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dc.contributor.authorShah, Melisa M
dc.contributor.authorKrystosik, Amy R
dc.contributor.authorNdenga, Bryson A
dc.contributor.authorMutuku, Francis M
dc.contributor.authorCaldwell, Jamie M
dc.contributor.authorOtuka, Victoria
dc.contributor.authorChebii, Philip K
dc.contributor.authorMaina, Priscillah W
dc.contributor.authorJembe, Zainab
dc.contributor.authorRonga, Charles
dc.contributor.authorBisanzio, Donal
dc.contributor.authorAnyamba, Assaf
dc.contributor.authorDamoah, Richard
dc.contributor.authorRipp, Kelsey
dc.contributor.authorJagannathan, Prasanna
dc.contributor.authorMordecai, Erin A
dc.contributor.authorLaBeaud, A. Desiree
dc.date.accessioned2021-06-08T11:32:22Z
dc.date.available2021-06-08T11:32:22Z
dc.date.issued2019
dc.identifier.urihttps://ir.tum.ac.ke/handle/123456789/17417
dc.description.abstractAmbient temperature is an important determinant of malaria transmission and suitability, afecting the life-cycle of the Plasmodium parasite and Anopheles vector. Early models predicted a thermal malaria transmission optimum of 31 °C, later revised to 25 °C using experimental data from mosquito and parasite biology. However, the link between ambient temperature and human malaria incidence remains poorly resolved. To evaluate the relationship between ambient temperature and malaria risk, 5833 febrile children (<18 years-old) with an acute, non-localizing febrile illness were enrolled from four heterogenous outpatient clinic sites in Kenya (Chulaimbo, Kisumu, Msambweni and Ukunda). Thick and thin blood smears were evaluated for the presence of malaria parasites. Daily temperature estimates were obtained from land logger data, and rainfall from National Oceanic and Atmospheric Administration (NOAA)’s Africa Rainfall Climatology (ARC) data. Thirty-day mean temperature and 30-day cumulative rainfall were estimated and each lagged by 30 days, relative to the febrile visit. A generalized linear mixed model was used to assess relationships between malaria smear positivity and predictors including temperature, rainfall, age, sex, mosquito exposure and socioeconomic status. Malaria smear positivity varied between 42–83% across four clinic sites in western and coastal Kenya, with highest smear positivity in the rural, western site. The temperature ranges were cooler in the western sites and warmer in the coastal sites. In multivariate analysis controlling for socioeconomic status, age, sex, rainfall and bednet use, malaria smear positivity peaked near 25 °C at all four sites, as predicted a priori from an ecological model. This study provides direct feld evidence of a unimodal relationship between ambient temperature and human malaria incidence with a peak in malaria transmission occurring at lower temperatures than previously recognized clinically. This nonlinear relationship with an intermediate optimal temperature implies that future climate warming could expand malaria incidence in cooler, highland regions while decreasing incidence in already warm regions with average temperatures above 25 °C. These fndings support eforts to further understand the nonlinear association between ambient temperature and vector-borne diseases to better allocate resources and respond to disease threats in a future, warmer world.en_US
dc.language.isoenen_US
dc.publisherParasites & Vectorsen_US
dc.subjectClimateen_US
dc.subjectMalariaen_US
dc.subjectKenyaen_US
dc.subjectClinic-based surveillanceen_US
dc.titleMalaria smear positivity among Kenyan children peaks at intermediate temperatures as predicted by ecological modelsen_US
dc.typeArticleen_US


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