Malaria elimination on Hainan Island despite climate change

Huaiyu Tian*, Naizhe Li, Yapin Li, Moritz U.G. Kraemer, Hua Tan, Yonghong Liu, Yidan Li, Ben Wang, Peiyi Wu, Bernard Cazelles, José Lourenço, Dongqi Gao, Dingwei Sun, Wenjing Song, Yuchun Li, Oliver G. Pybus, Guangze Wang*, Christopher Dye*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)

Abstract

Background: Rigorous assessment of the effect of malaria control strategies on local malaria dynamics is a complex but vital step in informing future strategies to eliminate malaria. However, the interactions between climate forcing, mass drug administration, mosquito control and their effects on the incidence of malaria remain unclear. Methods: Here, we analyze the effects of interventions on the transmission dynamics of malaria (Plasmodium vivax and Plasmodium falciparum) on Hainan Island, China, controlling for environmental factors. Mathematical models were fitted to epidemiological data, including confirmed cases and population-wide blood examinations, collected between 1995 and 2010, a period when malaria control interventions were rolled out with positive outcomes. Results: Prior to the massive scale-up of interventions, malaria incidence shows both interannual variability and seasonality, as well as a strong correlation with climatic patterns linked to the El Nino Southern Oscillation. Based on our mechanistic model, we find that the reduction in malaria is likely due to the large scale rollout of insecticide-treated bed nets, which reduce the infections of P. vivax and P. falciparum malaria by 93.4% and 35.5%, respectively. Mass drug administration has a greater contribution in the control of P. falciparum (54.9%) than P. vivax (5.3%). In a comparison of interventions, indoor residual spraying makes a relatively minor contribution to malaria control (1.3%–9.6%). Conclusions: Although malaria transmission on Hainan Island has been exacerbated by El Nino Southern Oscillation, control methods have eliminated both P. falciparum and P. vivax malaria from this part of China.

Original languageEnglish
Article number12
JournalCommunications medicine
Volume2
Issue number1
DOIs
Publication statusPublished - Dec 2022
Externally publishedYes

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