Health impacts of climate change and ozone depletion: an ecoepidemiologic modeling approach

Early childhood caries, climate change and the sustainable development goal 13: a scoping review

BACKGROUND

Sustainable development goal 13 centres on calls for urgent action to combat climate change and its impacts. The aim of this scoping review was to map the published literature for existing evidence on the association between the Sustainable Development Goal (SDG) 13 and early childhood caries (ECC).

METHODS

The scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. In August 2023, a search was conducted in PubMed, Web of Science, and Scopus using search terms related to SDG13 and ECC. Only English language publications were extracted. There was no restriction on the type of publications included in the study. A summary of studies that met the inclusion criteria was conducted highlighting the countries where the studies were conducted, the study designs employed, the journals (dental/non-dental) in which the studies were published, and the findings. In addition, the SDG13 indicators to which the study findings were linked was reported.

RESULTS

The initial search yielded 113 potential publications. After removing 57 duplicated papers, 56 publications underwent title and abstract screening, and two studies went through full paper review. Four additional papers were identified from websites and searching the references of the included studies. Two of the six retrieved articles were from India, and one was China, Japan, the United States, and the United Kingdom respectively. One paper was based on an intervention simulation study, two reported findings from archeologic populations and three papers that were commentaries/opinions. In addition, four studies were linked to SDG 13.1 and they suggested an increased risk for caries with climate change. Two studies were linked to SDG 13.2 and they suggested that the practice of pediatric dentistry contributes negatively to environmental degradation. One study provided evidence on caries prevention management strategies in children that can reduce environmental degradation.

CONCLUSION

The evidence on the links between SDG13 and ECC suggests that climate change may increase the risk for caries, and the management of ECC may increase environmental degradation. However, there are caries prevention strategies that can reduce the negative impact of ECC management on the environment. Context specific and inter-disciplinary research is needed to generate evidence for mitigating the negative bidirectional relationships between SDG13 and ECC.

Visualization and Analysis of Air Pollution and Human Health Based on Cluster Analysis: A Bibliometric Review from 2001 to 2021

Bibliometric techniques and social network analysis are employed in this study to evaluate 14,955 papers on air pollution and health that were published from 2001 to 2021. To track the research hotspots, the principle of machine learning is applied in this study to divide 10,212 records of keywords into 96 clusters through OmniViz software. Our findings highlight strong research interests and the practical need to control air pollution to improve human health, as evidenced by an annual growth rate of over 15.8% in the related publications. The cluster analysis showed that clusters C22 (exposure, model, mortality) and C8 (health, environment, risk) are the most popular topics in this field of research. Furthermore, we develop co-occurrence networks based on the cluster analysis results in which a more specific keyword classification was obtained. These key areas include: "Air pollutant source", "Exposure-Response relationship", "Public & Occupational Health", and so on. Future research hotspots are analyzed through characteristics of the cluster groups, including the advancement of health risk assessment techniques, an interdisciplinary approach to quantifying human exposure to air pollution, and strategies in health risk assessment.

Lessons for green management from the Hispanic Civil Rights movement: a pseudo-gap analysis

Purpose

Although green management has gained legitimacy as a sustainable business practice, little is known about the elements that will lead to the long-term success of the movement. To identify these elements, this study aims to review the existing literature on social movements and analyzes archival data from a specific social undertaking, the Hispanic Civil Rights movement in the USA.

Design/methodology/approach

A historiographical approach was used in which systematic combining used abductive logic to developed a provisional framework based on the interpretation of secondary sources of data concerning the Hispanic Civil Rights movement. Subsequently, an ethnomethodologically informed interpretation of primary data based on the League of United Latin American Citizens (LULAC) archives refined the provisional framework.

Findings

The authors identified common elements that are critical to the success of social movements, as supported by both secondary data on the Hispanic Civil Rights movement and primary data based on the LULAC archives. These elements consist of: ideology, identity, mobilization, goals, leadership and integration. Using these results, a pseudo-gap analysis approach was completed by systematically comparing the interpretive data with current knowledge of the green management movement to identify the missing gaps and to offer guidance for further development of green management as a contemporary movement.

Social implications

Applying the lessons learned from social movements will help the development and prosperity of the green movement in current business organizations. Such applications are important, given that local and global environmental crises can have profound implications on ecosystems, economics and social systems.

Originality/value

Social movements are an important means by which societal concerns such as injustices are addressed. By identifying the important elements needed for the green management movement to be successful in the long term, managers will know where to put their efforts. Such actions may help environmental awareness in business organizations to become more than a fad or marketing tool.

Cancer and climate change

The acute impact of climate change on human health is receiving increased attention, but little is known or appreciated about the effect of climate change on chronic diseases, particularly cancer. This Review provides a synopsis of what is known about climate change and the exposures it generates relevant to cancer. In the context of the world's cancer burden and the probable direction we could expect to follow in the absence of climate change, this scoping review of the literature summarises the effects that climate change is having on major cancers, from environmental exposures to ultraviolet radiation, air pollution, disruptions in the food and water supply, environmental toxicants, and infectious agents. Finally, we explore the effect of climate change on the possible disruption of health systems that have been essential to cancer control practice. We conclude with potential responses and opportunities for intervention.

The effect of climate change on yellow fever disease burden in Africa

Yellow Fever (YF) is an arbovirus endemic in tropical regions of South America and Africa and it is estimated to cause 78,000 deaths a year in Africa alone. Climate change may have substantial effects on the transmission of YF and we present the first analysis of the potential impact on disease burden. We extend an existing model of YF transmission to account for rainfall and a temperature suitability index and project transmission intensity across the African endemic region in the context of four climate change scenarios. We use these transmission projections to assess the change in burden in 2050 and 2070. We find disease burden changes heterogeneously across the region. In the least severe scenario, we find a 93.0%[95%CI(92.7, 93.2%)] chance that annual deaths will increase in 2050. This change in epidemiology will complicate future control efforts. Thus, we may need to consider the effect of changing climatic variables on future intervention strategies.

Priorities in prevention and control of flood hazards in Iran 2019 massive flood

Global climate change leads to an increasing in the number and severity of weather events such as floods. Floods have been reported one-half of all weather-associated disasters with high impacts on countries. Global warming causes a different pattern of rainfall in Iran caused long-term drought since 30 years ago and recent heavy raining which lead to a massive flood in this country. It is predicted that health subsequences of Iran 2019 flood such as communicable diseases vary due to the geographical extent and different climates of flooded areas. However, observing long term and short term preventive measures can be effective to reduce the high impact of flood in Iran.

Effects of extreme temperatures on cerebrovascular mortality in Lisbon: a distributed lag non-linear model

Cerebrovascular diseases are the leading cause of mortality in Portugal, especially when related with extreme temperatures. This study highlights the impacts of the exposure-response relationship or lagged effect of low and high temperatures on cerebrovascular mortality, which can be important to reduce the health burden from cerebrovascular diseases. The purpose of this study was to assess the effects of weather on cerebrovascular mortality, measured by ambient temperature in the District of Lisbon, Portugal. A quasi-Poisson generalized additive model combined with a distributed lag non-linear model was applied to estimate the delayed effects of temperature on cerebrovascular mortality up to 30 days. With reference to minimum mortality temperature threshold of 22 °C, there was a severe risk (RR = 2.09, 95% CI 1.74, 2.51) of mortality for a 30-day-cumulative exposure to extreme cold temperatures of 7.3 °C (1st percentile). Similarly, the cumulative effect of a 30-day exposure to an extreme hot temperature of 30 °C (99th percentile) was 52% (RR = 1.65, 95% CI 1.37, 1.98) higher than same-day exposure. Over the 13 years of study, non-linear effects of temperature on mortality were identified, and the probability of dying from cerebrovascular disease in Lisbon was 7% higher in the winter than in the summer. The findings of this study provide a baseline for future public health prevention programs on weather-related mortality.

Bootstrap approach to validate the performance of models for predicting mortality risk temperature in Portuguese Metropolitan Areas

BACKGROUND

There has been increasing interest in assessing the impacts of extreme temperatures on mortality due to diseases of the circulatory system. This is further relevant for future climate scenarios where marked changes in climate are expected. This paper presents a solid method do identify the relationship between extreme temperatures and mortality risk by using as predictors simulated temperature data for cold and hot conditions in two urban areas in Portugal.

METHODS

Based on the mortality and meteorological data from Porto Metropolitan Area (PMA) and Lisbon Metropolitan Area (LMA), a distributed lag nonlinear model (DLNM) was implemented to estimate the temperature effects on mortality due to diseases of the circulatory system. The performance of the models was validated via bootstrapping approaching by creating resamples with replacement from the validating data. Bootstrapping was also used to identify the best candidate model and to evaluate the sensitivity of the spline functions to the exposure-lag-response relationship.

RESULTS

It is found that the model is able to reproduce the temperature-related mortality risk for two metropolitan areas. Temperature previously simulated by climate models is useful and even better than observed temperature. Although, the biases in predictions in both metropolitan areas are low, mortality risk predictions in PMA are more accurate than in LMA. Using parametric bootstrapping, we found that the overall cumulative association estimated under different bi-dimensional exposure-lag-response relationship are relatively stable, especially for the model selected by Quasi-Akaike Information Criteria (QAIC). Exposure to summer temperature conditions is best related to mortality risk. The association between winter temperature and mortality risk is somewhat less strong.

CONCLUSIONS

The use of QAIC to choose from several candidate models provides valid predictions and reduced the uncertainty in the estimated relative risk for circulatory disease mortality. Our findings can be applied to better understand the characteristics and facilitate the prevention of circulatory disease mortality in Porto and Lisbon Metropolitan Areas, namely if we consider the actual context of climate change.

Insecticide Resistance Associated with kdr Mutations in Aedes albopictus: An Update on Worldwide Evidences

Insecticide resistance is an increasing problem worldwide that limits the efficacy of control methods against several pests of health interest. Among them, Aedes albopictus mosquitoes are efficient vectors of relevant pathogens causing animal and human diseases worldwide, including yellow fever, chikungunya, dengue, and Zika. Different mechanisms are associated in conferring resistance to chemical insecticides. One of the most widespread and analysed mechanisms is the knockdown resistance (kdr) causing resistance to DDT and pyrethroids. The mechanism is associated with mutations in the voltage sensitive sodium channel, which is involved in beginning and propagation of action potentials in nervous cells. The mechanism was originally discovered in the housefly and then it was found in a large number of arthropods. In 2011, a kdr associated mutation was evidenced for the first time in A. albopictus and afterward several evidences were reported in the different areas of the world, including China, USA, Brazil, India, and Mediterranean Countries. This review aims to update and summarize current evidences on kdr in A. albopictus, in order to stimulate further researches to analyse in depth A. albopictus resistance status across the world, especially in countries where the presence of this vector is still an emerging issue. Such information is currently needed given the well-known vector role of A. albopictus in the transmission of severe infectious diseases. Furthermore, the widespread use of chemical insecticides for control strategies against A. albopictus progressively lead to pressure selection inducing the rise of insecticide resistance-related mutations in the species. Such event is especially evident in some countries as China, often related to a history of uncontrolled use of chemical insecticides. Thus, a careful picture on the diffusion of kdr mutations worldwide represents a milestone for the implementation of control plans and the triggering of novel research on alternative strategies for mosquito-borne infections.

The seasonal influence of climate and environment on yellow fever transmission across Africa

Background

Yellow fever virus (YFV) is a vector-borne flavivirus endemic to Africa and Latin America. Ninety per cent of the global burden occurs in Africa where it is primarily transmitted by Aedes spp, with Aedes aegypti the main vector for urban yellow fever (YF). Mosquito life cycle and viral replication in the mosquito are heavily dependent on climate, particularly temperature and rainfall. We aimed to assess whether seasonal variations in climatic factors are associated with the seasonality of YF reports.

Methodology/Principal findings

We constructed a temperature suitability index for YFV transmission, capturing the temperature dependence of mosquito behaviour and viral replication within the mosquito. We then fitted a series of multilevel logistic regression models to a dataset of YF reports across Africa, considering location and seasonality of occurrence for seasonal models, against the temperature suitability index, rainfall and the Enhanced Vegetation Index (EVI) as covariates alongside further demographic indicators. Model fit was assessed by the Area Under the Curve (AUC), and models were ranked by Akaike’s Information Criterion which was used to weight model outputs to create combined model predictions. The seasonal model accurately captured both the geographic and temporal heterogeneities in YF transmission (AUC = 0.81), and did not perform significantly worse than the annual model which only captured the geographic distribution. The interaction between temperature suitability and rainfall accounted for much of the occurrence of YF, which offers a statistical explanation for the spatio-temporal variability in transmission.

Conclusions/Significance

The description of seasonality offers an explanation for heterogeneities in the West-East YF burden across Africa. Annual climatic variables may indicate a transmission suitability not always reflected in seasonal interactions. This finding, in conjunction with forecasted data, could highlight areas of increased transmission and provide insights into the occurrence of large outbreaks, such as those seen in Angola, the Democratic Republic of the Congo and Brazil.

In this article, we describe the development of a model to quantify the seasonal dynamics of yellow fever virus (YFV) transmission across Africa. YFV is a flavivirus transmitted, within Africa, primarily by Aedes spp where it causes an estimated 78,000 deaths a year despite the presence of a safe and effective vaccine. The importance of sufficient vaccination, made difficult by a global shortage, has been highlighted by recent large scale, devastating, outbreaks in Angola, the Democratic Republic of the Congo and Brazil. Here we describe a novel way of parameterising the effect of temperature on YFV transmission and implement statistical models to predict both the geographic and temporal heterogeneities in transmissions, while demonstrating their robustness in comparison to models simply predicting geographic distribution. We believe this quantification of seasonality could lead to more precise applications of vaccination campaigns and vector-control programmes. In turn this would help maximise their impact, especially vital with limited resources, and could contribute to lessening the risk of large scale outbreaks. Not only this, but the methods described here could be applied to other Aedes-borne diseases and as such provide a useful tool in understanding, and combatting, several other important diseases such as dengue and zika.

Environmental Determinants of Malaria Transmission Around the Koka Reservoir in Ethiopia

New dam construction is known to exacerbate malaria transmission in Africa as the vectors of malaria-Anopheles mosquitoes-use bodies of water as breeding sites. Precise environmental mechanisms of how reservoirs exacerbate malaria transmission are yet to be identified. Understanding of these mechanisms should lead to a better assessment of the impacts of dam construction and to new prevention strategies. Combining extensive multiyear field surveys around the Koka Reservoir in Ethiopia and rigorous model development and simulation studies, environmental mechanisms of malaria transmission around the reservoir were examined. Most comprehensive and detailed malaria transmission model, Hydrology, Entomology, and Malaria Transmission Simulator, was applied to a village adjacent to the reservoir. Significant contributions to the dynamics of malaria transmission are shaped by wind profile, marginal pools, temperature, and shoreline locations. Wind speed and wind direction influence Anopheles populations and malaria transmission during the major and secondary mosquito seasons. During the secondary mosquito season, a noticeable influence was also attributed to marginal pools. Temperature was found to play an important role, not so much in Anopheles population dynamics, but in malaria transmission dynamics. Change in shoreline locations drives malaria transmission dynamics, with closer shoreline locations to the village making malaria transmission more likely. Identified environmental mechanisms help in predicting malaria transmission seasons and in developing village relocation strategies upon dam construction to minimize the risk of malaria.

Modelling and observing the role of wind in Anopheles population dynamics around a reservoir

BACKGROUND

Wind conditions, as well as other environmental conditions, are likely to influence malaria transmission through the behaviours of Anopheles mosquitoes, especially around water-resource reservoirs. Wind-induced waves in a reservoir impose mortality on aquatic-stage mosquitoes. Mosquitoes' host-seeking activity is also influenced by wind through dispersion of [Formula: see text]. However, no malaria transmission model exists to date that simulated those impacts of wind mechanistically.

METHODS

A modelling framework for simulating the three important effects of wind on the behaviours of mosquito is developed: attraction of adult mosquitoes through dispersion of [Formula: see text] ([Formula: see text] attraction), advection of adult mosquitoes (advection), and aquatic-stage mortality due to wind-induced surface waves (waves). The framework was incorporated in a mechanistic malaria transmission simulator, HYDREMATS. The performance of the extended simulator was compared with the observed population dynamics of the Anopheles mosquitoes at a village adjacent to the Koka Reservoir in Ethiopia.

RESULTS

The observed population dynamics of the Anopheles mosquitoes were reproduced with some reasonable accuracy in HYDREMATS that includes the representation of the wind effects. HYDREMATS without the wind model failed to do so. Offshore wind explained the increase in Anopheles population that cannot be expected from other environmental conditions alone.

CONCLUSIONS

Around large water bodies such as reservoirs, the role of wind in the dynamics of Anopheles population, hence in malaria transmission, can be significant. Modelling the impacts of wind on the behaviours of Anopheles mosquitoes aids in reproducing the seasonality of malaria transmission and in estimation of the risk of malaria around reservoirs.

Modeling Lyme disease transmission

Lyme disease, a typical tick-borne disease, imposes increasing global public health challenges. A growing body of theoretical models have been proposed to better understand various factors determining the disease risk, which not only enrich our understanding on the ecological cycle of disease transmission but also promote new theoretical developments on model formulation, analysis and simulation. In this paper, we provide a review about the models and results we have obtained recently on modeling and analyzing Lyme disease transmission, with the purpose to highlight various aspects in the ecological cycle of disease transmission to be incorporated, including the growth of ticks with different stages in the life cycle, the seasonality, host diversity, spatial disease pattern due to host short distance movement and bird migration, co-infection with other tick-borne pathogens, and climate change impact.

Modeling the Response of Anopheles gambiae (Diptera: Culicidae) Populations in the Kenya Highlands to a Rise in Mean Annual Temperature

A dynamical model of Anopheles gambiae larval and adult populations is constructed that matches temperature-dependent maturation times and mortality measured experimentally as well as larval instar and adult mosquito emergence data from field studies in the Kenya Highlands. Spectral classification of high-resolution satellite imagery is used to estimate household density. Indoor resting densities collected over a period of one year combined with predictions of the dynamical model give estimates of both aquatic habitat and total adult mosquito densities. Temperature and precipitation patterns are derived from monthly records. Precipitation patterns are compared with average and extreme habitat estimates to estimate available aquatic habitat in an annual cycle. These estimates are coupled with the original model to produce estimates of adult and larval populations dependent on changing aquatic carrying capacity for larvae and changing maturation and mortality dependent on temperature. This paper offers a general method for estimating the total area of aquatic habitat in a given region, based on larval counts, emergence rates, indoor resting density data, and number of households.Altering the average daily temperature and the average daily rainfall simulates the effect of climate change on annual cycles of prevalence of An. gambiae adults. We show that small increases in average annual temperature have a large impact on adult mosquito density, whether measured at model equilibrium values for a single square meter of habitat or tracked over the course of a year of varying habitat availability and temperature.

Zika and chikungunya: mosquito-borne viruses in a changing world

The reemergence and growing burden of mosquito-borne virus infections have incited public fear and growing research efforts to understand the mechanisms of infection-associated health outcomes and to provide better approaches for mosquito vector control. While efforts to develop therapeutics, vaccines, and novel genetic mosquito-control technologies are underway, many important underlying ecological questions remain that could significantly enhance our understanding and ability to predict and prevent transmission. Here, we review the current knowledge about the transmission ecology of two recent arbovirus invaders, the chikungunya and Zika viruses. We introduce the viruses and mosquito vectors, highlighting viral biology, historical routes of transmission, and viral mechanisms facilitating rapid global invasion. In addition, we review factors contributing to vector global invasiveness and transmission efficiency. We conclude with a discussion of how human-induced biotic and abiotic environmental changes facilitate mosquito-borne virus transmission, emphasizing critical gaps in understanding. These knowledge gaps are tremendous; much of our data on basic mosquito ecology in the field predate 1960, and the mosquitoes themselves, as well as the world they live in, have substantially changed. A concerted investment in understanding the basic ecology of these vectors, which serve as the main drivers of pathogen transmission in both wildlife and human populations, is now more important than ever.

Projections of hepatitis A virus infection associated with flood events by 2020 and 2030 in Anhui Province, China

Assessing and responding to health risk of climate change is important because of its impact on the natural and societal ecosystems. More frequent and severe flood events will occur in China due to climate change. Given that population is projected to increase, more people will be vulnerable to flood events, which may lead to an increased incidence of HAV infection in the future. This population-based study is going to project the future health burden of HAV infection associated with flood events in Huai River Basin of China. The study area covered four cities of Anhui province in China, where flood events were frequent. Time-series adjusted Poisson regression model was developed to quantify the risks of flood events on HAV infection based on the number of daily cases during summer seasons from 2005 to 2010, controlling for other meteorological variables. Projections of HAV infection in 2020 and 2030 were estimated based on the scenarios of flood events and demographic data. Poisson regression model suggested that compared with the periods without flood events, the risks of severe flood events for HAV infection were significant (OR = 1.28, 95 % CI 1.05-1.55), while risks were not significant from moderate flood events (OR = 1.16, 95 % CI 0.72-1.87) and mild flood events (OR = 1.14, 95 % CI 0.87-1.48). Using the 2010 baseline data and the flood event scenarios (one severe flood event), increased incidence of HAV infection were estimated to be between 0.126/10⁵ and 0.127/10⁵ for 2020. Similarly, the increased HAV infection incidence for 2030 was projected to be between 0.382/10⁵ and 0.399/10⁵. Our study has, for the first time, quantified the increased incidence of HAV infection that will result from flood events in Anhui, China, in 2020 and 2030. The results have implications for public health preparation for developing public health responses to reduce HAV infection during future flood events.

A climate-driven mechanistic population model of Aedes albopictus with diapause

Background

The mosquito Aedes albopitus is a competent vector for the transmission of many blood-borne pathogens. An important factor that affects the mosquitoes’ development and spreading is climate, such as temperature, precipitation and photoperiod. Existing climate-driven mechanistic models overlook the seasonal pattern of diapause, referred to as the survival strategy of mosquito eggs being dormant and unable to hatch under extreme weather. With respect to diapause, several issues remain unaddressed, including identifying the time when diapause eggs are laid and hatched under different climatic conditions, demarcating the thresholds of diapause and non-diapause periods, and considering the mortality rate of diapause eggs.

Methods

Here we propose a generic climate-driven mechanistic population model of Ae. albopitus applicable to most Ae. albopictus-colonized areas. The new model is an improvement over the previous work by incorporating the diapause behaviors with many modifications to the stage-specific mechanism of the mosquitoes’ life-cycle. monthly Container Index (CI) of Ae. albopitus collected in two Chinese cities, Guangzhou and Shanghai is used for model validation.

Results

The simulation results by the proposed model is validated with entomological field data by the Pearson correlation coefficient r² in Guangzhou (r² = 0.84) and in Shanghai (r² = 0.90). In addition, by consolidating the effect of diapause-related adjustments and temperature-related parameters in the model, the improvement is significant over the basic model.

Conclusions

The model highlights the importance of considering diapause in simulating Ae. albopitus population. It also corroborates that temperature and photoperiod are significant in affecting the population dynamics of the mosquito. By refining the relationship between Ae. albopitus population and climatic factors, the model serves to establish a mechanistic relation to the growth and decline of the species. Understanding this relationship in a better way will benefit studying the transmission and the spatiotemporal distribution of mosquito-borne epidemics and eventually facilitating the early warning and control of the diseases.

Identifying Flood-Related Infectious Diseases in Anhui Province, China: A Spatial and Temporal Analysis

The aim of this study was to explore infectious diseases related to the 2007 Huai River flood in Anhui Province, China. The study was based on the notified incidences of infectious diseases between June 29 and July 25 from 2004 to 2011. Daily incidences of notified diseases in 2007 were compared with the corresponding daily incidences during the same period in the other years (from 2004 to 2011, except 2007) by Poisson regression analysis. Spatial autocorrelation analysis was used to test the distribution pattern of the diseases. Spatial regression models were then performed to examine the association between the incidence of each disease and flood, considering lag effects and other confounders. After controlling the other meteorological and socioeconomic factors, malaria (odds ratio [OR] = 3.67, 95% confidence interval [CI] = 1.77-7.61), diarrhea (OR = 2.16, 95% CI = 1.24-3.78), and hepatitis A virus (HAV) infection (OR = 6.11, 95% CI = 1.04-35.84) were significantly related to the 2007 Huai River flood both from the spatial and temporal analyses. Special attention should be given to develop public health preparation and interventions with a focus on malaria, diarrhea, and HAV infection, in the study region.

Climate, environmental and socio-economic change: weighing up the balance in vector-borne disease transmission

Arguably one of the most important effects of climate change is the potential impact on human health. While this is likely to take many forms, the implications for future transmission of vector-borne diseases (VBDs), given their ongoing contribution to global disease burden, are both extremely important and highly uncertain. In part, this is owing not only to data limitations and methodological challenges when integrating climate-driven VBD models and climate change projections, but also, perhaps most crucially, to the multitude of epidemiological, ecological and socio-economic factors that drive VBD transmission, and this complexity has generated considerable debate over the past 10-15 years. In this review, we seek to elucidate current knowledge around this topic, identify key themes and uncertainties, evaluate ongoing challenges and open research questions and, crucially, offer some solutions for the field. Although many of these challenges are ubiquitous across multiple VBDs, more specific issues also arise in different vector-pathogen systems.

Seasonality of Plasmodium falciparum transmission: a systematic review

Background

Although Plasmodium falciparum transmission frequently exhibits seasonal patterns, the drivers of malaria seasonality are often unclear. Given the massive variation in the landscape upon which transmission acts, intra-annual fluctuations are likely influenced by different factors in different settings. Further, the presence of potentially substantial inter-annual variation can mask seasonal patterns; it may be that a location has “strongly seasonal” transmission and yet no single season ever matches the mean, or synoptic, curve. Accurate accounting of seasonality can inform efficient malaria control and treatment strategies. In spite of the demonstrable importance of accurately capturing the seasonality of malaria, data required to describe these patterns is not universally accessible and as such localized and regional efforts at quantifying malaria seasonality are disjointed and not easily generalized.

Methods

The purpose of this review was to audit the literature on seasonality of P. falciparum and quantitatively summarize the collective findings. Six search terms were selected to systematically compile a list of papers relevant to the seasonality of P. falciparum transmission, and a questionnaire was developed to catalogue the manuscripts.

Results and discussion

152 manuscripts were identified as relating to the seasonality of malaria transmission, deaths due to malaria or the population dynamics of mosquito vectors of malaria. Among these, there were 126 statistical analyses and 31 mechanistic analyses (some manuscripts did both).

Discussion

Identified relationships between temporal patterns in malaria and climatological drivers of malaria varied greatly across the globe, with different drivers appearing important in different locations. Although commonly studied drivers of malaria such as temperature and rainfall were often found to significantly influence transmission, the lags between a weather event and a resulting change in malaria transmission also varied greatly by location.

Conclusions

The contradicting results of studies using similar data and modelling approaches from similar locations as well as the confounding nature of climatological covariates underlines the importance of a multi-faceted modelling approach that attempts to capture seasonal patterns at both small and large spatial scales.

Electronic supplementary material

The online version of this article (doi:10.1186/s12936-015-0849-2) contains supplementary material, which is available to authorized users.

Implementation of malaria dynamic models in municipality level early warning systems in Colombia. Part I: description of study sites

As part of the Integrated National Adaptation Pilot project and the Integrated Surveillance and Control System, the Colombian National Institute of Health is working on the design and implementation of a Malaria Early Warning System framework, supported by seasonal climate forecasting capabilities, weather and environmental monitoring, and malaria statistical and dynamic models. In this report, we provide an overview of the local ecoepidemiologic settings where four malaria process-based mathematical models are currently being implemented at a municipal level. The description includes general characteristics, malaria situation (predominant type of infection, malaria-positive cases data, malaria incidence, and seasonality), entomologic conditions (primary and secondary vectors, mosquito densities, and feeding frequencies), climatic conditions (climatology and long-term trends), key drivers of epidemic outbreaks, and non-climatic factors (populations at risk, control campaigns, and socioeconomic conditions). Selected pilot sites exhibit different ecoepidemiologic settings that must be taken into account in the development of the integrated surveillance and control system.

The effects of ambient temperature on cerebrovascular mortality: an epidemiologic study in four climatic zones in China

BACKGROUND

Little evidence is available about the association between temperature and cerebrovascular mortality in China. This study aims to examine the effects of ambient temperature on cerebrovascular mortality in different climatic zones in China.

METHOD

We obtained daily data on weather conditions, air pollution and cerebrovascular deaths from five cities (Beijing, Tianjin, Shanghai, Wuhan, and Guangzhou) in China during 2004-2008. We examined city-specific associations between ambient temperature and the cerebrovascular mortality, while adjusting for season, long-term trends, day of the week, relative humidity and air pollution. We examined cold effects using a 1°C decrease in temperature below a city-specific threshold, and hot effects using a 1°C increase in temperature above a city-specific threshold. We used a meta-analysis to summarize the cold and hot effects across the five cities.

RESULTS

Beijing and Tianjin (with low mean temperature) had lower thresholds than Shanghai, Wuhan and Guangzhou (with high mean temperature). In Beijing, Tianjin, Wuhan and Guangzhou cold effects were delayed, while in Shanghai there was no or short induction. Hot effects were acute in all five cities. The cold effects lasted longer than hot effects. The hot effects were followed by mortality displacement. The pooled relative risk associated with a 1°C decrease in temperature below thresholds (cold effect) was 1.037 (95% confidence interval (CI): 1.020, 1.053). The pooled relative risk associated with a 1°C increase in temperature above thresholds (hot effect) was 1.014 (95% CI: 0.979, 1.050).

CONCLUSION

Cold temperatures are significantly associated with cerebrovascular mortality in China, while hot effect is not significant. People in colder climate cities were sensitive to hot temperatures, while people in warmer climate cities were vulnerable to cold temperature.

Dry season refugia for anopheline larvae and mapping of the seasonal distribution in mosquito larval habitats in Kandi, northeastern Benin

BACKGROUND

The dynamics of mosquito populations depends on availability of suitable surface water for oviposition. It is well known that suitable management of mosquito larval habitats in the sub-Saharan countries, particularly during droughts, could help to suppress vector densities and malaria transmission. We conducted a field survey to investigate the spatial and seasonal distribution of mosquito larval habitats and identify drought-refugia for anopheline larvae.

METHODS

A GIS approach was used to identify, geo-reference and follow up longitudinally from May 2012 to May 2013, all mosquito breeding sites in two rural sites (Yondarou and Thui), one urban (Kossarou), and one peri-urban (Pèdè) site at Kandi, a municipality in northeastern Benin. In Kandi, droughts are excessive with no rain for nearly six months and a lot of sunshine. A comprehensive record of mosquito larval habitats was conducted periodically in all sites for the identification of drought-refugia of anopheline larval stages. With geospatialisation data, seasonal larval distribution maps were generated for each study site with the software ArcGIS version 10.2.

RESULTS

Overall, 187 mosquito breeding sites were identified of which 29.95% were recorded during drought. In rural, peri-urban and urban sites, most of the drought-refugia of anopheline larvae were domestic in nature (61.54%). Moreover, in rural settings, anopheline larvae were also sampled in cisterns and wells (25% of larval habitats sampled during drought in Yondarou and 20% in Thui). The mapping showed a significant decrease in the spatial distribution of mosquito larval habitats in rural, peri-urban and urban sites during drought, except in Yondarou (rural) where the aridity did not seem to influence the distribution of larval habitats.

CONCLUSION

Our data showed that the main drought-refugia of anopheline larvae were of a domestic nature as well as wells and cisterns. A suitable management of mosquito larvae in sub-Saharan countries, particularly during droughts, should target such larval habitats for a meaningful impact on the dynamics of mosquito populations and malaria transmission.

Projected impacts of climate change on environmental suitability for malaria transmission in West Africa

BACKGROUND

Climate change is expected to affect the distribution of environmental suitability for malaria transmission by altering temperature and rainfall patterns; however, the local and global impacts of climate change on malaria transmission are uncertain.

OBJECTIVE

We assessed the effect of climate change on malaria transmission in West Africa.

METHODS

We coupled a detailed mechanistic hydrology and entomology model with climate projections from general circulation models (GCMs) to predict changes in vectorial capacity, an indication of the risk of human malaria infections, resulting from changes in the availability of mosquito breeding sites and temperature-dependent development rates. Because there is strong disagreement in climate predictions from different GCMs, we focused on the GCM projections that produced the best and worst conditions for malaria transmission in each zone of the study area.

RESULTS

Simulation-based estimates suggest that in the desert fringes of the Sahara, vectorial capacity would increase under the worst-case scenario, but not enough to sustain transmission. In the transitional zone of the Sahel, climate change is predicted to decrease vectorial capacity. In the wetter regions to the south, our estimates suggest an increase in vectorial capacity under all scenarios. However, because malaria is already highly endemic among human populations in these regions, we expect that changes in malaria incidence would be small.

CONCLUSION

Our findings highlight the importance of rainfall in shaping the impact of climate change on malaria transmission in future climates. Even under the GCM predictions most conducive to malaria transmission, we do not expect to see a significant increase in malaria prevalence in this region.

Incorporating the effects of humidity in a mechanistic model of Anopheles gambiae mosquito population dynamics in the Sahel region of Africa

BACKGROUND

Low levels of relative humidity are known to decrease the lifespan of mosquitoes. However, most current models of malaria transmission do not account for the effects of relative humidity on mosquito survival. In the Sahel, where relative humidity drops to levels <20% for several months of the year, we expect relative humidity to play a significant role in shaping the seasonal profile of mosquito populations. Here, we present a new formulation for Anopheles gambiae sensu lato (s.l.) mosquito survival as a function of temperature and relative humidity and investigate the effect of humidity on simulated mosquito populations.

METHODS

Using existing observations on relationships between temperature, relative humidity and mosquito longevity, we developed a new equation for mosquito survival as a function of temperature and relative humidity. We collected simultaneous field observations on temperature, wind, relative humidity, and anopheline mosquito populations for two villages from the Sahel region of Africa, which are presented in this paper. We apply this equation to the environmental data and conduct numerical simulations of mosquito populations using the Hydrology, Entomology and Malaria Transmission Simulator (HYDREMATS).

RESULTS

Relative humidity drops to levels that are uncomfortable for mosquitoes at the end of the rainy season. In one village, Banizoumbou, water pools dried up and interrupted mosquito breeding shortly after the end of the rainy season. In this case, relative humidity had little effect on the mosquito population. However, in the other village, Zindarou, the relatively shallow water table led to water pools that persisted several months beyond the end of the rainy season. In this case, the decrease in mosquito survival due to relative humidity improved the model's ability to reproduce the seasonal pattern of observed mosquito abundance.

CONCLUSIONS

We proposed a new equation to describe Anopheles gambiae s.l. mosquito survival as a function of temperature and relative humidity. We demonstrated that relative humidity can play a significant role in mosquito population and malaria transmission dynamics. Future modeling work should account for these effects of relative humidity.

Climate Change and Malaria in Jhapa District of Nepal: Emerging Evidences from Nepal

Climate change is an escalating issue of concern especially towards health. Malaria, as one of the major public health problems in Jhapa district of Nepal, is one of the sensitive diseases related to climate change. This study has been carried out to assess the relationship between climatic variables and malaria and to find out the range of non-climatic factors that can confound the relationship of climate change and human health. This was a retrospective study in which data of past 10 years relating to climate and disease (malaria) variables were analyzed. The occurrence of malaria in Jhapa was seen almost throughout the year with seasonal fluctuations. With mean annual temperature increase (0.04°C/year), the increase in malaria cases in the district was observed with correlation of 0.284 (p <0.01) and 0.338 (p <0.001) with maximum and minimum temperature, respectively. Rainfall pattern was observed to be decreasing at an average rate of 7.1 mm/year but the malaria cases appeared mostly during the heavy rainfall season/period and had significant correlation between the two variables. On the contrary, Relative Humidity had no significant correlation with malaria occurrence. Climatic variables (except Relative Humidity) were found to be correlated with malaria occurrence but were not the significant predictors when time-series analysis was conducted.

A dynamic model of some malaria-transmitting anopheline mosquitoes of the Afrotropical region. I. Model description and sensitivity analysis

BACKGROUND

Most of the current biophysical models designed to address the large-scale distribution of malaria assume that transmission of the disease is independent of the vector involved. Another common assumption in these type of model is that the mortality rate of mosquitoes is constant over their life span and that their dispersion is negligible. Mosquito models are important in the prediction of malaria and hence there is a need for a realistic representation of the vectors involved.

RESULTS

We construct a biophysical model including two competing species, Anopheles gambiae s.s. and Anopheles arabiensis. Sensitivity analysis highlight the importance of relative humidity and mosquito size, the initial conditions and dispersion, and a rarely used parameter, the probability of finding blood. We also show that the assumption of exponential mortality of adult mosquitoes does not match the observed data, and suggest that an age dimension can overcome this problem.

CONCLUSIONS

This study highlights some of the assumptions commonly used when constructing mosquito-malaria models and presents a realistic model of An. gambiae s.s. and An. arabiensis and their interaction. This new mosquito model, OMaWa, can improve our understanding of the dynamics of these vectors, which in turn can be used to understand the dynamics of malaria.

How malaria models relate temperature to malaria transmission

BACKGROUND

It is well known that temperature has a major influence on the transmission of malaria parasites to their hosts. However, mathematical models do not always agree about the way in which temperature affects malaria transmission.

METHODS

In this study, we compared six temperature dependent mortality models for the malaria vector Anopheles gambiae sensu stricto. The evaluation is based on a comparison between the models, and observations from semi-field and laboratory settings.

RESULTS

Our results show how different mortality calculations can influence the predicted dynamics of malaria transmission.

CONCLUSIONS

With global warming a reality, the projected changes in malaria transmission will depend on which mortality model is used to make such predictions.

Assessment of the impact of climate shifts on malaria transmission in the Sahel

Climate affects malaria transmission through a complex network of causative pathways. We seek to evaluate the impact of hypothetical climate change scenarios on malaria transmission in the Sahel by using a novel mechanistic, high spatial- and temporal-resolution coupled hydrology and agent-based entomology model. The hydrology model component resolves individual precipitation events and individual breeding pools. The impact of future potential climate shifts on the representative Sahel village of Banizoumbou, Niger, is estimated by forcing the model of Banizoumbou environment with meteorological data from two locations along the north-south climatological gradient observed in the Sahel--both for warmer, drier scenarios from the north and cooler, wetter scenarios from the south. These shifts in climate represent hypothetical but historically realistic climate change scenarios. For Banizoumbou climatic conditions (latitude 13.54 N), a shift toward cooler, wetter conditions may dramatically increase mosquito abundance; however, our modeling results indicate that the increased malaria transmissibility is not simply proportional to the precipitation increase. The cooler, wetter conditions increase the length of the sporogonic cycle, dampening a large vectorial capacity increase otherwise brought about by increased mosquito survival and greater overall abundance. Furthermore, simulations varying rainfall event frequency demonstrate the importance of precipitation patterns, rather than simply average or time-integrated precipitation, as a controlling factor of these dynamics. Modeling results suggest that in addition to changes in temperature and total precipitation, changes in rainfall patterns are very important to predict changes in disease susceptibility resulting from climate shifts. The combined effect of these climate-shift-induced perturbations can be represented with the aid of a detailed mechanistic model.

[Medical consequences of global warming]

INTRODUCTION

The global warming of the planet and its anthropogenic origin are no longer debatable. Nevertheless, from a medical point of view, while the epidemiological consequences of the warming are rather well-known, the biological consequences are still poorly documented. This is a good example of evolutionary (or darwinian) medicine.

METHODS

The research strategy of this systematic review is based on both PubMed during the period of 2000-2007 and several reviews articles for the period >2000.

RESULTS

From a medical point of view, there are four types of consequences. 1-The simple elevation of the average external temperature is accompanied by an increased global mortality and morbidity, the mortality/external temperature is a J curve, with the warm branch more pronounced than the cold one. A recent study on 50 different cities had confirmed that global, and more specifically cardiovascular mortalities were enhanced at the two extreme of the temperatures. 2-The acute heatwaves, such as that which happened in France in August 2003, have been studied in detail by several groups. The mortality which was observed during the recent heatwaves was not compensated by harvesting, strongly suggesting that we were dealing with heat stroke, and that such an increased mortality was more reflecting the limits of our adaptational capacities than aggravation of a previously altered health status. 3-Climate changes have modified the repartition and virulence of pathogenic agents (dengue, malaria...) and above all their vectors. Such modifications were exponential and are likely to reflect the biological properties of parasites. 4-Indirect consequences of global warming include variations in the hydraulic cycle, the new form of tropical hurricanes and many different changes affecting both biodiversity and ecosystems. They will likely result in an increased level of poverty.

DISCUSSION

These finding gave rise to several basic biological questions, rarely evoked, and that concern the limits of the adaptational capacities of human genome. Our genome has indeed been shaped in the past by a rather cold environment which has acutely been modified. The immediate physiological regulation includes sweating and skin vasodilatation. The latter may strongly enhance the cardiac output which explains the heat-induced cardiac decompensation. Long term regulation depends upon the numerous mechanisms of uncoupling of the mitochondrial respiration. For the moment, the thermolytic mechanisms and their regulation were rather poorly documented.

Impact of regional climate change on human health

The World Health Organisation estimates that the warming and precipitation trends due to anthropogenic climate change of the past 30 years already claim over 150,000 lives annually. Many prevalent human diseases are linked to climate fluctuations, from cardiovascular mortality and respiratory illnesses due to heatwaves, to altered transmission of infectious diseases and malnutrition from crop failures. Uncertainty remains in attributing the expansion or resurgence of diseases to climate change, owing to lack of long-term, high-quality data sets as well as the large influence of socio-economic factors and changes in immunity and drug resistance. Here we review the growing evidence that climate-health relationships pose increasing health risks under future projections of climate change and that the warming trend over recent decades has already contributed to increased morbidity and mortality in many regions of the world. Potentially vulnerable regions include the temperate latitudes, which are projected to warm disproportionately, the regions around the Pacific and Indian oceans that are currently subjected to large rainfall variability due to the El Niño/Southern Oscillation sub-Saharan Africa and sprawling cities where the urban heat island effect could intensify extreme climatic events.

Uncertainty management in integrated assessment modeling: towards a pluralistic approach

Integrated Assessment (IA) is an evolving research community that aims to address complex societal issues through an interdisciplinary process. The most-widely used method in Integrated Assessment is modeling. The state of the art in Integrated Assessment modeling is described in this paper in terms of history, general features, classes of models, and in terms of the strengths and weaknesses, and the dilemmas and challenges modelers face. One of the key challenges is the issue of uncertainty management. The paper outlines the sources and types of uncertainty modelers are confronted with. It then discusses how uncertainties are currently managed in Integrated Assessment modeling, on which evaluation it is argued that complementary methods are needed that allow for pluralistic uncertainty management. The paper finalises with discussing pluralistic concepts and approaches that are currently explored in the IA community and that seem promising in view of the challenge to incorporate explicitly more than one hidden perspective in models.

Climate change and mosquito-borne disease

Global atmospheric temperatures are presently in a warming phase that began 250--300 years ago. Speculations on the potential impact of continued warming on human health often focus on mosquito-borne diseases. Elementary models suggest that higher global temperatures will enhance their transmission rates and extend their geographic ranges. However, the histories of three such diseases--malaria, yellow fever, and dengue--reveal that climate has rarely been the principal determinant of their prevalence or range; human activities and their impact on local ecology have generally been much more significant. It is therefore inappropriate to use climate-based models to predict future prevalence.

Climate change and mosquito-borne disease

Global atmospheric temperatures are presently in a warming phase that began 250--300 years ago. Speculations on the potential impact of continued warming on human health often focus on mosquito-borne diseases. Elementary models suggest that higher global temperatures will enhance their transmission rates and extend their geographic ranges. However, the histories of three such diseases--malaria, yellow fever, and dengue--reveal that climate has rarely been the principal determinant of their prevalence or range; human activities and their impact on local ecology have generally been much more significant. It is therefore inappropriate to use climate-based models to predict future prevalence.

Daily mortality in relation to weather and air pollution in Christchurch, New Zealand

OBJECTIVE

To investigate the relationship between the daily number of deaths, weather and ambient air pollution.

METHOD

An ecological study. We assembled daily data for the city of Christchurch, New Zealand (population 300,000) from June 1988 to December 1993. We used Poisson regression models, controlling for season using a parametric method.

RESULTS

Above the third quartile (20.5 degrees C) of maximum temperature, an increase of 1 degree C was associated with a 1% (95% CI: 0.4 to 2.1%) increase in all-cause mortality and a 3% (0.1 to 6.0%) increase in respiratory mortality. An increase in PM10 of 10 micrograms/m3 was associated (after a lag of one day) with a 1% (0.5 to 2.2%) increase in all-cause mortality and a 4% (1.5 to 5.9%) increase in respiratory mortality. We found no evidence of interaction between the effects of temperature and particulate air pollution.

CONCLUSIONS

High temperatures and particulate air pollution are independently associated with increased daily mortality in Christchurch. The fact that these results are consistent with those of similar studies in other countries strengthens the argument that the associations are likely to be causal.

IMPLICATIONS

These findings contribute to evidence of health consequences of fuel combustion, both in the short term (from local air pollution) and in the long term (from the global climatic effects of increased atmospheric CO2).

From Shakespeare to Defoe: malaria in England in the Little Ice Age

Present global temperatures are in a warming phase that began 200 to 300 years ago. Some climate models suggest that human activities may have exacerbated this phase by raising the atmospheric concentration of carbon dioxide and other greenhouse gases. Discussions of the potential effects of the weather include predictions that malaria will emerge from the tropics and become established in Europe and North America. The complex ecology and transmission dynamics of the disease, as well as accounts of its early history, refute such predictions. Until the second half of the 20th century, malaria was endemic and widespread in many temperate regions, with major epidemics as far north as the Arctic Circle. From 1564 to the 1730s the coldest period of the Little Ice Age malaria was an important cause of illness and death in several parts of England. Transmission began to decline only in the 19th century, when the present warming trend was well under way. The history of the disease in England underscores the role of factors other than temperature in malaria transmission.

Population health environmental indicators: ecologic monitoring of environment-related health and disease trends

BACKGROUND

Current State of the Environment (SoE) reporting focuses primarily on indicators directly related to the physical environment such as climate, and air, water and soil quality. As the environment has both direct and indirect effects on human health, an opportunity exists to include environment-related human disease indicators as an SoE indicator theme.

OBJECTIVE

To develop a set of population health environmental indicators (PHEIs, phi s) that can illustrate environment-related disease (ERD) trends at the population level.

METHODS

A literature review was conducted on environmental health monitoring and the current knowledge of environmental effects on human health. Key PHEIs were identified and routine health data collections accessed and analysed to illustrate temporal and geographic trends.

RESULTS

Diseases with an environmental aetiology are tabulated and examples are given of the type and range of PHEIs that can be developed for an Australian geographic area.

CONCLUSIONS

Illustrating environmental degradation in terms of resultant human diseases is a potent tool for promoting environmental protection measures. This paper examines a range of PHEIs that may be used as indicators of both environmental disease and environmental quality.

IMPLICATIONS

PHEIs could be developed as a useful SoE indicator theme, and as a tool to help foster the convergence which is occurring between environmental health and public health fields.