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      An integrated risk and vulnerability assessment framework for climate change and malaria transmission in East Africa

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          Abstract

          Background

          Malaria is one of the key research concerns in climate change-health relationships. Numerous risk assessments and modelling studies provide evidence that the transmission range of malaria will expand with rising temperatures, adversely impacting on vulnerable communities in the East African highlands. While there exist multiple lines of evidence for the influence of climate change on malaria transmission, there is insufficient understanding of the complex and interdependent factors that determine the risk and vulnerability of human populations at the community level. Moreover, existing studies have had limited focus on the nature of the impacts on vulnerable communities or how well they are prepared to cope. In order to address these gaps, a systems approach was used to present an integrated risk and vulnerability assessment framework for studies of community level risk and vulnerability to malaria due to climate change.

          Results

          Drawing upon published literature on existing frameworks, a systems approach was applied to characterize the factors influencing the interactions between climate change and malaria transmission. This involved structural analysis to determine influential, relay, dependent and autonomous variables in order to construct a detailed causal loop conceptual model that illustrates the relationships among key variables. An integrated assessment framework that considers indicators of both biophysical and social vulnerability was proposed based on the conceptual model.

          Conclusions

          A major conclusion was that this integrated assessment framework can be implemented using Bayesian Belief Networks, and applied at a community level using both quantitative and qualitative methods with stakeholder engagement. The approach enables a robust assessment of community level risk and vulnerability to malaria, along with contextually relevant and targeted adaptation strategies for dealing with malaria transmission that incorporate both scientific and community perspectives.

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          Most cited references75

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          Business Dynamics : Systems Thinking and Modeling for a Complex World

          Today's leading authority on the subject of this text is the author, MIT Standish Professor of Management and Director of the System Dynamics Group, John D. Sterman. Sterman's objective is to explain, in a true textbook format, what system dynamics is, and how it can be successfully applied to solve business and organizational problems. System dynamics is both a currently utilized approach to organizational problem solving at the professional level, and a field of study in business, engineering, and social and physical sciences.
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            Global Change and Human Vulnerability to Vector-Borne Diseases

            Global change includes climate change and climate variability, land use, water storage and irrigation, human population growth and urbanization, trade and travel, and chemical pollution. Impacts on vector-borne diseases, including malaria, dengue fever, infections by other arboviruses, schistosomiasis, trypanosomiasis, onchocerciasis, and leishmaniasis are reviewed. While climate change is global in nature and poses unknown future risks to humans and natural ecosystems, other local changes are occurring more rapidly on a global scale and are having significant effects on vector-borne diseases. History is invaluable as a pointer to future risks, but direct extrapolation is no longer possible because the climate is changing. Researchers are therefore embracing computer simulation models and global change scenarios to explore the risks. Credible ranking of the extent to which different vector-borne diseases will be affected awaits a rigorous analysis. Adaptation to the changes is threatened by the ongoing loss of drugs and pesticides due to the selection of resistant strains of pathogens and vectors. The vulnerability of communities to the changes in impacts depends on their adaptive capacity, which requires both appropriate technology and responsive public health systems. The availability of resources in turn depends on social stability, economic wealth, and priority allocation of resources to public health.
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              Impact of climate change on global malaria distribution.

              Malaria is an important disease that has a global distribution and significant health burden. The spatial limits of its distribution and seasonal activity are sensitive to climate factors, as well as the local capacity to control the disease. Malaria is also one of the few health outcomes that has been modeled by more than one research group and can therefore facilitate the first model intercomparison for health impacts under a future with climate change. We used bias-corrected temperature and rainfall simulations from the Coupled Model Intercomparison Project Phase 5 climate models to compare the metrics of five statistical and dynamical malaria impact models for three future time periods (2030s, 2050s, and 2080s). We evaluated three malaria outcome metrics at global and regional levels: climate suitability, additional population at risk and additional person-months at risk across the model outputs. The malaria projections were based on five different global climate models, each run under four emission scenarios (Representative Concentration Pathways, RCPs) and a single population projection. We also investigated the modeling uncertainty associated with future projections of populations at risk for malaria owing to climate change. Our findings show an overall global net increase in climate suitability and a net increase in the population at risk, but with large uncertainties. The model outputs indicate a net increase in the annual person-months at risk when comparing from RCP2.6 to RCP8.5 from the 2050s to the 2080s. The malaria outcome metrics were highly sensitive to the choice of malaria impact model, especially over the epidemic fringes of the malaria distribution.
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                Author and article information

                Contributors
                esther.onyango@griffithuni.edu.au
                o.sahin@griffith.edu.au
                aawiti@gmail.com
                c.chu@griffith.edu.au
                b.mackey@griffith.edu.au
                Journal
                Malar J
                Malar. J
                Malaria Journal
                BioMed Central (London )
                1475-2875
                11 November 2016
                11 November 2016
                2016
                : 15
                : 551
                Affiliations
                [1 ]Centre for Environment and Population Health, Griffith University, School of Environment, 170 Kessels Road, Nathan, 4111 Australia
                [2 ]School of Engineering, Griffith University, Gold Coast, 4222 Australia
                [3 ]East African Institute, Aga Khan University East Africa, 2nd Parklands Avenue, Nairobi, 00100 Kenya
                [4 ]Griffith Climate Change Response Program, Griffith University, Gold Coast, 4222 Australia
                Article
                1600
                10.1186/s12936-016-1600-3
                5105305
                27835976
                7a498ab0-2608-4152-9c70-650721998963
                © The Author(s) 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 21 June 2016
                : 4 November 2016
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100001791, Griffith University;
                Award ID: 21812
                Award Recipient :
                Categories
                Research
                Custom metadata
                © The Author(s) 2016

                Infectious disease & Microbiology
                integrated risk and vulnerability assessment,climate change impact on malaria transmission,systems approach,climate change and malaria risk,east africa

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