Teresa K. Yamana

Projected Impacts of Climate Change on Environmental Suitability for Malaria Transmission in West Africa

Background: Climate change is expected to affect the distribution of environmental suitability for malaria transmission by altering temperature and rainfall patterns; however, the local and global impacts of climate change on malaria transmission are uncertain. Objective: We assessed the effect of climate change on malaria transmission in West Africa. Methods: We coupled a detailed mechanistic hydrology and entomology model with climate projections from general circulation models (GCMs) to predict changes in vectorial capacity, an indication of the risk of human malaria infections, resulting from changes in the availability of mosquito breeding sites and temperature-dependent development rates. Because there is strong disagreement in climate predictions from different GCMs, we focused on the GCM projections that produced the best and worst conditions for malaria transmission in each zone of the study area. Results: Simulation-based estimates suggest that in the desert fringes of the Sahara, vectorial capacity would increase under the worst-case scenario, but not enough to sustain transmission. In the transitional zone of the Sahel, climate change is predicted to decrease vectorial capacity. In the wetter regions to the south, our estimates suggest an increase in vectorial capacity under all scenarios. However, because malaria is already highly endemic among human populations in these regions, we expect that changes in malaria incidence would be small. Conclusion: Our findings highlight the importance of rainfall in shaping the impact of climate change on malaria transmission in future climates. Even under the GCM predictions most conducive to malaria transmission, we do not expect to see a significant increase in malaria prevalence in this region. Citation: Yamana TK, Eltahir EA. 2013. Projected impacts of climate change on environmental suitability for malaria transmission in West Africa. Environ Health Perspect 121:1179–1186; http://dx.doi.org/10.1289/ehp.1206174

Superensemble forecasts of dengue outbreaks

In recent years, a number of systems capable of predicting future infectious disease incidence have been developed. As more of these systems are operationalized, it is important that the forecasts generated by these different approaches be formally reconciled so that individual forecast error and bias are reduced. Here we present a first example of such multi-system, or superensemble, forecast. We develop three distinct systems for predicting dengue, which are applied retrospectively to forecast outbreak characteristics in San Juan, Puerto Rico. We then use Bayesian averaging methods to combine the predictions from these systems and create superensemble forecasts. We demonstrate that on average, the superensemble approach produces more accurate forecasts than those made from any of the individual forecasting systems.

Linking environmental variability to village-scale malaria transmission using a simple immunity model

BackgroundIndividuals continuously exposed to malaria gradually acquire immunity that protects from severe disease and high levels of parasitization. Acquired immunity has been incorporated into numerous models of malaria transmission of varying levels of complexity (e.g. Bull World Health Organ 50:347, 1974; Am J Trop Med Hyg 75:19, 2006; Math Biosci 90:385–396, 1988). Most such models require prescribing inputs of mosquito biting rates or other entomological or epidemiological information. Here, we present a model with a novel structure that uses environmental controls of mosquito population dynamics to simulate the mosquito biting rates, malaria prevalence as well as variability in protective immunity of the population.MethodsA simple model of acquired immunity to malaria is presented and tested within the framework of the Hydrology, Entomology and Malaria Transmission Simulator (HYDREMATS), a coupled hydrology and agent-based entomology model. The combined model uses environmental data including rainfall, temperature, and topography to simulate malaria prevalence and level of acquired immunity in the human population. The model is used to demonstrate the effect of acquired immunity on malaria prevalence in two Niger villages that are hydrologically and entomologically very different. Simulations are conducted for the year 2006 and compared to malaria prevalence observations collected from the two villages.ResultsBlood smear samples from children show no clear difference in malaria prevalence between the two villages despite pronounced differences in observed mosquito abundance. The similarity in prevalence is attributed to the moderating effect of acquired immunity, which depends on prior exposure to the parasite through infectious bites - and thus the hydrologically determined mosquito abundance. Modelling the level of acquired immunity can affect village vulnerability to climatic anomalies.ConclusionsThe model presented has a novel structure constituting a mechanistic link between spatial and temporal environmental variability and village-scale malaria transmission. Incorporating acquired immunity into the model has allowed simulation of prevalence in the two villages, and isolation of the effects of acquired immunity in dampening the difference in prevalence between the two villages. Without these effects, the difference in prevalence between the two villages would have been significantly larger in response to the large differences in mosquito populations and the associated biting rates.

Impact of climate change on malaria in Africa: a combined modelling and observational study

Abstract Background Africa is the hotspot for malaria transmission where more than 90% of malaria deaths occur every year. The effect of climate change on malaria transmission in Africa has been controversial. Malaria is a major vector-borne parasitic disease transmitted to humans by Anopheles spp mosquitoes. Malaria transmission is an intricate function of climatic factors, which non-linearly affect the development of vectors and parasites. In this study, we aimed to project that the risk of malaria will increase towards the end of the 21st century in east Africa, but decrease in west Africa. Methods We combine a novel malaria transmission simulator, HYDREMATS, that has been developed based on comprehensive multi-year field surveys both in east Africa and west Africa, and the most reliable climate projections through regional dynamical downscaling and rigorous selection of global circulation models from among CMIP5 models. Findings We define a bell-shaped relation between malaria intensity and temperature, centered around a temperature of 28°C. Future risks of malaria are projected for two highly populated regions in Africa: the highlands in east Africa and the fringes of the desert in west Africa. In the highlands in east Africa, temperatures are substantially colder than this optimal temperature; warmer future climate exacerbate malaria conditions. In the Sahel fringes in west Africa, temperatures are around this optimal temperature; warming is not likely to exacerbate and might even reduce malaria burden. Unlike the highlands in east Africa, which receive major amounts of annual rainfall, dry conditions also limit malaria transmission in the Sahel fringes in west Africa. Interpretation The study shows disproportionate future risk of malaria due to climate change between east and west Africa, and should have an effect on guiding strategies for climate adaptation over Africa. Funding Cooperative agreement between US National Science Foundation and Cooperative Agreement between the Masdar Institute of Science and Technology (Masdar Institute), Abu Dhabi, UAE, and the Massachusetts Institute of Technology (MIT), Cambridge, MA, USA.

Individual versus superensemble forecasts of seasonal influenza outbreaks in the United States

Recent research has produced a number of methods for forecasting seasonal influenza outbreaks. However, differences among the predicted outcomes of competing forecast methods can limit their use in decision-making. Here, we present a method for reconciling these differences using Bayesian model averaging. We generated retrospective forecasts of peak timing, peak incidence, and total incidence for seasonal influenza outbreaks in 48 states and 95 cities using 21 distinct forecast methods, and combined these individual forecasts to create weighted-average superensemble forecasts. We compared the relative performance of these individual and superensemble forecast methods by geographic location, timing of forecast, and influenza season. We find that, overall, the superensemble forecasts are more accurate than any individual forecast method and less prone to producing a poor forecast. Furthermore, we find that these advantages increase when the superensemble weights are stratified according to the characteristics of the forecast or geographic location. These findings indicate that different competing influenza prediction systems can be combined into a single more accurate forecast product for operational delivery in real time.

Forecasting seasonal influenza in the U.S.: A collaborative multi-year, multi-model assessment of forecast performance

Influenza infects an estimated 9 to 35 million individuals each year in the United States and is a contributing cause for between 12,000 and 56,000 deaths annually. Seasonal outbreaks of influenza are common in temperate regions of the world, with highest incidence typically occurring in colder and drier months of the year. Real-time forecasts of influenza transmission can inform public health response to outbreaks. We present the results of a multi-institution collaborative effort to standardize the collection and evaluation of forecasting models for influenza in the US for the 2010/2011 through 2016/2017 influenza seasons. For these seven seasons, we assembled weekly real-time forecasts of 7 targets of public health interest from 22 different models. We compared forecast accuracy of each model relative to a historical baseline seasonal average. Across all regions of the US, over half of the models showed consistently better performance than the historical baseline when forecasting incidence of influenza-like illness 1, 2 and 3 weeks ahead of available data and when forecasting the timing and magnitude of the seasonal peak. In some regions, delays in data reporting were strongly and negatively associated with forecast accuracy. More timely reporting and an improved overall accessibility to novel and traditional data sources are needed to improve forecasting accuracy and its integration with real-time public health decision-making.

Evaluation of mechanistic and statistical methods in forecasting influenza-like illness

A variety of mechanistic and statistical methods to forecast seasonal influenza have been proposed and are in use; however, the effects of various data issues and design choices (statistical versus mechanistic methods, for example) on the accuracy of these approaches have not been thoroughly assessed. Here, we compare the accuracy of three forecasting approaches—a mechanistic method, a weighted average of two statistical methods and a super-ensemble of eight statistical and mechanistic models—in predicting seven outbreak characteristics of seasonal influenza during the 2016–2017 season at the national and 10 regional levels in the USA. For each of these approaches, we report the effects of real time under- and over-reporting in surveillance systems, use of non-surveillance proxies of influenza activity and manual override of model predictions on forecast quality. Our results suggest that a meta-ensemble of statistical and mechanistic methods has better overall accuracy than the individual methods. Supplementing surveillance data with proxy estimates generally improves the quality of forecasts and transient reporting errors degrade the performance of all three approaches considerably. The improvement in quality from ad hoc and post-forecast changes suggests that domain experts continue to possess information that is not being sufficiently captured by current forecasting approaches.