Climate and Health

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Activity	Objectives	Partners	Status	Next Steps
Malaria Early Warning Project (Funded by NOAA/NSF/EPRI Joint Call on Climate and Health 2003-todate)	Establish relations between climate and malaria and develop malaria early warning system for the Uva Province in Sri Lanka.	International Water Management Institute (IWMI), LDEO Climate Group, Dept. of Meteorology, Anti-Malaria Campaign of Sri Lanka (AMC), SJU, NASA GMAO	Data collection substantially completed. Downscaling of work completed for main rainy seasons, physically based hydrology model implemented over project area, analysis of remote sensing work undertaken, preliminary climate-malaria linkages have been assessed.	Develop environment based malaria risk prediction methods, integrate the models into an early warning system.
Climate and Hydrological Impacts on Dengue Fever.	Establish relations between climate and dengue for Sri Lanka.	Marianne Hopp, University of Toronto, Aravinda de Silva, University of North Carolina	Data collection at aggregate level completed. Analysis underway. Data to be collected at various sub-national levels	Solicit a formal project on Dengue Risk.

 

Dengue

Dengue is becoming an increasingly important public health hazard in Sri Lanka. Unlike malaria, dengue is prevalent mostly in the urban areas. Unlike malaria, which has seen many epidemics over centuries, dengue's more virulent and deadly form, dengue hemorrhagic fever (DHF) has only a history of two decades. Until recently, it was confined to the Colombo metropolitan area but since has emerged in other cities and suburbs.
A study on the link between climate and dengue in Sri Lanka is being carried out in collaboration with Prof. Aravinda De Silva of the Department of Epidemiology and Public Health of the University of North Carolina and Dr Marianne Hopp. Some of the preliminary analysis shows a strong seasonality of dengue incidence with the outbreaks being more prevalent during the boreal summer. The seasonality of dengue transmission thus differs from malaria which is a spring and fall phenomenon.

Summary: This analysis has already shown a seasonality with a summer peak, an inter-annual relationship with seasonal climate. Work is ongoing to consolidate and extend this work.

Malaria

Malaria is endemic in 101 countries and about 40% of the world’s population is at risk. In 1998, there were 273 million cases and 1.1 million deaths worldwide. In WHO's Southeast Asia region (which includes Sri Lanka), the case load was 16 million, with 73,000 deaths. Sri Lanka spends approximately 60% of its public health budget on malaria control. Malaria incidence in Sri Lanka has increased during the past 7 years. Plasmodium falciparum, which historically has been of low prevalence in Sri Lanka, has increased from 5% to about 25% of cases over the past decade and is increasingly resistant to the main anti-malarial drug, chloroquine. With an incidence rate of almost 12 per 1000 population Sri Lanka presently ranks as one of the most severely affected countries in Asia.

Sri Lanka has a history of malaria control dating to the 1920's, but was struggling until 2000 to contain the disease because of population increase, large-scale human settlement in disease-endemic areas, rapid agro-ecological change, and altered patterns of population mobility. Malaria in Sri Lanka is unstable and fluctuates in intensity both spatially and temporally. Thus resources have to be spread to cover all potential risk areas, regardless of whether an outbreak will occur or not at a given point in time. Geographic and seasonal specificity of impending malaria risk will be particularly useful in communicating with environmental managers such as irrigation engineers who can use water management techniques to reduce mosquito breeding in pools in river beds. A major constraint to a more focused approach to malaria control is the lack of a forecasting system.

While many factors play a role in the distribution of malaria and occurrence of malaria epidemics, climate is considered a major determinant. Temperature, rainfall, and humidity affect breeding and survival of vector mosquitoes and development of malaria parasites within the mosquitoes. Historically many epidemics have occurred during drought, as river margins retreat leaving numerous pools suitable for vector breeding, or in the season following a drought when rains return to normal. This post-drought epidemic often poses a major public health problem among populations whose vulnerability is heightened due to a period of poor nutrition associated with drought and lowered agricultural output. Sri Lanka has operated very effective malaria control in the past, however it has also suffered several major epidemics which have been triggered by climatic and hydrological anomalies. Recent evidence suggests that ENSO-associated climate variability influences vector borne diseases such as malaria. However, studies at finer temporal and spatial resolutions are needed to establish the mechanisms by which ENSO and other causes of climate variability may influence the transmission of malaria.

Malaria Seasonality

Disease incidence often follows closely the rainfall seasonality. Peak months of incidence are May to June and November to January.

Project Goals

• Evaluate micro scale interaction between climate and malaria transmission in Uva,
• Evaluate macro scale relationships between climate and malaria cases in Sri Lanka
• Develop models to forecast malaria risk
• Produce malaria risk maps
• Test the effectiveness of these maps at a pilot scale

 

Outputs

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Publications

• 2004: Lareef Zubair (2004a), Empowering the Vulnerable, TIEMPO, University of East Anglia, Volume 52. (developed from the presentation at the Climate and Health Meeting in the Maldives).
• 2006: Lareef Zubair and C.F. Ropelewski, in press, The strengthening influence of ENSO on North East Monsoon rainfall over Sri Lanka and Southern India, Journal of Climate.
• 2006: Lareef Zubair and Janaki Chandimala, in press, Journal of Hydrometeorology, Epochal Changes in ENSO-stream flow relationships in Sri Lanka.

Papers under Review

• 2005: Janaki Chandimala and Lareef Zubair, in second revision, Journal of Hydrology, ENSO based predictions for Water Resources Management in Sri Lanka.

Conference Proceedings

• 2004: Janaki Chandimala and Lareef Zubair, Predictability of Stream flow and Rainfall in the Kelani river basin in Sri Lanka using ENSO, International Conference on Sustainable Water Resources Management in the Changing Environment of the Monsoon Region, United Nations University, Colombo, Sri Lanka.
• 2004: Lareef Zubair, Joshua Qian, Neil Ward, Ousmane Ndiaye, Janaki Chandimala, Ruvini Perera, Vidhura Ralapanawe and Benno Blumenthal (2004b), Complementary Dynamical and Statistical Downscaling from a GCM: Maha rainfall over Sri Lanka, Annual Meeting of the American Geophysical Union, San Francisco.
• 2004: Lareef Zubair (2004c) Downscaling of Sri Lanka's Maha Rainfall from a GCM and Indian Ocean Dipole and ENSO influences, International Conference on Sustainable Water Resources Management in the Changing Environment of the Monsoon Region, United Nations University, Colombo, Sri Lanka.
• 2004: Lareef Zubair (2004e), Weather, Climate Variability and Climate Change, Workshop Report, Synthesis Workshop on Climate Variability, Climate Change and Health in Small-Island States, Bandos Island, Maldives, 1-4 December 2003, pages 13-14, World Health Organization, Bandos, Maldives.
• 2005: Lareef Zubair (2005a), Climate Risk Management: Case Studies in Public Health, Natural Disasters and Renewable Energy, Biennial Congress of the Association of Environmental Engineering and Science Professors, Potsdam, New York.

Reports

• Apr 2004: Olivier Briet and Lareef Zubair, Compilation of Presentations at the inaugural meeting of the Climate and Malaria Project, Passara, Badulla.
• Jun 2004: Year 1 Project Report on Progress, submitted to NOAA, OGP.    
• Jun 2005: Year 2 Project Report on Progress, submitted to NOAA, OGP.    
• Nov 2005: Janaki Chandimala and Lareef Zubair, Topmodel land surface model implementation for a catchment in the Uva.
• Jan 2006: Sarith Mahanama, Randall Koster and Lareef Zubair, Implementation of the “Catchment” Land surface model for Sri Lanka, in preparation. 
• Jan 2006: Hyemin Yang, Gawrie Galapaththy, Stephen Connor and Lareef Zubair, Association between ENSO and Malaria epidemics in Sri Lanka, in preparation, 2006.
• Jan 2006: Upamala Tennakoon and Lareef Zubair, Monthly maps of average malaria incidence in Sri Lanka by district and MOH division, in preparation.
• Jan 2006: Upamala Tennakoon, Manjula Siriwardhana, Yoosuf Ashraj, Siraj Razick. H.M. Faizal and Lareef Zubair, Spatial Atlas of Malaria Incidence in the Uva Province, in preparation.
• Jan 2006: Manjula Siriwardhana, Yoosuf Ashraj and Lareef Zubair, Malaria Incidence over the 19th and 20th centuries in Sri Lanka, in preparation.
• Jan 2006: Manjula Siriwardhana, Badra Nawarathna, Siraj Razick, Janaki Chandimala and Lareef Zubair, Downscaling of seasonal precipitation projections over different seasons in Sri Lanka. In preparation.