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ENHANCED NATIONAL CLIMATE SERVICES Climatic Suitability for Malaria Transmision (CSMT) Training Module Kenya August July 15, 2018 2016 Version 1.0 1178421 International Research Institute for Climate and Society (IRI), (2016). 2018 Climate Suitability for Malaria Transmission - Kenya. August. July 15, Version 1.0. Palisades: IRI. This work is licensed under a Creative Commons Attribution-Non Commercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) and may be adapted or reproduced with attribution to the IRI and for any non-commercial purpose.

Acknowledgements The ENACTS team, wishes to thank all the individuals and institutions that contributed in the many ways to the preparation of this manual. The shared technical knowledge, experiences, and perspectives have produced a training module that will have a significant positive impact on the capability of strengthening the ENACTS tools in various East African countries. Special thanks are extended to the IRI staff members who collaborated in the preparation of the different manuals: Dr. Pietro Ceccato, John delcorral, Dr. Tufa Dinku, Dr. James Hansen, Igor Khomyakov, Dr. Asher Siebert, Yohana Tesfamariam Tekeste, Aisha Owusu, Dr. Madeleine Thomson and Sarah Malik. The preparation of this manual would not have been possible without the support provided by our donor, UK DfID WISER ENACTS and we extend sincere appreciation to our donor.

CONTENTS 1 Climatic Suitability for Malaria Transmission (CSMT) Training - Kenya 1 1.1 Overview... 1 1.2 Definition... 1 1.3 Interpretation... 1 1.4 Access... 2 1.5 Analyses... 2 1.6 Case Study - Tanzania... 4 1.7 Exercise - Kenya... 4 1.8 Quiz... 6 1.9 Summary... 7 1.10 Reference(s)... 7 i

ii

CHAPTER ONE CLIMATIC SUITABILITY FOR MALARIA TRANSMISSION (CSMT) TRAINING - KENYA 1.1 Overview Why was it developed? The Climatic Suitability for Malaria Transmission (CSMT) tool was developed to help malaria control practitioners better plan activities at district or regional scales through a better understanding of the seasonality of malaria risk as indicated by climatic factors. What can the CSMT tool be used for? Estimating the probable length of the main malaria season(s) Planning for the timing of control activities, including dissemination of malaria commodities to individual districts Identifying epidemic prone districts Identifying districts where increasing temperature or precipitation trends may increase malaria transmission What can the CSMT tool NOT be used for? Predicting epidemics in the coming season/year Investigating malaria risk caused by factors other than precipitation and/or temperature 1.2 Definition The CSMT tool is an interactive map that displays the number of months during the year when climatological (i.e. long-term average) conditions are considered to be suitable for malaria transmission. Suitability is based on empirically-derived thresholds of precipitation, temperature and relative humidity. 1.3 Interpretation The CSMT map shows the number of months suitable for malaria transmission, based on climatological averages. Suitability is defined as the coincidence of monthly precipitation accumulation greater than 80 mm, monthly mean temperature between 18 C and 32 C, and monthly relative humidity greater than 60%. These thresholds are based on a consensus of the literature. In practice, the optimal and limiting conditions for transmission are dependent on the particular species of the parasite and the mosquito vectors. 1

1.4 Access Figure 1.1 displays a clickable map used in the CSMT interface that can be accessed through the Kenya Climate and Health Maproom http://41.215.70.189:8081/maproom/health/csmt/index.html Latitude 4 S 3 S 2 S 1 S 0 1 N 2 N 3 N 4 N 34 E 35 E 36 E 37 E 38 E 39 E 40 E 41 E Longitude Fig. 1.1: Seasonal Climatic Suitability for Malaria Transmission in Kenya This Kenya CSMT illustrates the number of months during the year that are suitable for malaria transmission based on climatological conditions derived from precipitation (Meteo Kenya ENACTS climatology 1983-2010), temperature (Meteo Kenya ENACTS climatology 1981-2010) and relative humidity (National Centers for Environmental Prediction/National Center for Atmospheric Research). 1.5 Analyses In Figure 1.2, the time series graphs display the percent occurrence of climate conditions that were suitable for malaria transmission during 1983-2010 for the Eastern province of Kenya. 2 Chapter 1. Climatic Suitability for Malaria Transmission (CSMT) Training - Kenya

Fig. 1.2: Percent occurence of climate conditions suitable for malaria transmission for Samburu 1.5. Analyses 3

By clicking on any location of interest, it is possible to generate and visualize the map of percent occurrence of climate conditions suitable for malaria transmission and the individual graphs of corresponding precipitation, temperature and relative humidity percentage occurrences. 1.6 Case Study - Tanzania The President Malaria Initiative (PMI) wants to start a campaign of mosquito control in an area in South East Tanzania. When would be the best time to apply insecticide and control the mosquitoes? The answer can be obtained by selecting a southeastern district within the toolbar or the clicking on a location in southeastern Tanzania, as seen in Figure 1.3. Fig. 1.3: Seasonal Climatic Suitability for Malaria Transmission in an area in South East Tanzania The resulting graphs in Figure 1.4 show that the malaria transmission usually starts in November and lasts until May. Therefore, the most appropriate time to run the control campaign would be just before the beginning of the malaria transmission September or October. 1.7 Exercise - Kenya Please perform the following exercise: 4 Chapter 1. Climatic Suitability for Malaria Transmission (CSMT) Training - Kenya

Fig. 1.4: Percent occurence of climate conditions suitable for malaria transmission for a district in an area in South East Tanzania 1.7. Exercise - Kenya 5

E1. Using the CSMT tool and its toolbar, generate maps and graphs for the Bomet County of Kenya. Latitude 4 S 2 S 0 2 N 4 N 34 E 36 E 38 E 40 E Longitude Fig. 1.5: Seasonal Climatic Suitability for Malaria Transmission in Bomet County, Kenya Please answer the following question: Q1. Based on your map, also seen in Figure 1.5, when would be the best time to control mosquitoes in the county of Bomet, Kenya, where CSMT is 5 months? 1.7.1 Exercise - Answers A1: As per figure 1.6, Jan, Feb, Jun, Jul, August, and September would be the best months to control mosquitos because the malaria transmission is at the lowest, although Bomet has a high malaria transmission in all the months. 1.8 Quiz Please answer the following questions: 1. The CSMT tool can be used to identify the timing of interventions (T/F) 2. The CSMT tool can be used to predict malaria epidemics (T/F) 3. The CSMT tool can be used to evaluate the impact of interventions (T/F) 6 Chapter 1. Climatic Suitability for Malaria Transmission (CSMT) Training - Kenya

Fig. 1.6: Total percent occurence of climate conditions suitable for malaria transmission for the county of Bomet, Kenya 1.8.1 Quiz - Answers A1: True, the CSMT tool can be used to identify the timing of interventions. A2: False, the CSMT tool CANNOT be used to predict malaria epidemics. A3: False, the CSMT tool CANNOT be used to evaluate the impact of interventions. 1.9 Summary The CSMT is a tool for use in malaria surveillance intervention. It enables the user to access the information about when and where malaria transmission is suitable based on a combination of precipitation, temperature and relative humidity. 1.10 Reference(s) Grover-Kopec, E. K., Blumenthal, M. B., Ceccato, P., Dinku, T., Omumbo, J., Connor, S. J. (2006). Web-based climate information resources for malaria control in Africa. Malaria Journal, 5:38 1.9. Summary 7