Gilma Mantilla

The role of ENSO in understanding changes in Colombia's annual malaria burden by region, 1960-2006.

BackgroundMalaria remains a serious problem in Colombia. The number of malaria cases is governed by multiple climatic and non-climatic factors. Malaria control policies, and climate controls such as rainfall and temperature variations associated with the El Niño/Southern Oscillation (ENSO), have been associated with malaria case numbers. Using historical climate data and annual malaria case number data from 1960 to 2006, statistical models are developed to isolate the effects of climate in each of Colombias five contrasting geographical regions.MethodsBecause year to year climate variability associated with ENSO causes interannual variability in malaria case numbers, while changes in population and institutional control policy result in more gradual trends, the chosen predictors in the models are annual indices of the ENSO state (sea surface temperature [SST] in the tropical Pacific Ocean) and time reference indices keyed to two major malaria trends during the study period. Two models were used: a Poisson and a Negative Binomial regression model. Two ENSO indices, two time reference indices, and one dummy variable are chosen as candidate predictors. The analysis was conducted using the five geographical regions to match the similar aggregation used by the National Institute of Health for its official reports.ResultsThe Negative Binomial regression model is found better suited to the malaria cases in Colombia. Both the trend variables and the ENSO measures are significant predictors of malaria case numbers in Colombia as a whole, and in two of the five regions. A one degree Celsius change in SST (indicating a weak to moderate ENSO event) is seen to translate to an approximate 20% increase in malaria cases, holding other variables constant.ConclusionRegional differentiation in the role of ENSO in understanding changes in Colombias annual malaria burden during 1960–2006 was found, constituting a new approach to use ENSO as a significant predictor of the malaria cases in Colombia. These results naturally point to additional needed work: (1) refining the regional and seasonal dependence of climate on the ENSO state, and of malaria on the climate variables; (2) incorporating ENSO-related climate variability into dynamic malaria models.

Toward an integrated approach to nutritional quality, environmental sustainability, and economic viability: research and measurement gaps

Nutrition is affected by numerous environmental and societal causes. This paper starts with a simple framework based on three domains: nutritional quality, economic viability, and environmental sustainability, and calls for an integrated approach in research to simultaneously account for all three. It highlights limitations in the current understanding of each domain, and how they influence one another. Five research topics are identified: measuring the three domains (nutritional quality, economic viability, environmental sustainability); modeling across disciplines; furthering the analysis of food systems in relation to the three domains; connecting climate change and variability to nutritional quality; and increasing attention to inequities among population groups in relation to the three domains. For an integrated approach to be developed, there is a need to identify and disseminate available metrics, modeling techniques, and tools to researchers, practitioners, and policy makers. This is a first step so that a systems approach that takes into account potential environmental and economic trade‐offs becomes the norm in analyzing nutrition and food‐security patterns. Such an approach will help fill critical knowledge gaps and will guide researchers seeking to define and address specific research questions in nutrition in their wider socioeconomic and environmental contexts.

Climate and health in Africa

This paper describes the work of the International Research Institute for Climate and Society (IRI) and its partners towards the development of climate services for the health sector in Africa; integrating research, operational applications and capacity building alongside policy development and advocacy. It follows the evolution of IRI’s health work from an initial focus on the use of seasonal climate forecasts to a wider agenda serving climate and environmental information needs to a broad range of health-related users. Recognizing that climate information must be relevant to the priority policy and programming needs of national and international health stakeholders, this review highlights an approach that has centered not only on the assessment and creation of evidence, but also on knowledge transfer through engagement with decision-makers. Current opportunities and priorities identified for the routine use of climate and environmental information in health in Africa include: i) understanding mechanisms by which climate impacts on transmission and occurrence of disease; ii) mapping populations at risk both in space and by season; iii) developing early warning systems; iv) understanding the contributions of climate to trends in disease incidence v) improving the evaluation of the impacts of climate-sensitive interventions.While traditional metrics (e.g. peer review publications) have been important in establishing evidence for policy, the IRI’s role as a knowledge broker (in research and professional capacity building, facilitation of communities of practice, and engagement in policy dialogue at local and global scale) has been critical to delivery of its mission.

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.

Integration of Seasonal Forecasts into Early Warning Systems for Climate-Sensitive Diseases such as Malaria and Dengue

Effective prevention and control of epidemics has been a key element of global, regional and national disease control policies for many years. Epidemics are by their nature abnormal events and will clearly challenge the normal routine approaches to control and provision of treatment. Epidemics are caused by unusual changes in the existing equilibrium between the human host, the pathogen and its vector. While the level of risk may be exacerbated by social factors, climate variability plays an important role and indeed it is most often abnormality in meteorological and environmental conditions that ‘triggers’ epidemics of the climate sensitive diseases.

Capacity development through the sharing of climate information with diverse user communities

The International Research Institute for Climate and Society (IRI) is a premier global research and capacity development institution focused on enhancing society’s capability to understand, use, manage and evaluate climate information. Its goal is to strengthen the technical capacity of individuals and organizations in order to increase the demand for climate information and its application.In the early years of IRI, staff trained local meteorologists and decision makers, often in developing countries, on using information products that IRI’s forecast group judged would be of value. However, in the last decade, IRI’s approach to training has evolved into one that is more user-driven. Today, users are brought on board during the development of training curricula to learn what information and methodologies would be most useful for their local needs. This establishes a sense of trust and ownership in the training process. Approaches are tailored to different contexts and communities, and focus is placed on cultivating long-lasting partnerships.The work presented in this article demonstrates the evolution of IRI’s capacity building and development processes. It highlights how the IRI implements capacity development activities, with a particular emphasis on the early engagement of practitioners and end users. Numerous examples are provided of the successes related to knowledge gains and to the concrete applications of climate information that can occur when the design and implementation of activities are preformed in an integrative manner. This approach builds channels for interaction among practitioners, policymakers, scientists and other societal decision making groups. Though it has seen numerous successes, the IRI is continually evaluating its capacity development methods and looking for ways to improve upon them.