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.     

Increased risks of malaria due to limited residual life of insecticide and outdoor biting versus protection by combined use of nets and indoor residual spraying on Bioko Island, Equatorial Guinea

ABSTRACT: BACKGROUND: Malaria is endemic on Bioko Island, Equatorial Guinea, with year-round transmission. In 2004 an intensive malaria control strategy primarily based on indoor residual spraying (IRS) was launched. The limited residual life of IRS poses particular challenges in a setting with year-round transmission, such as Bioko. Recent reports of outdoor biting by Anopheles gambiae are an additional cause for concern. In this study, the effect of the short residual life of bendiocarb insecticide and of children spending time outdoors at night, on malaria infection prevalence was examined. METHODS: Data from the 2011 annual malaria indicator survey and from standard WHO cone bioassays were used to examine the relationship between time since IRS, mosquito mortality and prevalence of infection in children. How often children spend time outside at night and the association of this behaviour with malaria infection were also examined. RESULTS: Prevalence of malaria infection in two to 14 year-olds in 2011 was 18.4 %, 21.0 % and 28.1 % in communities with median time since IRS of three, four and five months respectively. After adjusting for confounders, each extra month since IRS corresponded to an odds ratio (OR) of 1.44 (95 % CI 1.15-1.81) for infection prevalence in two to 14 year-olds. Mosquito mortality was 100 %, 96 %, 81 % and 78 %, at month 2, 3, 4 and 5 respectively after spraying. Only 4.1 % of children spent time outside the night before the survey between the hours of 22.00 and 06.00 and those who did were not at a higher risk of infection (OR 0.87, 95 % CI 0.50-1.54). Sleeping under a mosquito net provided additive protection (OR 0.68, 95 % CI 0.54-0.86). CONCLUSIONS: The results demonstrate the epidemiological impact of reduced mosquito mortality with time since IRS. The study underscores that in settings of year-round transmission there is a compelling need for longer-lasting IRS insecticides, but that in the interim, high coverage of long-lasting insecticidal nets (LLINs) may ameliorate the loss of effect of current shorterlasting IRS insecticides. Moreover, continued use of IRS and LLINs for indoor-oriented vector control is warranted given that there is no evidence that spending time outdoors at night increases infection prevalence in children.     

Assessing the impact of low-technology emanators alongside long-lasting insecticidal nets to control malaria

Malaria control in sub-Saharan Africa relies on the widespread use of long-lasting insecticidal nets (LLINs) or the indoor residual spraying of insecticide. Disease transmission may be maintained even when these indoor interventions are universally used as some mosquitoes will bite in the early morning and evening when people are outside. As countries seek to eliminate malaria, they can target outdoor biting using new vector control tools such as spatial repellent emanators, which emit airborne insecticide to form a protective area around the user. Field data are used to incorporate a low-technology emanator into a mathematical model of malaria transmission to predict its public health impact across a range of scenarios. Targeting outdoor biting by repeatedly distributing emanators alongside LLINs increases the chance of elimination, but the additional benefit depends on the level of anthropophagy in the local mosquito population, emanator effectiveness and the pre-intervention proportion of mosquitoes biting outdoors. High proportions of pyrethroid-resistant mosquitoes diminish LLIN impact because of reduced mosquito mortality. When mosquitoes are highly anthropophagic, this reduced mortality leads to more outdoor biting and a reduced additional benefit of emanators, even if emanators are assumed to retain their effectiveness in the presence of pyrethroid resistance. Different target product profiles are examined, which show the extra epidemiological benefits of spatial repellents that induce mosquito mortality.This article is part of the theme issue ‘Novel control strategies for mosquito-borne diseases’.     

Large-scale use of mosquito larval source management for malaria control in Africa: a cost analysis

Background

At present, large-scale use of two malaria vector control methods, long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS) is being scaled up in Africa with substantial funding from donors. A third vector control method, larval source management (LSM), has been historically very successful and is today widely used for mosquito control globally, except in Africa. With increasing risk of insecticide resistance and a shift to more exophilic vectors, LSM is now under re-evaluation for use against afro-tropical vector species. Here the costs of this intervention were evaluated.

Methods

The 'ingredients approach' was used to estimate the economic and financial costs per person protected per year (pppy) for large-scale LSM using microbial larvicides in three ecologically diverse settings: (1) the coastal metropolitan area of Dar es Salaam in Tanzania, (2) a highly populated Kenyan highland area (Vihiga District), and (3) a lakeside setting in rural western Kenya (Mbita Division). Two scenarios were examined to investigate the cost implications of using alternative product formulations. Sensitivity analyses on product prices were carried out.

Results

The results show that for programmes using the same granular formulation larviciding costs the least pppy in Dar es Salaam (US$0.94), approximately 60% more in Vihiga District (US$1.50) and the most in Mbita Division (US$2.50). However, these costs are reduced substantially if an alternative water-dispensable formulation is used; in Vihiga, this would reduce costs to US$0.79 and, in Mbita Division, to US$1.94. Larvicide and staff salary costs each accounted for approximately a third of the total economic costs per year. The cost pppy depends mainly on: (1) the type of formulation required for treating different aquatic habitats, (2) the human population density relative to the density of aquatic habitats and (3) the potential to target the intervention in space and/or time.

Conclusion

Costs for LSM compare favourably with costs for IRS and LLINs, especially in areas with moderate and focal malaria transmission where mosquito larval habitats are accessible and well defined. LSM presents an attractive tool to be integrated in ongoing malaria control effort in such settings. Further data on the epidemiological health impact of larviciding is required to establish cost effectiveness.     

Present and future projections of habitat suitability of the Asian tiger mosquito,a vector of viral pathogens,from global climate simulation

Climate change can influence the transmission of vector-borne diseases (VBDs) through altering the habitat suitability of insect vectors. Here we present global climate model simulations and evaluate the associated uncertainties in view of the main meteorological factors that may affect the distribution of the Asian tiger mosquito (Aedes albopictus), which can transmit pathogens that cause chikungunya, dengue fever, yellow fever and various encephalitides. Using a general circulation model at 50 km horizontal resolution to simulate mosquito survival variables including temperature, precipitation and relative humidity, we present both global and regional projections of the habitat suitability up to the middle of the twenty-first century. The model resolution of 50 km allows evaluation against previous projections for Europe and provides a basis for comparative analyses with other regions. Model uncertainties and performance are addressed in light of the recent CMIP5 ensemble climate model simulations for the RCP8.5 concentration pathway and using meteorological re-analysis data (ERA-Interim/ECMWF) for the recent past. Uncertainty ranges associated with the thresholds of meteorological variables that may affect the distribution of Ae. albopictus are diagnosed using fuzzy-logic methodology, notably to assess the influence of selected meteorological criteria and combinations of criteria that influence mosquito habitat suitability. From the climate projections for 2050, and adopting a habitat suitability index larger than 70%, we estimate that approximately 2.4 billion individuals in a land area of nearly 20 million km² will potentially be exposed to Ae. albopictus. The synthesis of fuzzy-logic based on mosquito biology and climate change analysis provides new insights into the regional and global spreading of VBDs to support disease control and policy making.     

The clinical efficacy of artemether/lumefantrine (Coartem®)

Background

In March 2008, the Solomon Islands and Vanuatu governments raised the goal of their National Malaria Programmes from control to elimination. Vector control measures, such as indoor residual spraying (IRS) and long-lasting insecticidal bed nets (LLINs) are key integral components of this programme. Compliance with these interventions is dependent on their acceptability and on the socio-cultural context of the local population. These factors need to be investigated locally prior to programme implementation.

Method

Twelve focus group discussions (FGDs) were carried out in Malaita and Temotu Provinces, Solomon Islands in 2008. These discussions explored user perceptions of acceptability and preference for three brands of long-lasting insecticide-treated bed nets (LLINs) and identified a number of barriers to their proper and consistent use.

Results

Mosquito nuisance and perceived threat of malaria were the main determinants of bed net use. Knowledge of malaria and the means to prevent it were not sufficient to guarantee compliance with LLIN use. Factors such as climate, work and evening social activities impact on the use of bed nets, particularly in men. LLIN acceptability plays a varying role in compliance with their use in villages involved in this study. Participants in areas of reported high and year round mosquito nuisance and perceived threat of malaria reported LLIN use regardless of any reported unfavourable characteristics. Those in areas of low or seasonal mosquito nuisance were more likely to describe the unfavourable characteristics of LLINs as reasons for their intermittent or non-compliance. The main criterion for LLIN brand acceptability was effectiveness in preventing mosquito bites and malaria. Discussions highlighted considerable confusion around LLIN care and washing which may be impacting on their effectiveness and reducing their acceptability in Solomon Islands.

Conclusion

Providing LLINs that are acceptable will be more important for improving compliance in areas of low or seasonal mosquito nuisance and malaria transmission. The implications of these findings on malaria elimination in Solomon Islands are discussed.     

Local and Global Effects of Climate on Dengue Transmission in Puerto Rico

The four dengue viruses, the agents of dengue fever and dengue hemorrhagic fever in humans, are transmitted predominantly by the mosquito Aedes aegypti. The abundance and the transmission potential of Ae. aegypti are influenced by temperature and precipitation. While there is strong biological evidence for these effects, empirical studies of the relationship between climate and dengue incidence in human populations are potentially confounded by seasonal covariation and spatial heterogeneity. Using 20 years of data and a statistical approach to control for seasonality, we show a positive and statistically significant association between monthly changes in temperature and precipitation and monthly changes in dengue transmission in Puerto Rico. We also found that the strength of this association varies spatially, that this variation is associated with differences in local climate, and that this relationship is consistent with laboratory studies of the impacts of these factors on vector survival and viral replication. These results suggest the importance of temperature and precipitation in the transmission of dengue viruses and suggest a reason for their spatial heterogeneity. Thus, while dengue transmission may have a general system, its manifestation on a local scale may differ from global expectations.     

沿水分梯度草原群落NPP动态及对气候变化响应的模拟分析

 水分条件不仅影响半干旱区群落的组成, 而且在一定程度上决定了群落的功能。处于不同水分条件生境下群落的优势物种在水分利用和同化物利用效率方面的功能特征会存在差异, 这些差异将导致群落对于气候变化产生不同的响应, 进而影响到景观和区域尺度上对于全球变化下碳动态和格局的分析。该文选取了锡林河流域典型草原区沿水分梯度的4个代表群落, 在野外实验测定并结合长期定位研究成果基础上, 利用BIOME-BGC模型对代表群落的长期净初级生产力(Net primary productivity,NPP)动态进行了模拟和模型验证。 通过分析该地区1953～2005年气候变化趋势, 推测了未来可能的气候变化情景, 进而模拟了气候变化下4个群落长期NPP动态的响应。结果表明,当前气候条件下, 羊草(Leymus chinensis)群落NPP平均值为197.76 gC·m^-2 (SE=7.11), 大针茅(Stipa grandis)群落NPP平均值为198.95 gC·m^-2 (SE=6.41), 贝加尔针茅(Stipa baicalensis)群落NPP平均值为210.41 gC·m^-2(SE=7.87), 克氏针茅(Stipa krylovii)群落NPP平均值为144.92 gC·m^{- 2} (SE=4.64), 4个群落NPP平均值为188.01 gC·m^-2 (SE=3.72); 气候变化情景下, 温度增加下(P0T1),NPP平均下降14.2%,降水增加下(P1T0), NPP平均增加13.2%,温度与降水都增加情景下(P1T1), NPP平均下降2 .7%, 但由于生境水分条件差别和优势物种功能特征差异, 4个群落表现出了增减幅度不同的趋势。对气候因子的敏感性分析及回归分析表明, 降水是该地区NPP最主要的决定因子, 而温度决定作用相对较小,主要通过影响植物的呼吸和水分蒸散等过程影响NPP。在最有可能代表未来气候 变化的温度增加的两种情景下(P0T1、P1T1), NPP均呈下降趋势。群落NPP对气候变化的响应趋势与水分胁迫系数(Water stress index, WSI)、碳胁迫系数(Carbon stress index, CSI)变化密切相关。克氏针茅群落由于所处生境水分条件差,WSI高,对降水的依赖程度最大;贝加尔针茅群落一方面处于较好的水分生境,具有较小的WSI,另一方面,由于具有高碳氮比,维持呼吸消耗的光合产物比例低,CSI远低于其它3个群落, 未来气候变化下, NPP较其它3个群落仍较高。     

An Economic Analysis of Strategies to Control Clostridium Difficile Transmission and Infection Using an Agent-Based Simulation Model

Background

A number of strategies exist to reduce Clostridium difficile (C. difficile) transmission. We conducted an economic evaluation of “bundling” these strategies together.

Methods

We constructed an agent-based computer simulation of nosocomial C. difficile transmission and infection in a hospital setting. This model included the following components: interactions between patients and health care workers; room contamination via C. difficile shedding; C. difficile hand carriage and removal via hand hygiene; patient acquisition of C. difficile via contact with contaminated rooms or health care workers; and patient antimicrobial use. Six interventions were introduced alone and "bundled" together: (a) aggressive C. difficile testing; (b) empiric isolation and treatment of symptomatic patients; (c) improved adherence to hand hygiene and (d) contact precautions; (e) improved use of soap and water for hand hygiene; and (f) improved environmental cleaning. Our analysis compared these interventions using values representing 3 different scenarios: (1) base-case (BASE) values that reflect typical hospital practice, (2) intervention (INT) values that represent implementation of hospital-wide efforts to reduce C. diff transmission, and (3) optimal (OPT) values representing the highest expected results from strong adherence to the interventions. Cost parameters for each intervention were obtained from published literature. We performed our analyses assuming low, normal, and high C. difficile importation prevalence and transmissibility of C. difficile.

Results

INT levels of the “bundled” intervention were cost-effective at a willingness-to-pay threshold of $100,000/quality-adjusted life-year in all importation prevalence and transmissibility scenarios. OPT levels of intervention were cost-effective for normal and high importation prevalence and transmissibility scenarios. When analyzed separately, hand hygiene compliance, environmental decontamination, and empiric isolation and treatment were the interventions that had the greatest impact on both cost and effectiveness.

Conclusions

A combination of available interventions to prevent CDI is likely to be cost-effective but the cost-effectiveness varies for different levels of intensity of the interventions depending on epidemiological conditions such as C. difficile importation prevalence and transmissibility.     

Thermal biology of mosquito‐borne disease

Mosquito‐borne diseases cause a major burden of disease worldwide. The vital rates of these ectothermic vectors and parasites respond strongly and nonlinearly to temperature and therefore to climate change. Here, we review how trait‐based approaches can synthesise and mechanistically predict the temperature dependence of transmission across vectors, pathogens, and environments. We present 11 pathogens transmitted by 15 different mosquito species – including globally important diseases like malaria, dengue, and Zika – synthesised from previously published studies. Transmission varied strongly and unimodally with temperature, peaking at 23–29ºC and declining to zero below 9–23ºC and above 32–38ºC. Different traits restricted transmission at low versus high temperatures, and temperature effects on transmission varied by both mosquito and parasite species. Temperate pathogens exhibit broader thermal ranges and cooler thermal minima and optima than tropical pathogens. Among tropical pathogens, malaria and Ross River virus had lower thermal optima (25–26ºC) while dengue and Zika viruses had the highest (29ºC) thermal optima. We expect warming to increase transmission below thermal optima but decrease transmission above optima. Key directions for future work include linking mechanistic models to field transmission, combining temperature effects with control measures, incorporating trait variation and temperature variation, and investigating climate adaptation and migration.     

Global patterns of aegyptism without arbovirus

The world’s most important mosquito vector of viruses, Aedes aegypti, is found around the world in tropical, subtropical and even some temperate locations. While climate change may limit populations of Ae. aegypti in some regions, increasing temperatures will likely expand its territory thus increasing risk of human exposure to arboviruses in places like Europe, Northern Australia and North America, among many others. Most studies of Ae. aegypti biology and virus transmission focus on locations with high endemicity or severe outbreaks of human amplified urban arboviruses, such as dengue, Zika, and chikungunya viruses, but rarely on areas at the margins of endemicity. The objective in this study is to explore previously published global patterns in the environmental suitability for Ae. aegypti and dengue virus to reveal deviations in the probability of the vector and human disease occurring. We developed a map showing one end of the gradient being higher suitability of Ae. aegypti with low suitability of dengue and the other end of the spectrum being equal and higher environmental suitability for both Ae. aegypti and dengue. The regions of the world with Ae. aegypti environmental suitability and no endemic dengue transmission exhibits a phenomenon we term ‘aegyptism without arbovirus’. We then tested what environmental and socioeconomic variables influence this deviation map revealing a significant association with human population density, suggesting that locations with lower human population density were more likely to have a higher probability of aegyptism without arbovirus. Characterizing regions of the world with established populations of Ae. aegypti but little to no autochthonous transmission of human-amplified arboviruses is an important step in understanding and achieving aegyptism without arbovirus.     

Modeled response of the West Nile virus vector Culex quinquefasciatus to changing climate using the dynamic mosquito simulation model

Climate can strongly influence the population dynamics of disease vectors and is consequently a key component of disease ecology. Future climate change and variability may alter the location and seasonality of many disease vectors, possibly increasing the risk of disease transmission to humans. The mosquito species Culex quinquefasciatus is a concern across the southern United States because of its role as a West Nile virus vector and its affinity for urban environments. Using established relationships between atmospheric variables (temperature and precipitation) and mosquito development, we have created the Dynamic Mosquito Simulation Model (DyMSiM) to simulate Cx. quinquefasciatus population dynamics. The model is driven with climate data and validated against mosquito count data from Pasco County, Florida and Coachella Valley, California. Using 1-week and 2-week filters, mosquito trap data are reproduced well by the model (P < 0.0001). Dry environments in southern California produce different mosquito population trends than moist locations in Florida. Florida and California mosquito populations are generally temperature-limited in winter. In California, locations are water-limited through much of the year. Using future climate projection data generated by the National Center for Atmospheric Research CCSM3 general circulation model, we applied temperature and precipitation offsets to the climate data at each location to evaluate mosquito population sensitivity to possible future climate conditions. We found that temperature and precipitation shifts act interdependently to cause remarkable changes in modeled mosquito population dynamics. Impacts include a summer population decline from drying in California due to loss of immature mosquito habitats, and in Florida a decrease in late-season mosquito populations due to drier late summer conditions.     

Reducing Plasmodium falciparum Malaria Transmission in Africa: A Model-Based Evaluation of Intervention Strategies

Background

Over the past decade malaria intervention coverage has been scaled up across Africa. However, it remains unclear what overall reduction in transmission is achievable using currently available tools.

Methods and Findings

We developed an individual-based simulation model for Plasmodium falciparum transmission in an African context incorporating the three major vector species (Anopheles gambiae s.s., An. arabiensis, and An. funestus) with parameters obtained by fitting to parasite prevalence data from 34 transmission settings across Africa. We incorporated the effect of the switch to artemisinin-combination therapy (ACT) and increasing coverage of long-lasting insecticide treated nets (LLINs) from the year 2000 onwards. We then explored the impact on transmission of continued roll-out of LLINs, additional rounds of indoor residual spraying (IRS), mass screening and treatment (MSAT), and a future RTS,S/AS01 vaccine in six representative settings with varying transmission intensity (as summarized by the annual entomological inoculation rate, EIR: 1 setting with low, 3 with moderate, and 2 with high EIRs), vector–species combinations, and patterns of seasonality. In all settings we considered a realistic target of 80% coverage of interventions. In the low-transmission setting (EIR∼3 ibppy [infectious bites per person per year]), LLINs have the potential to reduce malaria transmission to low levels (<1% parasite prevalence in all age-groups) provided usage levels are high and sustained. In two of the moderate-transmission settings (EIR∼43 and 81 ibppy), additional rounds of IRS with DDT coupled with MSAT could drive parasite prevalence below a 1% threshold. However, in the third (EIR = 46) with An. arabiensis prevailing, these interventions are insufficient to reach this threshold. In both high-transmission settings (EIR∼586 and 675 ibppy), either unrealistically high coverage levels (>90%) or novel tools and/or substantial social improvements will be required, although considerable reductions in prevalence can be achieved with existing tools and realistic coverage levels.

Conclusions

Interventions using current tools can result in major reductions in P. falciparum malaria transmission and the associated disease burden in Africa. Reduction to the 1% parasite prevalence threshold is possible in low- to moderate-transmission settings when vectors are primarily endophilic (indoor-resting), provided a comprehensive and sustained intervention program is achieved through roll-out of interventions. In high-transmission settings and those in which vectors are mainly exophilic (outdoor-resting), additional new tools that target exophagic (outdoor-biting), exophilic, and partly zoophagic mosquitoes will be required. Please see later in the article for the Editors'' Summary     

山西翅果油树的适生区预测及其对气候变化的响应

研究濒危物种生境在气候变化下的响应对保护物种多样性和保持生态系统功能完整性具有重要意义.本文选取我国特有濒危植物翅果油树为研究对象,以该物种73个野外调查数据和35个环境因子为基础,应用最大熵模型对山西翅果油树当前的适生分布区进行预测;进而结合政府间气候变化专门委员会第五次评估报告发布的气候模式数据,探讨未来不同气候情景下山西翅果油树分布格局的变化趋势.结果表明:受试者工作特征曲线分析法的AUC值为0.987,表明模型的模拟精度很好且预测可靠性高;刀切法检验结果显示,降水量季节变化、温度年变化范围、年均温、等温线、表层土p H值和年降水量是影响翅果油树分布的主要环境因子,其累积贡献率达到了94.8%;当前,山西翅果油树的适生区主要集中在山西省吕梁山南部和中条山地带;未来不同气候情景下,到21世纪70年代翅果油树适生区面积均有不同幅度的缩减,低浓度情景(RCP 2.6)下呈先增后减趋势,中高浓度情景(RCP 4.5和RCP8.5)下响应较敏感且呈先减后增趋势.两个不同适生区的空间分布格局对气候变化也有不同的响应,吕梁山南部表现出纬度方向的轻微波动,而中条山地带则是海拔方向的迁移.     

Determinants of the cost-effectiveness of intermittent preventive treatment for malaria in infants and children

Background

Trials of intermittent preventive treatment in infants (IPTi) and children (IPTc) have shown promising results in reducing malaria episodes but with varying efficacy and cost-effectiveness. The effects of different intervention and setting characteristics are not well known. We simulate the effects of the different target age groups and delivery channels, seasonal or year-round delivery, transmission intensity, seasonality, proportions of malaria fevers treated and drug characteristics.

Methods

We use a dynamic, individual-based simulation model of Plasmodium falciparum malaria epidemiology, antimalarial drug action and case management to simulate DALYs averted and the cost per DALY averted by IPTi and IPTc. IPT cost components were estimated from economic studies alongside trials.

Results

IPTi and IPTc were predicted to be cost-effective in most of the scenarios modelled. The cost-effectiveness is driven by the impact on DALYs, particularly for IPTc, and the low costs, particularly for IPTi which uses the existing delivery strategy, EPI. Cost-effectiveness was predicted to decrease with low transmission, badly timed seasonal delivery in a seasonal setting, short-acting and more expensive drugs, high frequencies of drug resistance and high levels of treatment of malaria fevers. Seasonal delivery was more cost-effective in seasonal settings, and year-round in constant transmission settings. The difference was more pronounced for IPTc than IPTi due to the different proportions of fixed costs and also different assumed drug spacing during the transmission season. The number of DALYs averted was predicted to decrease as a target five-year age-band for IPTc was shifted from children under 5 years into older ages, except at low transmission intensities.

Conclusions

Modelling can extend the information available by predicting impact and cost-effectiveness for scenarios, for outcomes and for multiple strategies where, for practical reasons, trials cannot be carried out. Both IPTi and IPTc are generally cost-effective but could be rendered cost-ineffective by characteristics of the setting, drug or implementation.     

Climate and the Timing of Imported Cases as Determinants of the Dengue Outbreak in Guangzhou, 2014: Evidence from a Mathematical Model

As the world’s fastest spreading vector-borne disease, dengue was estimated to infect more than 390 million people in 2010, a 30-fold increase in the past half century. Although considered to be a non-endemic country, mainland China had 55,114 reported dengue cases from 2005 to 2014, of which 47,056 occurred in 2014. Furthermore, 94% of the indigenous cases in this time period were reported in Guangdong Province, 83% of which were in Guangzhou City. In order to determine the possible determinants of the unprecedented outbreak in 2014, a population-based deterministic model was developed to describe dengue transmission dynamics in Guangzhou. Regional sensitivity analysis (RSA) was adopted to calibrate the model and entomological surveillance data was used to validate the mosquito submodel. Different scenarios were created to investigate the roles of the timing of an imported case, climate, vertical transmission from mosquitoes to their offspring, and intervention. The results suggested that an early imported case was the most important factor in determining the 2014 outbreak characteristics. Precipitation and temperature can also change the transmission dynamics. Extraordinary high precipitation in May and August, 2014 appears to have increased vector abundance. Considering the relatively small number of cases in 2013, the effect of vertical transmission was less important. The earlier and more frequent intervention in 2014 also appeared to be effective. If the intervention in 2014 was the same as that in 2013, the outbreak size may have been over an order of magnitude higher than the observed number of new cases in 2014.The early date of the first imported and locally transmitted case was largely responsible for the outbreak in 2014, but it was influenced by intervention, climate and vertical transmission. Early detection and response to imported cases in the spring and early summer is crucial to avoid large outbreaks in the future.     

Impact of climate variation on mosquito abundance in California

Temporal variation in the abundance of the encephalitis virus vector mosquito, Culex tarsalis Coquillet, was linked significantly with coincident and antecedent measures of regional climate, including temperature, precipitation, snow pack, and the El Ni?o/Southern Oscillation anomaly. Although variable among traps, historical records that spanned two to five decades revealed climate influences on spring and summer mosquito abundance as early as the previous fall through early summer. Correlations between winter and spring precipitation and snow pack and spring Cx. tarsalis abundance were stronger than correlations with summer abundance. Spring abundance was also correlated positively with winter and spring temperature, whereas summer abundance correlated negatively with spring temperature and not significantly with summer temperature. Correlations with antecedent climate provide the opportunity to forecast vector abundance and therefore encephalitis virus risk, a capability useful in intervention decision support systems at local and state levels.     

Back to the future: using historical climate variation to project near‐term shifts in habitat suitable for coast redwood

Studies that model the effect of climate change on terrestrial ecosystems often use climate projections from downscaled global climate models (GCMs). These simulations are generally too coarse to capture patterns of fine‐scale climate variation, such as the sharp coastal energy and moisture gradients associated with wind‐driven upwelling of cold water. Coastal upwelling may limit future increases in coastal temperatures, compromising GCMs’ ability to provide realistic scenarios of future climate in these coastal ecosystems. Taking advantage of naturally occurring variability in the high‐resolution historic climatic record, we developed multiple fine‐scale scenarios of California climate that maintain coherent relationships between regional climate and coastal upwelling. We compared these scenarios against coarse resolution GCM projections at a regional scale to evaluate their temporal equivalency. We used these historically based scenarios to estimate potential suitable habitat for coast redwood (Sequoia sempervirens D. Don) under ‘normal’ combinations of temperature and precipitation, and under anomalous combinations representative of potential future climates. We found that a scenario of warmer temperature with historically normal precipitation is equivalent to climate projected by GCMs for California by 2020–2030 and that under these conditions, climatically suitable habitat for coast redwood significantly contracts at the southern end of its current range. Our results suggest that historical climate data provide a high‐resolution alternative to downscaled GCM outputs for near‐term ecological forecasts. This method may be particularly useful in other regions where local climate is strongly influenced by ocean–atmosphere dynamics that are not represented by coarse‐scale GCMs.     

中国水分状况对全球气候变化的敏感性分析

中国气候信息库提供了全国太阳辐射日资料以及12个月的气温,降水量,相对湿度,日照百分率和风速资料。利用改进后的Penman式估算出全国潜在蒸散和干燥指数的空间分布,以及降水量增加10％,平均气温上升1．5度,3．0度和4．5倍,3种假定未来气候情况下的潜在蒸散和干燥指数,以评价全球气候变化对中国水分状况的可能影响,结果表明,随着气温的升高,潜在蒸散量会显著增加,而干燥指数变化较为复杂,与当前气候怦景相比较,降水量增加10％,平均气温上升1．5度时中国水分状况会稍微湿润,气温上升4．5度时会稍微干燥,而气温上升3．0度时中国水分状况将介于稍微润与稍干燥之间。     

内蒙古锡林河流域羊草草原净初级生产力及其对全球气候变化的响应

利用CENTURY模型对内蒙古锡林河流域羊草草原在未来气候变化以及大气CO₂浓度增高条件下的年地上净初级生产力(annual aboveground net primary productivity,ANPP)动态进行了模拟研究.结果表明：CENTURY模型可以较好地预测ANPP的变化.进一步的情景模拟发现,虽然全球气候变化所引起的温度和降水改变、以及大气CO₂浓度升高都会影响ANPP,但降水是关键的影响因子.多个全球气候模型(GCM) 预测该地区未来降水量会减少,故可能导致其ANPP降低,但在以下气候变化情景下研究区ANPP可能会升高：1)CO₂浓度倍增,温度升高2 ℃,降水保持不变或增加10%～20%;2)CO₂浓度保持不变,温度升高2 ℃,降水增加20%.气候变化将对内蒙古锡林河流域羊草草原产生显著影响.