Effect of ultraviolet radiation on immature stages of Aedes aegypti, Anopheles stephensi and Culex quinquefasciatus mosquitoes.

Background & objectives: Understanding the influence of ultraviolet light on organisms is important for examining the hazards of exposure to ultraviolet (UV) light. However, little is known about the biological toxicity of ultraviolet light against mosquitoes, which are regularly exposed to UV light. This study was planned to determine the impact of UV radiation on different aquatic stages of Aedes aegypti, Anopheles stephensi and Culex quinquefaciatus mosquitoes. Methods: We exposed I/II instar larvae, III/IV instar larvae and pupae of Ae. aegypti, An. stephensi and Cx. quinquefaciatus mosquitoes to UV radiation of 253 nm wavelength in a closed chamber of 30×30 cm. The exposure was done for different time intervals viz. 1, 2, 3, 4 minutes and so on. Development of larvae/pupae to adult stage was monitored daily and mortality, if any, was recorded. Results: Development of I/II instar larvae of Ae. aegypti and Cx. quinquefasciatus to pupal stage was unsuccessful at an exposure time of one minute while only 1.7% pupation occurred in I/II instar larvae of Ae. aegypti upon similar exposure. When III/IV stage larvae were exposed to UV light, pupal development occurred only at 30seconds and one-minute exposure in An. stephensi and Cx. quinquefaciatus but in Ae. aegypti, no pupation occurred with one-minute exposure. With four-minute UV exposure of pupae, no adult emerged in Ae. aegypti; 33.3% adult emerged in An. stephensi and 66.7% adult emerged in Cx. quinquefaciatus. Interpretation & conclusion: Our results show that UV radiation results in developmental arrest of Ae. aegypti, An. stephensi and Cx. quinquefaciatus mosquitoes.

Laboratory evaluation of the efficacy of boric acid containing toxic sugar baits against Anopheles culicifacies, An. stephensi and Aedes aegypti mosquitoes.

BACKGROUND & OBJECTIVES: Attractive toxic sugar baits (ATSB) is a novel tool which employs mosquito sugar feeding behaviour to kill them. The potential of ATSB against mosquito vectors has been demonstrated in limited scope around the world including Israel, some of the African countries and USA. But their efficacy against mosquito vectors of India is yet to be ascertained. Therefore, current study was planned to evaluate the efficacy of TSB (without attractant) against two important malaria vectors Anopheles culicifacies and An. stephensi along with major dengue vector Aedes aegypti. METHODS: TSB solution was prepared by dissolving different concentrations of boric acid in glucose and tested against each of the mosquito species. Another experiment was done by spraying this boric acid sugar solution on to Calendula officinalis plant. It served as a sole source of mosquito feed and mortality of mosquitoes was counted after 24 hours. RESULTS: The TSB resulted in 100% mortality of Ae. aegypti and An. stephensi at 4% concentration of boric acid while in An. culicifacies 100% mortality was achieved at 3% concentration TSB solution. TSB solution with 2% boric acid, resulted in 99.1% mortality in An. culicifacies while ~95 % mortality of An. stephensi and Ae. aegypti. When TSB solution with 2% boric acid was sprayed on plant, ~89-94% mortality was observed in both An. stephensi and An. culicifacies. INTERPRETATION & CONCLUSION: Based on the results, boric acid based toxic sugar bait solution could be a promising tool for vector control. Further studies are needed to find out its toxicity of TSB against non-target organisms and residual efficacy in field trials in different ecotypes.

Kyasanur forest disease and climatic attributes in India.

BACKGROUND & OBJECTIVES: In India, Kyasanur Forest Disease has been reported from the states of Karnataka, Kerala, Goa, and Maharashtra. The relationship between climatic factors and transmission of KFD remains untouched, therefore, the present study was undertaken. METHODS: Based on the occurrence of cases, Shivamogga district (Karnataka) and Wayanad district in Kerala and northern Goa (Goa state) were selected for the study. Data on the incidence of KFD and climate factors were collected from concerned authorities. To determine the relationship between dependent and independent variables, spearman's correlation was calculated for monthly as well as with lag months. RESULTS: KFD cases and temperature (°C) were found significantly correlated up to 1 months' lag period (p<0.05) while with precipitation relationship was found negatively significant for 0-3 months' lag. The range of suitable temperature for KFD in Shivamogga, Goa and Wayanad was found as 20-31°C, 25-29°C and 27-31°C respectively. The cumulative precipitation during transmission months (November-May) ranged from <150-500mm, while in non-transmission months (June-October) from >1100-2400mm. INTERPRETATION & CONCLUSION: The analysis of three sites revealed that with the increase in temperature, the intensity of KFD transmission decreases as corroborated by the seasonal fluctuations in Shivamogga, Goa and Wayanad. High precipitation from June to October rovides suitable ecology to tick vector and sets in transmission season from November to May when cumulative precipitation is <500 mm.

Insecticide susceptibility status of malaria vectors in Himachal Pradesh, India.

BACKGROUND & OBJECTIVES: The state of Himachal Pradesh is one of the hilly forested states of India. Warming of climate has been evidenced in the state due to the ongoing climate change which may cause the upsurge/introduction of mosquito-borne diseases. To curb disease transmission, an effective vector control strategy will be required. METHODS: Insecticide susceptibility status of available malaria vectors was determined using the standard WHO method in six districts Kangra, Una, Mandi, Bilaspur, Solan and Mandi of the state. An. culicifacies and An. fluviatilis were tested against DDT (4%), malathion (5%) and deltamethrin (0.05%) using WHO insecticide susceptibility kits. RESULTS: Overall, An. culicifacies was found resistant to DDT in all the six districts, susceptible to malathion in all districts except Bilaspur and Solan where it showed possible resistance. It was susceptible to deltamethrin in all the study districts. An. fluviatilis was resistant to DDT and susceptible to malathion and deltamethrin in Kangra and Una districts. INTERPRETATION & CONCLUSION: At present, indoor residual spraying (IRS) is not being undertaken in Himachal Pradesh. However, with the information generated through the present study, the state government can plan evidence-based IRS at least for focal spray in limited foci reporting malaria incidence.

Validation of micro-chip based PCR assays for diagnosis of both Plasmodium falciparum and Plasmodium vivax.

BACKGROUND & OBJECTIVES: Microscopy is considered as the gold standard for malaria diagnosis, however sub-microscopic infections can only be detected by Polymerase chain reaction, which demands high cost and elaborate laboratory setup. The Micro-chip PCR based Truenat Malaria Pv-Pf and Pf assay is a portable solution for detection of sub-microscopic/asymptomatic cases of malaria in the field, three lots of which were evaluated for P. falciparum and P. vivax malaria. METHODS: Three lots of Truenat® Malaria Pv-Pf and Pf assay (kits) were assessed using blood samples of P. vivax and P. falciparum as well as malaria negative blood samples. DNA was extracted from the blood samples using the Trueprep Auto v2 Universal Cartridge based sample prep device and real time qPCR was performed using Truelab DUO micro PCR Analyzer with three lots of Truenat® Malaria Pv-Pf and Pf Assays. Mean, Standard deviation and one-way analysis of variance (ANOVA) was used to assess the significance of inter-lot variability in Cycle threshold values. RESULTS: The Truenat® Malaria Pv-Pf and Pf assays identified the malaria parasites with 100% accuracy. Based on the test for variance (ANOVA) the inter-lot variability in cycle threshold values were not significant, indicating a high degree of precision. INTERPRETATION & CONCLUSION: Based on high accuracy and precision between different lots, the Truenat® Malaria Pv-Pf and Pf assays were found to be suitable for the diagnosis of sub-microscopic infections in field conditions to provide support in elimination of malaria.

Identification of bio-climatic determinants and potential risk areas for Kyasanur forest disease in Southern India using MaxEnt modelling approach.

BACKGROUND: Kyasanur forest disease (KFD), known as monkey fever, was for the first time reported in 1957 from the Shivamogga district of Karnataka. But since 2011, it has been spreading to the neighbouring state of Kerala, Goa, Maharashtra, and Tamil Nadu. The disease is transmitted to humans, monkeys and by the infected bite of ticks Haemaphysalis spinigera. It is known that deforestation and ecological changes are the main reasons for KFD emergence, but the bio-climatic understanding and emerging pathways remain unknown. METHODS: The present study aims to understand the bio-climatic determinants of distribution of tick vector of KFD in southern India using the Maximum Entropy (MaxEnt) model. The analysis was done using 34 locations of Haemaphysalis spinigera occurrence and nineteen bio-climatic variables from WorldClim. Climatic variables contribution was assessed using the Jackknife test and mean AUC 0.859, indicating the model performs with very high accuracy. RESULTS: Most influential variables affecting the spatial distribution of Haemaphysalis spinigera were the average temperature of the warmest quarter (bio10, contributed 32.5%), average diurnal temperature range (bio2, contributed 21%), precipitation of wettest period (bio13, contributed 17.6%), and annual precipitation (bio12, contributed 11.1%). The highest probability of Haemaphysalis spinigera presence was found when the mean warmest quarter temperature ranged between 25.4 and 30 °C. The risk of availability of the tick increased noticeably when the mean diurnal temperature ranged between 8 and 10 °C. The tick also preferred habitat having an annual mean temperature (bio1) between 23 and 26.2 °C, mean temperature of the driest quarter (bio9) between 20 and 28 °C, and mean temperature of the wettest quarter (bio8) between 22.5 and 25 °C. CONCLUSIONS: The results have established the relationship between bioclimatic variables and KFD tick distribution and mapped the potential areas for KFD in adjacent areas wherein surveillance for the disease is warranted for early preparedness before the occurrence of outbreaks etc. The modelling approach helps link bio-climatic variables with the present and predicted distribution of Haemaphysalis spinigera tick.

Unlicensed medical practitioners in tribal dominated rural areas of central India: bottleneck in malaria elimination.

BACKGROUND: In India, Accredited Social Health Activists (ASHAs) deliver services for diagnosis and treatment of malaria, although unlicensed medical practitioners (UMPs) (informal health providers) are most preferred in communities. A cross sectional survey was conducted to: (i) assess knowledge and treatment-seeking practices in the community, and (ii) explore the diagnosis and treatment practices related to malaria of UMPs working in rural and tribal-dominated high malaria endemic areas of central India, and whether they adhere to the national guidelines. METHODS: A multi-stage sampling method and survey technique was adopted. Heads of the households and UMPs were interviewed using a structured interview schedule to assess knowledge and malaria treatment practices. RESULTS: Knowledge regarding malaria symptoms was generally accurate, but misconceptions emerged related to malaria transmission and mosquito breeding places. Modern preventive measures were poorly accessed by the households. UMPs were the most preferred health providers (49%) and the first choice in households for seeking treatment. UMPs typically lacked knowledge of the names of malaria parasite species and species-specific diagnosis and treatment. Further, irrational use of anti-malarial drugs was common. CONCLUSIONS: UMPs were the most preferred type of health care providers in rural communities where health infrastructure is poor. The study suggests enhancing training of UMPs on national guidelines for malaria diagnosis and treatment to strengthen their ability to contribute to achievement of India's malaria elimination goals.

El Niño Southern Oscillation as an early warning tool for dengue outbreak in India.

BACKGROUND: Dengue is rapidly expanding climate-sensitive mosquito-borne disease worldwide. Outbreaks of dengue occur in various parts of India as well but there is no tool to provide early warning. The current study was, therefore, undertaken to find out the link between El Niño, precipitation, and dengue cases, which could help in early preparedness for control of dengue. METHODS: Data on Oceanic Niño Index (ONI) was extracted from CPC-IRI (USA) while the data on monthly rainfall was procured from India Meteorological Department. Data on annual dengue cases was taken from the website of National Vector Borne Disease Control Programme (NVBDCP). Correlation analysis was used to analyse the relationship between seasonal positive ONI, rainfall index and dengue case index based on past 20 years' state-level data. The dengue case index representing 'relative deviation from mean' was correlated to the 3 months average ONI. The computed r values of dengue case index and positive ONI were further interpreted using generated spatial correlation map. The short-term prediction of dengue probability map has been prepared based on phase-wise (El Niño, La Niña, and Neutral) 20 years averaged ONI. RESULTS: A high correlation between positive ONI and dengue incidence was found, particularly in the states of Arunachal Pradesh, Chhattisgarh, Haryana, Uttarakhand, Andaman and Nicobar Islands, Delhi, Daman and Diu. The states like Assam, Himachal Pradesh, Meghalaya, Manipur, Mizoram, Jammu & Kashmir, Uttar Pradesh, Orissa, and Andhra Pradesh shown negative correlation between summer El Niño and dengue incidence. Two - three month lag was found between monthly 'rainfall index' and dengue cases at local-scale analysis. CONCLUSION: The generated map signifies the spatial correlation between positive ONI and dengue case index, indicating positive correlation in the central part, while negative correlation in some coastal, northern, and north-eastern part of India. The findings offer a tool for early preparedness for undertaking intervention measures against dengue by the national programme at state level. For further improvement of results, study at micro-scale district level for finding month-wise association with Indian Ocean Dipole and local weather variables is desired for better explanation of dengue outbreaks in the states with 'no association'.

Entomological investigation of an outbreak of Japanese encephalitis in Solan district, Himachal Pradesh.

An outbreak of Japanese encephalitis (JE) was reported in Solan district of Himachal Pradesh, India in May 2018 wherein a total of eight JE cases were reported by the state health department, of which seven cases were confirmed by ELISA. An entomological survey was carried out to investigate the presence of vector mosquitoes in the affected area. Field visits were undertaken in eight villages of two blocks in Solan district. Larval collections were made from the major aquatic sites and emerging mosquito species were identified. Seepage water ditches were the main source of JE vector mosquitoes Culex tritaeniorhynchus and Cx. bitaeniorhynchus. During hand catch collections of adult mosquitoes, three vector species of JE,Culex tritaeniorhynchus (Man Hour Density 1-14), Cx. vishnui (MHD 2) and Cx. bitaeniorhynchus (MHD 1-2) were collected. A few specimens of Cx. tritaeniorhynchus (6 no.) were also collected in light trap collections. Since this was the first reported outbreak of JE from Himachal Pradesh, India, studies on sero-surveillance in addition to bionomics of JE vectors are required for better understanding of epidemiology of JE in Himachal Pradesh. Moreover, there is a need to study the role of climate change especially rising temperature in the context of JE in Himachal Pradesh.

Interspecific competition between larval stages of Aedes aegypti and Anopheles stephensi.

BACKGROUND & OBJECTIVES: Interspecific competition occurs between members of two or more different species and can often have an influence on mosquito populations. Both Aedes aegypti and Anopheles stepehensi are container breeding mosquitoes and co-exist which may result in larval competition. In this study, interspecific competition between the above two species has been monitored under the laboratory conditions. METHODS: Three sets of experiments were conducted with different stages of Ae. aegypti and An. stephensi larvae. First two experiments were set up with I/II instar and III/IV instar larvae of Ae. aegypti and An. stephensi respectively in the ratios of 20:20, 20:40 and 40:20 in plastic bowls. For third set of experiment 20 IV instar larvae of Ae. aegypti were put with equal number of I instar larvae of An. stephensi. RESULTS: In the presence of food, 12.5-15 % mortality was recorded in I/II stage larvae of Ae. aegypti while in An. stephensi mortality ranged from 21-55%. Pupation commenced from Day 6 onwards in Ae. aegypti while in An. stephensi it commenced from Day 11 onwards. In the absence of food, there was no pupation in both the species but Ae. aegypti survived up to longer duration (7.5-18.5 days with 50% mortality) in comparison to An. stephensi (2-7 days with 50% mortality). When younger stages of An. stephensi (I/II) were put together with older stages of Ae. aegypti (III/IV) in the presence of food, pupation was completed in 85% Ae. aegypti population while there was 100% mortality in An. stephensi population. INTERPRETATION & CONCLUSION: The better survival and development of Ae. aegypti than An. stephensi under the same conditions exhibits interspecies competition showing competitive advantage of Ae. aegypti over An. stephensi. Further research is required to have a thorough understanding of the interaction between these two container inhabiting mosquito species in the nature.

Preparedness for malaria elimination in the wake of climate change in the State of Uttarakhand (India).

BACKGROUND & OBJECTIVES: Climate change is an emerging issue particularly in the context of vector-borne diseases. A study was undertaken in Nainital and Almora districts of Uttarakhand to provide evidences of changing climatic conditions, abundance of vectors, and knocking of malaria in hilly areas. MATERIAL AND METHODS: Longitudinal data on temperature and relative humidity were procured from Tussar Silk Centre, Bhimtal, India as well as generated using HOBO device. Monthly density of malaria vectors, their positivity for sporozoite proteins of malaria parasite and fever surveys were conducted as per the standard procedures from 2010 to 2013. Epidemiological data were procured from the State Programme Officer of Uttarakhand state. RESULTS: It was found that the temperature has increased since 1990 resulting in extension in windows of malaria transmission, temporal distribution as well as man hour density of Anopheles culicifacies and An. fluviatilis in hilly districts of Uttarakhand state. Both the vectors were found in high density up to a maximum man hour density of 110 (An. culicifacies) and 69 (An. fluviatilis) as compared to 32 and 33, respectively during 1998. The field collected vector species were also found positive for sporozoite proteins of malaria parasites in the month of October and November. Evidence of occurrence of malaria cases was also found in areas hitherto free from malaria. INTERPRETATION & CONCLUSION: The findings reveal that Himalayan region needs attention to strengthen surveillance for malaria to identify emerging new foci of malaria transmission in view of climate change. Health education to communities about preventive measures to contain breeding of vectors and seeking timely treatment should be imparted so as to achieve the goal of malaria elimination in category-1 in the first instance.

El Niño Southern Oscillation as an early warning tool for malaria outbreaks in India.

BACKGROUND: Risks of malaria epidemics in relation to El Niño and Southern Oscillation (ENSO) events have been mapped and studied at global level. In India, where malaria is a major public health problem, no such effort has been undertaken that inter-relates El Niño, Indian Summer Monsoon Rainfall (ISMR) and malaria. The present study has been undertaken to find out the relationship between ENSO events, ISMR and intra-annual variability in malaria cases in India, which in turn could help mitigate the malaria outbreaks. METHODS: Correlation coefficients among 'rainfall index' (ISMR), '+ winter ONI' (NDJF) and 'malaria case index' were calculated using annual state-level data for the last 22 years. The 'malaria case index' representing 'relative change from mean' was correlated to the 4 month (November-February) average positive Oceanic Niño Index (ONI). The resultant correlations between '+ winter ONI' and 'malaria case index' were further analysed on geographical information system platform to generate spatial correlation map. RESULTS: The correlation between '+ winter ONI' and 'rainfall index' shows that there is great disparity in effect of ENSO over ISMR distribution across the country. Correlation between 'rainfall index' and 'malaria case index' shows that malaria transmission in all geographical regions of India are not equally affected by the ISMR deficit or excess. Correlation between '+ winter ONI' and 'malaria case index' was found ranging from -0.5 to + 0.7 (p < 0.05). A positive correlation indicates that increase in El Niño intensity (+ winter ONI) will lead to rise in total malaria cases in the concurrent year in the states of Orissa, Chhattisgarh, Jharkhand, Bihar, Goa, eastern parts of Madhya Pradesh, part of Andhra Pradesh, Uttarakhand and Meghalaya. Whereas, negative correlations were found in the states of Rajasthan, Haryana, Gujarat, part of Tamil Nadu, Manipur, Mizoram and Sikkim indicating the likelihood of outbreaks in La Nina condition. CONCLUSIONS: The generated map, representing spatial correlation between ' + winter ONI' and 'malaria case index', indicates positive correlations in eastern part, while negative correlations in western part of India. This study provides plausible guidelines to national programme for planning intervention measures in view of ENSO events. For better resolution, district level study with inclusion of IOD and 'epochal variation of monsoon rainfall' factors at micro-level is desired for better forecast of malaria outbreaks in the regions with 'no correlation'.

Devising a method towards development of early warning tool for detection of malaria outbreak.

Background & objectives: Uncertainty often arises in differentiating seasonal variation from outbreaks of malaria. The present study was aimed to generalize the theoretical structure of sine curve for detecting an outbreak so that a tool for early warning of malaria may be developed. Methods: A 'case/mean-ratio scale' system was devised for labelling the outbreak in respect of two diverse districts of Assam and Rajasthan. A curve-based method of analysis was developed for determining outbreak and using the properties of sine curve. It could be used as an early warning tool for Plasmodium falciparum malaria outbreaks. Result: In the present method of analysis, the critical Cmax(peak value of sine curve) value of seasonally adjusted curve for P. falciparum malaria outbreak was 2.3 for Karbi Anglong and 2.2 for Jaisalmer districts. On case/mean-ratio scale, the Cmax value of malaria curve between Cmaxand 3.5, the outbreak could be labelled as minor while >3.5 may be labelled as major. In epidemic years, with mean of case/mean ratio of ≥1.00 and root mean square (RMS) ≥1.504 of case/mean ratio, outbreaks can be predicted 1-2 months in advance. Interpretation & conclusions: The present study showed that in P. falciparum cases in Karbi Anglong (Assam) and Jaisalmer (Rajasthan) districts, the rise in Cmaxvalue of curve was always followed by rise in average/RMS or both and hence could be used as an early warning tool. The present method provides better detection of outbreaks than the conventional method of mean plus two standard deviation (mean+2 SD). The identified tools are simple and may be adopted for preparedness of malaria outbreaks.

Genotyping of Plasmodium vivax by minisatellite marker and its application in differentiating relapse and new infection.

BACKGROUND: Plasmodium vivax malaria is a major public health problem in India. Control of vivax malaria is challenging due to various factors including relapse which increase the burden significantly. There is no well studied marker to differentiate relapse from reinfection. This creates hindrance in search for anti-relapse medicines. The genomic study of minisatellite can help in characterization of relapse and new infection of vivax malaria. METHODS: Eighty-eight samples of P. vivax were collected from malaria clinic. All the 14 chromosomes of P. vivax were scanned for minisatellite marker by Tandem Repeat Finder software Version 4.07b. Minisatellite marker CH1T1M13779 from chromosome one was applied for genotyping in 88 samples of P. vivax including 2 recurrence cases. RESULTS: Whole genome of P. vivax was scanned and found to have one hundred minisatellite markers. CH1T1M13779 minisatellite marker from chromosome-1 was used for amplification in 88 samples of P. vivax. Of 66 amplified samples, 14 alleles were found with varied allele frequency. The base size of 280 (13.63 %) 320 bp (13.63 %) and 300 bp (16.66 %) showed the predominant allele in the P. vivax population. Genotyping of two paired samples (day 0 and day relapse) could demonstrate the presence of relapse and reinfection. CONCLUSION: The CH1T1M13779 can be potential minisatellite marker which can be used to differentiate between relapse and new infection of P. vivax strain.

Intricacies of using temperature of different niches for assessing impact on malaria transmission.

BACKGROUND & OBJECTIVES: The influence of temperature on the life cycle of mosquitoes as well as on development of malaria parasite in mosquitoes is well studied. Most of the studies use outdoor temperature for understanding the transmission dynamics and providing projections of malaria. As the mosquitoes breed in water and rest usually indoors, it is logical to relate the transmission dynamics with temperature of micro-niche. The present study was, therefore, undertaken to understand the influence of different formats of temperature of different micro-niches on transmission of malaria for providing more realistic projections. METHODS: The study was conducted in one village each of Assam and Uttarakhand s0 tates of India. Temperatures recorded from outdoor (air) as well as indoor habitats (resting place of mosquito) were averaged into daily, fortnightly and monthly and were used for determination of transmission windows (TWs) for Plasmodium vivax (Pv) and P. falciparum (Pf) based on minimum temperature threshold required for transmission. RESULTS: The daily temperature was found more useful for calculation of sporogony than fortnightly and monthly temperatures. Monthly TWs were further refined using fortnightly temperature, keeping in view the completion of more than one life cycle of malaria vectors and sporogony of malaria parasite in a month. A linear regression equation was generated to find out the relationship between outdoor and indoor temperatures and R [2] to predict the percentage of variation in indoor temperature as a function of outdoor temperature at both localities. INTERPRETATION & CONCLUSIONS: The study revealed that the indoor temperature was more than outdoors in stable malarious area (Assam) but fluctuating in low endemic area like Uttarakhand. Transmission windows of malaria should be determined by transforming outdoor data to indoor and preferably at fortnightly interval. With daily recorded temperature, sporogonic and gonotrophic cycles can also be calculated which is otherwise not possible with monthly data. The study highlights that the projections made for malaria in view of climate change need to be seen with limitation of difference in outdoor and indoor temperatures at different locations, highlighting the need for local data generation at least at sub-district level.

Long-lasting transition toward sustainable elimination of desert malaria under irrigation development.

In arid areas, people living in the proximity of irrigation infrastructure are potentially exposed to a higher risk of malaria due to changes in ecohydrological conditions that lead to increased vector abundance. However, irrigation provides a pathway to economic prosperity that over longer time scales is expected to counteract these negative effects. A better understanding of this transition between increased malaria risk and regional elimination, in particular whether it is slow or abrupt, is relevant to sustainable development and disease management. By relying on space as a surrogate for stages of time, we investigate this transition in a semidesert region of India where a megairrigation project is underway and expected to cover more than 1,900 million hectares and benefit around 1 million farmers. Based on spatio-temporal epidemiological cases of Plasmodium vivax malaria and land-use irrigation from remote sensing sources, we show that this transition is characterized by an enhanced risk in areas adjacent to the trunk of the irrigation network, despite a forceful and costly insecticide-based control. Moreover, this transition between climate-driven epidemics and sustained low risk has already lasted a decade. Given the magnitude of these projects, these results suggest that increased health costs have to be planned for over a long time horizon. They further highlight the need to integrate assessments of both health and environmental impacts to guide adaptive mitigation strategies. Our results should help to define and track these transitions in other arid parts of the world subjected to similar tradeoffs.

Diversity of breeding habitats of anophelines (Diptera: Culicidae) in Ramgarh district, Jharkhand, India.

BACKGROUND & OBJECTIVES: The Ramgarh district of Jharkhand state, India is highly malarious owing to abundance of different malaria vector species, namely Anopheles culicifacies, An. fluviatilis and An. annularis. In spite of high prevalence of malaria vectors in Ramgarh, their larval ecology and climatic conditions affecting malaria dynamics have never been studied. Therefore, the objective of this study was to identify the diversity of potential breeding habitats and breeding preferences of anopheline vectors in the Ramgarh district. METHODS: Anopheles immature collection was carried out at potential aquatic habitats in Ramgarh and Gola sites using the standard dipper on fortnightly basis from August 2012 to July 2013. The immatures were reared till adult emergence and further identified using standard keys. Temperature of outdoor and water bodies was recorded through temperature data loggers, and rainfall through standard rain gauges installed at each site. RESULTS: A total of 6495 immature specimens representing 17 Anopheles species including three malaria vectors, viz. An. culicifacies, An. fluviatilis and An. annularis were collected from 11 types of breeding habitats. The highly preferred breeding habitats of vector anophelines were river bed pools, rivulets, wells, ponds, river margins, ditches and irrigation channels. Larval abundance of vector species showed site-specific variation with temperature and rainfall patterns throughout the year. The Shannon-Weiner diversity index ranged from 0.19 to 1.94 at Ramgarh site and 0.16 to 1.76 at Gola site. INTERPRETATION & CONCLUSION: The study revealed that malaria vector species have been adapted to breed in a wide range of water bodies. The regular monitoring of such specific vector breeding sites under changing ecological and environmental conditions will be useful in guiding larval control operations selectively for effective vector/ malaria control.

Predictability of epidemic malaria under non-stationary conditions with process-based models combining epidemiological updates and climate variability.

BACKGROUND: Previous studies have demonstrated the feasibility of early-warning systems for epidemic malaria informed by climate variability. Whereas modelling approaches typically assume stationary conditions, epidemiological systems are characterized by changes in intervention measures over time, at scales typically longer than inter-epidemic periods. These trends in control efforts preclude simple application of early-warning systems validated by retrospective surveillance data; their effects are also difficult to distinguish from those of climate variability itself. METHODS: Rainfall-driven transmission models for falciparum and vivax malaria are fitted to long-term retrospective surveillance data from four districts in northwest India. Maximum-likelihood estimates (MLEs) of model parameters are obtained for each district via a recently introduced iterated filtering method for partially observed Markov processes. The resulting MLE model is then used to generate simulated yearly forecasts in two different ways, and these forecasts are compared with more recent (out-of-fit) data. In the first approach, initial conditions for generating the predictions are repeatedly updated on a yearly basis, based on the new epidemiological data and the inference method that naturally lends itself to this purpose, given its time-sequential application. In the second approach, the transmission parameters themselves are also updated by refitting the model over a moving window of time. RESULTS: Application of these two approaches to examine the predictability of epidemic malaria in the different districts reveals differences in the effectiveness of intervention for the two parasites, and illustrates how the 'failure' of predictions can be informative to evaluate and quantify the effect of control efforts in the context of climate variability. The first approach performs adequately, and sometimes even better than the second one, when the climate remains the major driver of malaria dynamics, as found for Plasmodium vivax for which an effective clinical intervention is lacking. The second approach offers more skillful forecasts when the dynamics shift over time, as is the case of Plasmodium falciparum in recent years with declining incidence under improved control. CONCLUSIONS: Predictive systems for infectious diseases such as malaria, based on process-based models and climate variables, can be informative and applicable under non-stationary conditions.

Altitude, temperature, and malaria vectors in Nainital and Udham Singh Nagar districts of Uttarakhand, India: an evidence-based study.

BACKGROUND & OBJECTIVES: The relationship between altitude, temperature and malaria are poorly understood. Hence, a study was undertaken at three sites of Udham Singh Nagar (erstwhile Nainital district) and Nainital district (Uttarakhand) during 2010- 11 for the generation of evidences in the context of potential threat of climate change. METHODS: Data on temperature and relative humidity (RH) were recorded through data-logger device in study villages at the altitudes of 166, 226 and 609 m were selected for detailed work. Mosquito collections were made fortnightly during 0600- 0800 hrs. Malaria incidence data were procured from concerned Primary Health Centres. RESULTS: The study provides evidences of decrease in temperature with increase in altitude, even within a district resulting in variation in temporal distribution of malaria vector. With the increase of 67 m altitude between plains and foothill village, there was a reduction in temperature to the tune of 1.1°C and with further increase in altitude of 416 m between foothill and hilly villages, the temperature decreased by 0.27°C. The difference in temperature at three altitudes affects the Transmission windows (TWs) of both Plasmodium vivax (Pv) and P. falciparum (Pf), and opening of TWs are inversely proportional to altitude. In the plains, the TW for Pv and Pf were open for 11 and 10 months respectively, while 10 and 9 months in the foothills and 9 and 8 months, respectively for both the parasites at hilly altitude. Comparison of malaria vectors in plains, foothills, and hilly villages showed that the availability of Anopheles culicifacies and An. fluviatilis decreased with an increase in altitude from foothills to hilly areas. INTERPRETATION & CONCLUSION: This study may be extrapolated to know the suitability of occurrence of malaria vectors and transmission of parasites at different altitudes from the viewpoint of temperature as limiting factor in unknown areas.