Severe Flooding and Malaria Transmission in the Western Ugandan Highlands: Implications for Disease Control in an Era of Global Climate Change
Severe Flooding and Malaria Transmission in the Western Ugandan Highlands: Implications for Disease Control in an Era of Global Climate Change
复制标题
DOI：
10.1093/infdis/jiw363
复制
发表时间：
2016-11-01
影响因子：
6.4
通讯作者：
Siedner, Mark J.
中科院分区：
文献类型：
--
作者：
Boyce, Ross;Reyes, Raquel;Siedner, Mark J.
背景全球气候变化可能通过几种机制影响疟疾传播。我们试图评估与全球气候变化相关的极端降水事件的频率增加将如何影响东非高原地区的疟疾传播。方法：aEuro积分我们使用差异中的差异、准实验设计来检查实验室确认的疟疾病例的发病率和疟疾相关的住院率在村庄之间的空间变异性（1）在高海拔与低海拔，（2）有河流与无河流的对比;（3）2013年5月在乌干达西部地区卡塞塞区发生严重洪水之前和之后的上游与下游的对比。结果：a Euro积分在研究期间，进行了7596次诊断测试，1285名患者被诊断为疟疾。我们观察到，与远离河流的村庄相比，极端洪水导致洪水影响河流沿岸村庄洪水后疟疾诊断测试阳性结果的个人风险增加约30%，对上游村庄的相对影响大于下游村庄（调整后的比率，1.91对1.33）。结论. a欧洲积分极端降水，如这里描述的洪水，可能对疟疾控制计划构成重大挑战，并将需要及时的反应，以减轻对人类健康的有害影响。
Background. There are several mechanisms by which global climate change may impact malaria transmission. We sought to assess how the increased frequency of extreme precipitation events associated with global climate change will influence malaria transmission in highland areas of East Africa.Methods.aEuro integral We used a differences-in-differences, quasi-experimental design to examine spatial variability in the incidence rate of laboratory-confirmed malaria cases and malaria-related hospitalizations between villages (1) at high versus low elevations, (2) with versus without rivers, and (3) upstream versus downstream before and after severe flooding that occurred in Kasese District, Western Region, Uganda, in May 2013.Results.aEuro integral During the study period, 7596 diagnostic tests were performed, and 1285 patients were admitted with a diagnosis of malaria. We observed that extreme flooding resulted in an increase of approximately 30% in the risk of an individual having a positive result of a malaria diagnostic test in the postflood period in villages bordering a flood-affected river, compared with villages farther from a river, with a larger relative impact on upstream versus downstream villages (adjusted rate ratio, 1.91 vs 1.33).Conclusions.aEuro integral Extreme precipitation such as the flooding described here may pose significant challenges to malaria control programs and will demand timely responses to mitigate deleterious impacts on human health.