Climatic Suitability for Malaria Transmision (CSMT)

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Climatic Suitability for Malaria Transmision (CSMT) Training Module Malawi June 27, 2017 Version 1.0 International Research Institute for Climate and Society (IRI), (2017). Climate Suitability for Malaria Transmission - Malawi. June 27, 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. Although at the moment ENACTS has not yet been implemented in Malawi we look forward to having Malawi as part of the ENACTS countries in the near future. 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, and Dr. Madeleine Thomson. The preparation of this manual would not have been possible without the support provided by our donors WHO - Global Framework for Climate Services and UK DfID WISER ENACTS and we extend sincere appreciation to our donors.

CONTENTS 1 Climatic Suitability for Malaria Transmission (CSMT) Training - Malawi 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... 2 1.7 Exercise - Malawi... 4 1.8 Quiz... 4 1.9 Summary... 5 1.10 Reference(s)... 5 i

ii

CHAPTER ONE CLIMATIC SUITABILITY FOR MALARIA TRANSMISSION (CSMT) TRAINING - MALAWI 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

Climatic Suitability for Malaria Transmission (CSMT) - Malawi, Release 1.0.0 1.4 Access Figure 1.1 displays a clickable map used in the CSMT interface that can be accessed through the Malawi Climate and Health Maproom (http://datalib.medccmslawi.com:8091/maproom/health/csmt/index.html) Latitude 17 S 16 S 15 S 14 S 13 S 12 S 11 S 10 S 33 E 34 E 35 E 36 E Longitude Fig. 1.1: Seasonal Climatic Suitability for Malaria Transmission in Malawi This Malawi CSMT illustrates the number of months during the year that are suitable for malaria transmission based on climatological conditions derived from precipitation (Malawi Meteorological Agency - DCCMS ENACTS climatology 1983-2010), temperature (DCCMS 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 an area in Central Region of Malawi. 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. 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. 2 Chapter 1. Climatic Suitability for Malaria Transmission (CSMT) Training - Malawi

Climatic Suitability for Malaria Transmission (CSMT) - Malawi, Release 1.0.0 Fig. 1.2: Percent occurence of climate conditions suitable for malaria transmission for an area in Central Region of Malawi Fig. 1.3: Seasonal Climatic Suitability for Malaria Transmission in an area in South East Tanzania Fig. 1.4: Percent occurence of climate conditions suitable for malaria transmission for a district in an area in South East Tanzania 1.6. Case Study - Tanzania 3

Climatic Suitability for Malaria Transmission (CSMT) - Malawi, Release 1.0.0 1.7 Exercise - Malawi Please perform the following exercises: E1. Using the CSMT tool and the mouse, click on Mzimba district located in the northern region of Malawi, to generate maps and graphs, similar to those in figures 1.5 and 1.6 below. Latitude 17 S 16 S 15 S 14 S 13 S 12 S 11 S 10 S 33 E 34 E 35 E 36 E Longitude Fig. 1.5: Seasonal Climatic Suitability for Malaria Transmission in Mzimba District, Malawi Please answer the following question: Q1. Based on the above map and bar graph, also seen in Figure 1.5 and 1.6, when would be the best time to control mosquitoes in Mzimba distric of Malawi, where CSMT is 9 months? 1.7.1 Exercise - Answers A1: As per figure 1.6, the months of May to November, would be the best months to control mosquitos because the malaria transmission is at the lowest. 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) 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. 4 Chapter 1. Climatic Suitability for Malaria Transmission (CSMT) Training - Malawi

Climatic Suitability for Malaria Transmission (CSMT) - Malawi, Release 1.0.0 Fig. 1.6: Total percent occurence of climate conditions suitable for malaria transmission for an area of North Malawi 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 and 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 5