be considered for interventions to reduce the spread of emerging drug resistance in the DRC.
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Affiliation(s)
- Cedar L Mitchell
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Mark M Janko
- Duke Global Health Institute, Duke University, Durham, North Carolina
| | - Robert Verity
- Medical Research Council Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | - Melchior M Kashamuka
- Kinshasa School of Public Health, Kinshasa University, Kinshasa, Democratic Republic of the Congo
| | - Jeffrey A Bailey
- Department of Pathology and Laboratory Medicine, Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Antoinette K Tshefu
- Kinshasa School of Public Health, Kinshasa University, Kinshasa, Democratic Republic of the Congo
| | - Jonathan B Parr
- Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Jonathan J Juliano
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
- Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, North Carolina
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2
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de Souza WM, Weaver SC. Effects of climate change and human activities on vector-borne diseases. Nat Rev Microbiol 2024; 22:476-491. [PMID: 38486116 DOI: 10.1038/s41579-024-01026-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2024] [Indexed: 03/18/2024]
Abstract
Vector-borne diseases are transmitted by haematophagous arthropods (for example, mosquitoes, ticks and sandflies) to humans and wild and domestic animals, with the largest burden on global public health disproportionately affecting people in tropical and subtropical areas. Because vectors are ectothermic, climate and weather alterations (for example, temperature, rainfall and humidity) can affect their reproduction, survival, geographic distribution and, consequently, ability to transmit pathogens. However, the effects of climate change on vector-borne diseases can be multifaceted and complex, sometimes with ambiguous consequences. In this Review, we discuss the potential effects of climate change, weather and other anthropogenic factors, including land use, human mobility and behaviour, as possible contributors to the redistribution of vectors and spread of vector-borne diseases worldwide.
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Affiliation(s)
- William M de Souza
- Department of Microbiology, Immunology and Molecular Genetics, University of Kentucky, College of Medicine, Lexington, KY, USA
- World Reference Center for Emerging Viruses and Arboviruses, University of Texas Medical Branch, Galveston, TX, USA
- Institute for Human Infections and Immunity, University of Texas Medical Branch, Galveston, TX, USA
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, USA
- Global Virus Network, Baltimore, MD, USA
| | - Scott C Weaver
- World Reference Center for Emerging Viruses and Arboviruses, University of Texas Medical Branch, Galveston, TX, USA.
- Institute for Human Infections and Immunity, University of Texas Medical Branch, Galveston, TX, USA.
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX, USA.
- Global Virus Network, Baltimore, MD, USA.
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Barros JDA, Granja F, Silva DDSE, Citó AC, Peterka C, Ferreira-da-Cruz MDF. A snapshot of a representative Brazilian state of illegal mining in indigenous areas during the era of malaria elimination. CAD SAUDE PUBLICA 2024; 40:e00224023. [PMID: 39082563 PMCID: PMC11290832 DOI: 10.1590/0102-311xen224023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 03/20/2024] [Accepted: 03/29/2024] [Indexed: 08/02/2024] Open
Abstract
Malaria is a public health problem and the cases diagnosed in the capital of Roraima, Brazil, show potential to characterize the burden of the disease in the state. This study aimed to describe the epidemiological, clinical, and laboratory aspects of malaria cases diagnosed in Boa Vista. For this purpose, a descriptive, cross-sectional study was conducted in two health units in the city, with individuals diagnosed and who agreed to respond the questionnaire. Of the total of 206 participants, characterized as men, mixed-race, and young, 96% (198) reported participating in illegal mining activity. Among the group of miners, 66% (131) came from other states of Brazil or other countries. The mines were mainly located in the Yanomami territory in Roraima. Plasmodium vivax infection occurred in 74% (153) of participants. In the miner's group, hospitalizations for severe malaria, previous malaria attacks, and delays in treatment after the onset of symptoms were reported. Although 73% (145) of miners reported knowing how malaria was transmitted, only 54% (107) used mosquito nets or repellents. The use of Artecom and chloroquine by miners is not for the complete treatment but only to relieve symptoms for returning to gold mines, highlighting the importance of molecular surveillance to antimalarial resistance. Indigenous peoples are considered vulnerable to malaria and miners promotes the increase of malaria in Roraima Indigenous Lands. Therefore, access to diagnosis and treatment in Indigenous areas invaded by miners is imperative to confront this disease that ravages Indigenous communities and threatens public health on a large scale to achieve the goal of eliminating malaria in the state.
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Affiliation(s)
- Jacqueline de Aguiar Barros
- Coordenação Geral de Vigilância em Saúde, Secretaria de Estado da Saúde de Roraima, Boa Vista, Brasil
- Programa de Pós-graduação em Biodiversidade e Biotecnologia da Rede BIONORTE, Boa Vista, Brasil
| | - Fabiana Granja
- Programa de Pós-graduação em Biodiversidade e Biotecnologia da Rede BIONORTE, Boa Vista, Brasil
- Centro de Estudos da Biodiversidade, Universidade Federal de Roraima, Boa Vista, Brasil
| | | | - Arthur Camurça Citó
- Núcleo de Apoio à Pesquisa em Roraima, Instituto Nacional de Pesquisas da Amazônia, Boa Vista, Brasil
| | - Cássio Peterka
- Superintendência de Vigilância em Saúde do Amapá, Macapá, Brasil
| | - Maria de Fátima Ferreira-da-Cruz
- Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
- Centro de Pesquisa, Diagnóstico e Treinamento em Malária, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
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Sanna A, Suárez-Mutis M, Lambert Y, Carvalho L, Cairo H, Cox H, de Bort C, Gomes do Socorro Mendonça M, Forero-Peña DA, Gabaldón-Figueira JC, Grillet ME, Klein F, Lazarus C, Lazrek Y, Louzada J, Malafaia D, Marchesini P, Musset L, Oliveira-Ferreira J, Peterka C, Rousseau C, Roux E, Villegas L, Vreden S, Wiedner-Papin S, Laporta GZ, Hiwat H, Douine M. Cooperation for malaria control and elimination in the Guiana Shield. Lancet Glob Health 2024; 12:e875-e881. [PMID: 38614635 DOI: 10.1016/s2214-109x(24)00047-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 12/28/2023] [Accepted: 01/23/2024] [Indexed: 04/15/2024]
Abstract
The Guiana Shield, a small region of South America, is currently one of the main hotspots of malaria transmission on the continent. This Amazonian area is characterised by remarkable socioeconomic, cultural, health, and political heterogeneity and a high degree of regional and cross-border population mobility, which has contributed to the increase of malaria in the region in the past few years. In this context, regional cooperation to control malaria represents both a challenge and an indispensable initiative. This Viewpoint advocates for the creation of a regional cooperative mechanism for the elimination of malaria in the Guiana Shield. This strategy would help address operational and political obstacles to successful technical cooperation in the region and could contribute to reversing the regional upsurge in malaria incidence through creating a functional international control and elimination partnership.
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Affiliation(s)
- Alice Sanna
- French West Indies-French Guiana Center for Clinical Investigation (CIC Inserm 1424), Department of Research, Innovation, and Public Health, Cayenne Hospital, Cayenne, French Guiana, France.
| | - Martha Suárez-Mutis
- Laboratory of Parasitic Diseases, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil; International Joint Laboratory Sentinela, Fundação Oswaldo Cruz, University of Brasília, French National Research Institute for Sustainable Development, Rio de Janeiro, Brazil
| | - Yann Lambert
- French West Indies-French Guiana Center for Clinical Investigation (CIC Inserm 1424), Department of Research, Innovation, and Public Health, Cayenne Hospital, Cayenne, French Guiana, France
| | | | - Hedley Cairo
- National Malaria Program, Ministry of Health, Paramaribo, Suriname
| | - Horace Cox
- Vector-Borne Diseases Unit, Caribbean Public Health Agency, Port of Spain, Trinidad and Tobago
| | - Clara de Bort
- Regional Health Agency, Cayenne, French Guiana, France
| | | | - David A Forero-Peña
- Faculty of Medicine, Central University of Venezuela, Caracas, Venezuela; Biomedical Research and Therapeutic Vaccines Institute, Ciudad Bolívar, Venezuela
| | | | - Maria Eugenia Grillet
- Laboratory of Biology of Vectors and Parasites, Institute of Zoology and Tropical Ecology, Faculty of Sciences, Central University of Venezuela, Caracas, Venezuela
| | - François Klein
- Directorate General for Health, Ministry of Health and Prevention, Paris, France
| | - Clément Lazarus
- Directorate General for Health, Ministry of Health and Prevention, Paris, France
| | - Yassamine Lazrek
- Laboratory of Parasitology, Pasteur Institute in French Guiana, Cayenne, French Guiana, France
| | - Jaime Louzada
- Department of Nursing Science, Federal University of Roraima, Boa Vista, Brazil
| | - Dorinaldo Malafaia
- Vigifronteiras Program, Fundação Oswald Cruz, Rio de Janeiro, Brazil; Chamber of Deputies, National Congress, Brasília, Brazil
| | - Paola Marchesini
- Overall Coordination of Surveillance of Zoonoses and Vector-Borne Diseases, Ministry of Health of Brazil, Brasília, Brazil
| | - Lise Musset
- Laboratory of Parasitology, Pasteur Institute in French Guiana, Cayenne, French Guiana, France
| | - Joseli Oliveira-Ferreira
- Laboratory of Immunoparasitology, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Cassio Peterka
- Coordination of Malaria Elimination, Ministry of Health of Brazil, Brasília, Brazil
| | - Cyril Rousseau
- Division of Decentralized Primary Care Centers, Cayenne Hospital, Cayenne, French Guiana, France
| | - Emmanuel Roux
- ESPACE-DEV, French National Research Institute for Sustainable Development, University of Montpellier, University of the French West Indies, University of French Guiana, University of Reunion Island, and University of Perpignan Via Domitia, Montpellier, France; International Joint Laboratory Sentinela, Fundação Oswaldo Cruz, University of Brasília, French National Research Institute for Sustainable Development, Rio de Janeiro, Brazil
| | | | - Stephen Vreden
- Foundation for the Advancement of Scientific Research in Suriname, Paramaribo, Suriname
| | | | | | - Helene Hiwat
- National Malaria Program, Ministry of Health, Paramaribo, Suriname
| | - Maylis Douine
- French West Indies-French Guiana Center for Clinical Investigation (CIC Inserm 1424), Department of Research, Innovation, and Public Health, Cayenne Hospital, Cayenne, French Guiana, France
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Lopes-Rafegas I, Cox H, Mora T, Sicuri E. The contribution of risk perception and social norms to reported preventive behaviour against selected vector-borne diseases in Guyana. Sci Rep 2023; 13:16866. [PMID: 37803142 PMCID: PMC10558444 DOI: 10.1038/s41598-023-43991-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 10/01/2023] [Indexed: 10/08/2023] Open
Abstract
Preventing vector-borne diseases (VBDs) mainly relies on effective vector control tools and strategies, which in turn depend on population acceptance and adherence. Inspired by the abundant recent literature on SARS-COV-2, we investigate the relationship between risk perception and preventive behaviour for selected VBDs and the extent to which risk perception is determined by social norms. We use cross-sectional data collected from 497 individuals in four regions of Guyana in 2017. We use a conditional mixed process estimator with multilevel coefficients, estimated through a Generalized Linear Model (GLM) framework, applying a simultaneous equation structure. We find robust results on malaria: risk perception was significantly influenced by the risk perception of the reference group across different definitions of the reference group, hinting at the existence of social norms. Risk perception significantly increased the likelihood of passive behaviour by 4.48%. Less clear-cut results were found for dengue. This study applies quantitative social science methods to public health issues in the context of VBDs. Our findings point to the relevance of tailoring communications on health risks for VBDs to groups defined at the intersection of socio-economic and demographic characteristics. Such tailored strategies are expected to align risk perception among reference groups and boost preventive behaviour.
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Affiliation(s)
| | - Horace Cox
- Vector Control Services, Ministry of Health, Georgetown, Guyana
| | - Toni Mora
- Research Institute for Evaluation and Public Policies (IRAPP), Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Elisa Sicuri
- ISGlobal, Hospital Clínic Universitat de Barcelona, Barcelona, Spain.
- LSE Health, London School of Economics and Political Science, London, UK.
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Hasyim H, Dewi WC, Lestari RAF, Flora R, Novrikasari N, Liberty IA, Marini H, Elagali A, Herlinda S, Maharani FE. Risk factors of malaria transmission in mining workers in Muara Enim, South Sumatra, Indonesia. Sci Rep 2023; 13:14755. [PMID: 37679466 PMCID: PMC10484942 DOI: 10.1038/s41598-023-40418-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 08/09/2023] [Indexed: 09/09/2023] Open
Abstract
Eliminating malaria by 2030 is stated as goal three in the UN's Sustainable Development Goals (SDGs). However, malaria still remains a significant public health problem. This study aims to identify the factors determining malaria transmission in artisanal or small-scale miner (ASM) communities in three villages: Tanjung Agung, Tanjung Lalang, and Penyandingan, located in the Tanjung Enim District, Muara Enim, South Sumatra, Indonesia. Researchers conducted a cross-sectional study involving 92 participants from the study area. They used a logistic regression model to investigate the risk factors related to malaria occurrence. The multivariable analysis revealed that age (Adjusted Prevalence Ratio (APR) = 7.989 with 95% CI 1.724-37.002) and mosquito breeding (APR = 7.685 with 95% CI 1.502-39.309) were risk factors for malaria. On the other hand, higher education (APR = 0.104 with 95% CI 0.027-0.403), the use of mosquito repellent (APR = 0.138 with 95% CI 0.035-0.549), and the condition of house walls (APR = 0.145 with 95% CI 0.0414-0.511) were identified as protective factors. The current study highlights age and mosquito breeding sites as risk factors for malaria. Additionally, higher education, insect repellent use, and the condition of house walls are protective factors against malaria. Therefore, reducing risk factors and increasing protective measures through effective communication, information, and education are highly recommended to eliminate malaria in mining areas.
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Affiliation(s)
- Hamzah Hasyim
- Faculty of Public Health, Universitas Sriwijaya, Palembang, Indonesia.
- Faculty of Medicine, Institute for Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Frankfurt Am Main, Germany.
| | - Wita Citra Dewi
- Faculty of Public Health, Universitas Sriwijaya, Palembang, Indonesia
| | | | - Rostika Flora
- Faculty of Public Health, Universitas Sriwijaya, Palembang, Indonesia
| | | | - Iche Andriyani Liberty
- Faculty of Medicine, Department of Public Health and Community Medicine, Universitas Sriwijaya, Palembang, Indonesia
| | - Heni Marini
- Faculty of Public Health, Universitas Sriwijaya, Palembang, Indonesia
| | - Ahmed Elagali
- School of Biological Sciences, The University of Western Australia, Perth, Australia
- Minderoo Foundation, Perth, Australia
| | - Siti Herlinda
- Faculty of Agriculture, Department of Plant Protection, Universitas Sriwijaya, Palembang, Indonesia
- Research Center for Sub-Optimal Lands (PUR-PLSO), Universitas Sriwijaya, Palembang, Indonesia
| | - Fadhilah Eka Maharani
- Faculty of Mathematics and Natural Sciences, Biology Department, Universitas Sriwijaya, Palembang, Indonesia
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7
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Carrasquilla M, Early AM, Taylor AR, Knudson Ospina A, Echeverry DF, Anderson TJC, Mancilla E, Aponte S, Cárdenas P, Buckee CO, Rayner JC, Sáenz FE, Neafsey DE, Corredor V. Resolving drug selection and migration in an inbred South American Plasmodium falciparum population with identity-by-descent analysis. PLoS Pathog 2022; 18:e1010993. [PMID: 36542676 PMCID: PMC9815574 DOI: 10.1371/journal.ppat.1010993] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 01/05/2023] [Accepted: 11/09/2022] [Indexed: 12/24/2022] Open
Abstract
The human malaria parasite Plasmodium falciparum is globally widespread, but its prevalence varies significantly between and even within countries. Most population genetic studies in P. falciparum focus on regions of high transmission where parasite populations are large and genetically diverse, such as sub-Saharan Africa. Understanding population dynamics in low transmission settings, however, is of particular importance as these are often where drug resistance first evolves. Here, we use the Pacific Coast of Colombia and Ecuador as a model for understanding the population structure and evolution of Plasmodium parasites in small populations harboring less genetic diversity. The combination of low transmission and a high proportion of monoclonal infections means there are few outcrossing events and clonal lineages persist for long periods of time. Yet despite this, the population is evolutionarily labile and has successfully adapted to changes in drug regime. Using newly sequenced whole genomes, we measure relatedness between 166 parasites, calculated as identity by descent (IBD), and find 17 distinct but highly related clonal lineages, six of which have persisted in the region for at least a decade. This inbred population structure is captured in more detail with IBD than with other common population structure analyses like PCA, ADMIXTURE, and distance-based trees. We additionally use patterns of intra-chromosomal IBD and an analysis of haplotypic variation to explore past selection events in the region. Two genes associated with chloroquine resistance, crt and aat1, show evidence of hard selective sweeps, while selection appears soft and/or incomplete at three other key resistance loci (dhps, mdr1, and dhfr). Overall, this work highlights the strength of IBD analyses for studying parasite population structure and resistance evolution in regions of low transmission, and emphasizes that drug resistance can evolve and spread in small populations, as will occur in any region nearing malaria elimination.
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Affiliation(s)
- Manuela Carrasquilla
- Department of Immunology and Infectious Diseases, Harvard T.H.Chan School of Public Health, Boston, Massachusetts, United States of America
- Infectious Disease and Microbiome Program, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, United States of America
| | - Angela M. Early
- Department of Immunology and Infectious Diseases, Harvard T.H.Chan School of Public Health, Boston, Massachusetts, United States of America
- Infectious Disease and Microbiome Program, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, United States of America
| | - Aimee R. Taylor
- Infectious Disease and Microbiome Program, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, United States of America
- Center for Communicable Disease Dynamics, Harvard T.H.Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Angélica Knudson Ospina
- Departamento de Microbiología, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Diego F. Echeverry
- Departamento de Microbiología, Facultad de Salud, Universidad del Valle, Cali, Colombia
- Centro Internacional de Entrenamiento e Investigaciones Médicas (CIDEIM), Cali, Colombia
| | - Timothy J. C. Anderson
- Program in Disease Intervention and Prevention, Texas Biomedical Research Institution, San Antonio, Texas, United States of America
| | - Elvira Mancilla
- Secretaría Departamental de Salud del Cauca, Popayán, Colombia
| | - Samanda Aponte
- Departamento de Salud Pública, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia
| | - Pablo Cárdenas
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
| | - Caroline O. Buckee
- Center for Communicable Disease Dynamics, Harvard T.H.Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Julian C. Rayner
- Wellcome Sanger Institute, Hinxton, Cambridge, United Kingdom
- Cambridge Institute for Medical Research, University of Cambridge, Cambridge, United Kingdom
| | - Fabián E. Sáenz
- Centro de Investigación para la Salud en América Latina, Facultad de Ciencias Exactas y Naturales, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
| | - Daniel E. Neafsey
- Department of Immunology and Infectious Diseases, Harvard T.H.Chan School of Public Health, Boston, Massachusetts, United States of America
- Infectious Disease and Microbiome Program, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, United States of America
| | - Vladimir Corredor
- Departamento de Salud Pública, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia
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8
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Fletcher IK, Grillet ME, Moreno JE, Drakeley C, Hernández-Villena J, Jones KE, Lowe R. Synergies between environmental degradation and climate variation on malaria re-emergence in southern Venezuela: a spatiotemporal modelling study. Lancet Planet Health 2022; 6:e739-e748. [PMID: 36087604 PMCID: PMC10265648 DOI: 10.1016/s2542-5196(22)00192-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 07/26/2022] [Accepted: 07/28/2022] [Indexed: 05/20/2023]
Abstract
BACKGROUND Environmental degradation facilitates the emergence of vector-borne diseases, such as malaria, through changes in the ecological landscape that increase human-vector contacts and that expand vector habitats. However, the modifying effects of environmental degradation on climate-disease relationships have not been well explored. Here, we investigate the rapid re-emergence of malaria in a transmission hotspot in southern Venezuela and explore the synergistic effects of environmental degradation, specifically gold-mining activity, and climate variation. METHODS In this spatiotemporal modelling study of the 46 parishes of the state of Bolívar, southeast Venezuela, we used data from the Venezuelan Ministry of Health including population data and monthly cases of Plasmodium falciparum malaria and Plasmodium vivax malaria between 1996 and 2016. We estimated mean precipitation and temperature using the ERA5-Land dataset and used monthly anomalies in sea-surface temperature as an indicator of El Niño events between 1996 and 2016. The location of suspected mining sites in Bolívar in 2009, 2017, and 2018 were sourced from the Amazon Geo-Referenced Socio-Environmental Information Network. We estimated measures of cumulative forest loss and urban development by km2 using annual land cover maps from the European Space Agency Climate Change Initiative between 1996 and 2016. We modelled monthly cases of P falciparum and P vivax malaria using a Bayesian hierarchical mixed model framework. We quantified the variation explained by mining activity before exploring the modifying effects of environmental degradation on climate-malaria relationships. FINDINGS We observed a 27% reduction in the additional unexplained spatial variation in incidence of P falciparum malaria and a 23% reduction in P vivax malaria when mining was included in our models. The effect of temperature on malaria was greater in high mining areas than low mining areas, and the P falciparum malaria effect size at temperatures of 26·5°C (2·4 cases per 1000 people [95% CI 1·78-3·06]) was twice as high as the effect in low mining areas (1 case per 1000 people [0·68-1·49]). INTERPRETATION We show that mining activity in southern Venezuela is associated with hotspots of malaria transmission. Increased temperatures exacerbated malaria transmission in mining areas, highlighting the need to consider how environmental degradation modulates climate effect on disease risk, which is especially important in areas subjected to rapidly rising temperatures and land-use change globally. Our findings have implications for the progress towards malaria elimination in the Latin American region. Our findings are also important for effectively targeting timely treatment programmes and vector-control activities in mining areas with high rates of malaria transmission. FUNDING Biotechnology and Biological Sciences Research Council, Royal Society, US National Institutes of Health, and Global Challenges Research Fund. TRANSLATION For the Spanish translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Isabel K Fletcher
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK; Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK.
| | - Maria Eugenia Grillet
- Instituto de Zoología y Ecología Tropical, Facultad de Ciencias, Universidad Central de Venezuela, Caracas, Venezuela
| | - Jorge E Moreno
- Centro de Investigaciones Francesco Vitanza, Servicio Autónomo Instituto de Altos Estudios Dr Arnoldo Gabaldon, Ministerio del Poder Popular para la Salud, Bolívar, Venezuela
| | - Chris Drakeley
- Department of Infection Biology, London School of Hygiene & Tropical Medicine, London, UK
| | - Juan Hernández-Villena
- Instituto de Zoología y Ecología Tropical, Facultad de Ciencias, Universidad Central de Venezuela, Caracas, Venezuela
| | - Kate E Jones
- Centre for Biodiversity and Environment Research, University College London, London, UK
| | - Rachel Lowe
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK; Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK; Barcelona Supercomputing Center, Barcelona, Spain; Catalan Institution for Research and Advanced Studies, Barcelona, Spain
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