Malaria in Senegal: Recent and Future Changes Based on Bias-Corrected CMIP6 Simulations.

Malaria is a constant reminder of the climate change impacts on health. Many studies have investigated the influence of climatic parameters on aspects of malaria transmission. Climate conditions can modulate malaria transmission through increased temperature, which reduces the duration of the parasite's reproductive cycle inside the mosquito. The rainfall intensity and frequency modulate the mosquito population's development intensity. In this study, the Liverpool Malaria Model (LMM) was used to simulate the spatiotemporal variation of malaria incidence in Senegal. The simulations were based on the WATCH Forcing Data applied to ERA-Interim data (WFDEI) used as a point of reference, and the biased-corrected CMIP6 model data, separating historical simulations and future projections for three Shared Socio-economic Pathways scenarios (SSP126, SSP245, and SSP585). Our results highlight a strong increase in temperatures, especially within eastern Senegal under the SSP245 but more notably for the SSP585 scenario. The ability of the LMM model to simulate the seasonality of malaria incidence was assessed for the historical simulations. The model revealed a period of high malaria transmission between September and November with a maximum reached in October, and malaria results for historical and future trends revealed how malaria transmission will change. Results indicate a decrease in malaria incidence in certain regions of the country for the far future and the extreme scenario. This study is important for the planning, prioritization, and implementation of malaria control activities in Senegal.

Heat waves and health risks in the northern part of Senegal: analysing the distribution of temperature-related diseases and associated risk factors.

The Sahelian zone of Senegal experienced heat waves in the previous decades, such as 2013, 2016 and 2018 that were characterised by temperatures exceeding 45°C for up to 3 successive days. The health impacts of these heat waves are not yet analysed in Senegal although their negative effects have been shown in many countries. This study analyses the health impacts of observed extreme temperatures in the Sahelian zone of the country, focusing on morbidity and mortality by combining data from station observation, climate model projections, and household survey to investigate heat wave detection, occurrence of climate-sensitive diseases and risk factors for exposure. To do this, a set of climatic (temperatures) and health (morbidity, mortality) data were collected for the months of April, May and June from 2009 to 2019. These data have been completed with 1246 households' surveys on risk factor exposure. Statistical methods were used to carry out univariate and bivariate analyses while cartographic techniques allowed mapping of the main climatic and health indicators. The results show an increase in temperatures compared to seasonal normal for the 1971-2000 reference period with threshold exceedances of the 90th percentiles (42°C) for the maxima and (27°C) the minima and higher temperatures during the months of May and June. From health perspective, it was noted an increase in cases of consultation in health facilities as well as a rise in declared morbidity by households especially in the departments of Kanel (17.7%), Ranérou (16.1 %), Matam (13.7%) and Bakel (13.7%). The heat waves of May 2013 were also associated with cases of death with a reported mortality (observed by medical staff) of 12.4% unequally distributed according to the departments with a higher number of deaths in Matam (25, 2%) and in Bakel (23.5%) than in Podor (8.4%) and Kanel (0.8%). The morbidity and mortality distribution according to gender shows that women (57%) were more affected than men (43%). These health risks have been associated with a number of factors including age, access to drinkable water, type of fuel, type of housing and construction materials, existence of fan and an air conditioner, and health history.The heat wave recurrence has led to a frequency in certain diseases sensitive to rising temperatures, which is increasingly a public health issue in the Sahelian zone of Senegal.

Climate Variability and Malaria over West Africa.

Malaria is a major public health problem in West Africa. Previous studies have shown that climate variability significantly affects malaria transmission. The lack of continuous observed weather station data and the absence of surveillance data for malaria over long periods have led to the use of reanalysis data to drive malaria models. In this study, we use the Liverpool Malaria Model (LMM) to simulate spatiotemporal variability of malaria in West Africa using daily rainfall and temperature from the following: Twentieth Century Reanalysis (20th CR), National Center for Environmental Prediction (NCEP), European Centre for Medium-Range Weather Forecasts (ECMWF) Atmospheric Reanalysis of the Twentieth Century (ERA20C), and interim ECMWF Re-Analysis (ERA-Interim). Malaria case data from the national surveillance program in Senegal are used for model validation between 2001 and 2016. The warm temperatures found over the Sahelian fringe of West Africa can lead to high malaria transmission during wet years. The rainfall season peaks in July to September over West Africa and Senegal, and the malaria season lasts from September to November, about 1-2 months after the rainfall peak. The long-term trends exhibit interannual and decadal variabilities. The LMM shows acceptable performance in simulating the spatial distribution of malaria incidence. However, some discrepancies are found. These results are useful for decision-makers who plan public health and control measures in affected West African countries. The study would have substantial implications for directing malaria surveillance activities and health policy. In addition, this malaria modeling framework could lead to the development of an early warning system for malaria in West Africa.

Declines in Malaria Burden and All-Cause Child Mortality following Increases in Control Interventions in Senegal, 2005-2010.

Malaria is endemic in Senegal. The national malaria control strategy focuses on achieving universal coverage for major interventions, with a goal of reaching preelimination status by 2018. Senegal began distribution of insecticide-treated nets (ITNs) and introduced artemisinin-based combination therapy in 2006, then introduced rapid diagnostic tests in 2007. We evaluated the impact of these efforts using a plausibility design based on malaria's contribution to all-cause under-five mortality (ACCM) and considering other contextual factors which may influence ACCM. Between 2005 and 2010, household ownership of ITNs increased from 20% to 63%, and the proportion of people sleeping under an ITN the night prior to the survey increased from 6% to 29%. Malaria parasite prevalence declined from 6% to 3% from 2008 to 2010 among children under five. Some nonmalaria indicators of child health improved, for example, increase of complete vaccination coverage from 58% to 64%; however, nutritional indicators deteriorated, with an increase in stunting from 16% to 26%. Although economic indicators improved, environmental conditions favored an increase in malaria transmission. ACCM decreased 40% between 2005 and 2010, from 121 (95% confidence interval [CI] 113-129) to 72 (95% CI 66-77) per 1,000, and declines were greater among age groups, epidemiologic zones, and wealth quintiles most at risk for malaria. After considering coverage of malaria interventions, trends in malaria morbidity, effects of contextual factors, and trends in ACCM, it is plausible that malaria control interventions contributed to a reduction in malaria mortality and to the impressive gains in child survival in Senegal.

Comparison of Malaria Simulations Driven by Meteorological Observations and Reanalysis Products in Senegal.

The analysis of the spatial and temporal variability of climate parameters is crucial to study the impact of climate-sensitive vector-borne diseases such as malaria. The use of malaria models is an alternative way of producing potential malaria historical data for Senegal due to the lack of reliable observations for malaria outbreaks over a long time period. Consequently, here we use the Liverpool Malaria Model (LMM), driven by different climatic datasets, in order to study and validate simulated malaria parameters over Senegal. The findings confirm that the risk of malaria transmission is mainly linked to climate variables such as rainfall and temperature as well as specific landscape characteristics. For the whole of Senegal, a lag of two months is generally observed between the peak of rainfall in August and the maximum number of reported malaria cases in October. The malaria transmission season usually takes place from September to November, corresponding to the second peak of temperature occurring in October. Observed malaria data from the Programme National de Lutte contre le Paludisme (PNLP, National Malaria control Programme in Senegal) and outputs from the meteorological data used in this study were compared. The malaria model outputs present some consistencies with observed malaria dynamics over Senegal, and further allow the exploration of simulations performed with reanalysis data sets over a longer time period. The simulated malaria risk significantly decreased during the 1970s and 1980s over Senegal. This result is consistent with the observed decrease of malaria vectors and malaria cases reported by field entomologists and clinicians in the literature. The main differences between model outputs and observations regard amplitude, but can be related not only to reanalysis deficiencies but also to other environmental and socio-economic factors that are not included in this mechanistic malaria model framework. The present study can be considered as a validation of the reliability of reanalysis to be used as inputs for the calculation of malaria parameters in the Sahel using dynamical malaria models.

Modelling hotspots of the two dominant Rift Valley fever vectors (Aedes vexans and Culex poicilipes) in Barkédji, Sénégal.

BACKGROUND: Climatic and environmental variables were used successfully by using models to predict Rift Valley fever (RVF) virus outbreaks in East Africa. However, these models are not replicable in the West African context due to a likely difference of the dynamic of the virus emergence. For these reasons specific models mainly oriented to the risk mapping have been developed. Hence, the areas of high vector pressure or virus activity are commonly predicted. However, the factors impacting their occurrence are poorly investigated and still unknown. In this study, we examine the impact of climate and environmental factors on the likelihood of occurrence of the two main vectors of RVF in West Africa (Aedes vexans and Culex poicilipes) hotspots. METHODS: We used generalized linear mixed models taking into account spatial autocorrelation, in order to overcome the default threshold for areas with high mosquito abundance identified by these models. Getis' Gi*(d) index was used to define local adult mosquito abundance clusters (hotspot). RESULTS: For Culex poicilipes, a decrease of the minimum temperature promotes the occurrence of hotspots, whereas, for Aedes vexans, the likelihood of hotspot occurrence is negatively correlated with relative humidity, maximum and minimum temperatures. However, for the two vectors, proximity to ponds would increase the risk of being in an hotspot area. CONCLUSIONS: These results may be useful in the improvement of RVF monitoring and vector control management in the Barkedji area.

Statistical modeling of the abundance of vectors of West African Rift Valley fever in Barkédji, Senegal.

Rift Valley fever is an emerging mosquito-borne disease that represents a threat to human and animal health. The exophilic and exophagic behavior of the two main vector in West Africa (Aedes vexans and Culex poicilipes), adverse events post-vaccination, and lack of treatment, render ineffective the disease control. Therefore it is essential to develop an information system that facilitates decision-making and the implementation of adaptation strategies. In East Africa, RVF outbreaks are linked with abnormally high rainfall, and can be predicted up to 5 months in advance by modeling approaches using climatic and environmental parameters. However, the application of these models in West Africa remains unsatisfactory due to a lack of data for animal and human cases and differences in the dynamics of the disease emergence and the vector species involved in transmission. Models have been proposed for West Africa but they were restricted to rainfall impact analysis without a spatial dimension. In this study, we developed a mixed Bayesian statistical model to evaluate the effects of climatic and ecological determinants on the spatiotemporal dynamics of the two main vectors. Adult mosquito abundance data were generated from July to December every fortnight in 2005-2006 at 79 sites, including temporary ponds, bare soils, shrubby savannah, wooded savannah, steppes, and villages in the Barkédji area. The results demonstrate the importance of environmental factors and weather conditions for predicting mosquito abundance. The rainfall and minimum temperature were positively correlated with the abundance of Cx. poicilipes, whereas the maximum temperature had negative effects. The rainfall was negatively correlated with the abundance of Ae. vexans. After combining land cover classes, weather conditions, and vector abundance, our model was used to predict the areas and periods with the highest risks of vector pressure. This information could support decision-making to improve RVF surveillance activities and to implement better intervention strategies.

Anopheles arabiensis seasonal densities and infection rates in relation to landscape classes and climatic parameters in a Sahelian area of Senegal.

BACKGROUND: The influence of environmental and climatic factors on malaria vector bionomics and transmission is an important topic in the context of climatic change particularly at macro-geographical level. Sahelian areas could be particularly affected due to heterogeneous features including high inter-annual variability in rainfall and others associated parameters. Therefore, baseline information on the impact of environmental and climatic factors on malaria transmission at micro-geographical level is required for vector risk management and implementation of control strategies. METHODS: Malaria vectors were collected indoors by pyrethrum spray catches in 14 villages belonging to 4 different landscape classes (wooded savanna, shrubby savanna, bare soils and steppe) in the sylvo-pastoral area of Senegal. Plasmodium falciparum infection rates were determined using an indirect enzyme-linked immunosorbent assay (ELISA). RESULTS: An. arabiensis was the predominant species in all landscape classes and was the only species collected at the end of the rainy season excepted in villages located in bare soils where it cohabited with An. coluzzii. Mean temperature and relative humidity showed similar variations in all the landscape classes covered whereas rainfall was more heterogeneous in terms of pattern, frequency and amount. The mean densities of An. arabiensis displayed high seasonal differences with peaks observed in August or September. A positive non-significant correlation was observed between An. arabiensis densities for rainfall and humidity whereas a negative non-significant correlation was reported for temperature. Plasmodium falciparum-infected mosquitoes were detected only in wooded savanna and bare soils villages. CONCLUSIONS: These observations suggest key roles played by landscape classes and rainfall in malaria vector densities, infection rates and malaria transmission that could be more pronounced in villages situated in wooded savanna and bare soils. Due to the close relationship between environmental and meteorological parameters in this Sahelian region, additional studies on the impact of these parameters are required to further ascertain their association with entomological parameters involved in malaria transmission. From the public health point of view, such information could be useful for human population settlements as well as for monitoring and modelling purposes giving early warning system for implementation of interventions in these unstable transmission zones.

Decision making environment on Rift Valley fever in Ferlo (Senegal).

The Rift Valley fever (RVF), which first appeared in Kenya in 1912, is an anthropozoonosis widespread in tropical areas. In Senegal, it is particularly felt in the Ferlo area where a strong presence of ponds shared by humans, cattle and vectors is noted. As part of the studies carried out on the environmental factors which favour its start and propagation, the focus of this paper is put on the decision making process to evaluate the impacts, the interactions and to make RVF monitoring easier. The present paper proposes a model based on data mining techniques and dedicated to trade experts. This model integrates all the involved data and the results of the analyses made on the characteristics of the surrounding ponds. This approach presents some advantage in revealing the relationship between environmental factors and RVF transmission vectors for space-time epidemiology monitoring purpose.

Eco-geographical diversity of cowpea bradyrhizobia in Senegal is marked by dominance of two genetic types.

The genetic diversity of native cowpea rhizobia originating from 60 sites across four eco-geographic zones in Senegal was studied. More than 300 cowpea nodules were analyzed by PCR-RFLP of the 16S-23S rDNA InterGenic Spacer region (IGS). Alignments of IGS sequences indicated that all genotypes were grouping within the Bradyrhizobium genus. The geographical distribution showed that apart from five IGS types, the others were specifically found in only one region. The diversity was significantly higher in the Senegal River valley zone, which presents lower mean annual rainfalls and slightly alkaline soils. Interestingly, two IGS types dominated the Senegalese rhizobial collection, one IGS type (VI) was found on more than half of the nodules collected in the northern Senegal River valley while another IGS type (I) was recovered from the great majority of nodules in the three other regions sampled. Two representative strains from each of these two dominant types were isolated and further analyzed. Multi Locus Sequence Analyses using 6 housekeeping genes indicate that they belong to a new Bradyrhizobium species closely related to B. yuanmingense. Phylogenetic analyses of 2 symbiotic genes nodC and nifH show that they are clustered with B. arachidis. Physiological tests on these strains have shown that under laboratory conditions, the growth of the IGS type VI strains was slightly less affected by a higher osmotic strength in the medium and to alkaline pH, which corroborates the soil physico-chemical parameters.

Rift Valley fever dynamics in Senegal: a project for pro-active adaptation and improvement of livestock raising management.

The multi-disciplinary French project "Adaptation à la Fiévre de la Vallée du Rift" (AdaptFVR) has concluded a 10-year constructive interaction between many scientists/partners involved with the Rift Valley fever (RVF) dynamics in Senegal. The three targeted objectives reached were (i) to produce--in near real-time--validated risk maps for parked livestock exposed to RVF mosquitoes/vectors bites; (ii) to assess the impacts on RVF vectors from climate variability at different time-scales including climate change; and (iii) to isolate processes improving local livestock management and animal health. Based on these results, concrete, pro-active adaptive actions were taken on site, which led to the establishment of a RVF early warning system (RVFews). Bulletins were released in a timely fashion during the project, tested and validated in close collaboration with the local populations, i.e. the primary users. Among the strategic, adaptive methods developed, conducted and evaluated in terms of cost/benefit analyses are the larvicide campaigns and the coupled bio-mathematical (hydrological and entomological) model technologies, which are being transferred to the staff of the "Centre de Suivi Ecologique" (CSE) in Dakar during 2013. Based on the results from the AdaptFVR project, other projects with similar conceptual and modelling approaches are currently being implemented, e.g. for urban and rural malaria and dengue in the French Antilles.

Spatio-temporal analysis of host preferences and feeding patterns of malaria vectors in the sylvo-pastoral area of Senegal: impact of landscape classes.

BACKGROUND: The study of vector feeding behaviour is an important step in the understanding of the epidemiology of vector borne diseases. The main objective of this work was to study the spatio-temporal host preferences and blood-feeding patterns of malaria vectors in a pastoral area of Senegal where cattle breeding is the main human activity. METHODS: Malaria vectors were collected indoors by pyrethrum spray catch in 16 villages belonging to 4 different landscape classes (wooded savanna, shrubby savanna, bare soils and steppe). Blood meals sources were determined using a direct enzyme-linked immunosorbent assay (ELISA). RESULTS: The blood meal origins of 1886 freshly fed An. gambiae s.l. were determined. Among these blood meals, most were taken on a single host: 40.1% on human and 37.1% on animal. The range in proportions of blood meals taken from human were 25-62.4% in wooded savanna villages, 23.5-61.9% in shrubby savanna villages, 31.3-70% in bare soils villages and 57.7-68.7 in steppe villages. Blood meals taken from bovines were very heterogeneous with two clusters localized in the Northeast and Southwest axis of the study area that corresponds to the distribution of the main water ponds. Patent mixed blood meals taken from human and non-human were significantly higher than those taken from two animals, the highest proportions being observed in September (shrubby savanna, bare soils and steppe villages) or October (wooded savanna villages). CONCLUSIONS: These observations suggest that in this pastoral area, differences in feeding patterns of malaria vectors are merely linked to the specific localization of villages and are not influenced by landscape class distribution. In addition, the temporal variations in the anthropophilic rates are influenced by the presence of standing water in the study area.

Climate and health: observation and modeling of malaria in the Ferlo (Senegal).

The aim of this work, undertaken in the framework of QWeCI (Quantifying Weather and Climate Impacts on health in the developing countries) project, is to study how climate variability could influence malaria seasonal incidence. It will also assess the evolution of vector-borne diseases such as malaria by simulation analysis of climate models according to various climate scenarios for the next years. Climate variability seems to be determinant for the risk of malaria development (Freeman and Bradley, 1996 [1], Lindsay and Birley, 1996 [2], Kuhn et al., 2005 [3]). Climate can impact on the epidemiology of malaria by several mechanisms, directly, via the development rates and survival of both pathogens and vectors, and indirectly, through changes in vegetation and land surface characteristics such as the variability of breeding sites like ponds.

Rift Valley fever in a zone potentially occupied by Aedes vexans in Senegal: dynamics and risk mapping.

This paper presents an analysis of the interaction between the various variables associated with Rift Valley fever (RVF) such as the mosquito vector, available hosts and rainfall distribution. To that end, the varying zones potentially occupied by mosquitoes (ZPOM), rainfall events and pond dynamics, and the associated exposure of hosts to the RVF virus by Aedes vexans, were analyzed in the Barkedji area of the Ferlo, Senegal, during the 2003 rainy season. Ponds were identified by remote sensing using a high-resolution SPOT-5 satellite image. Additional data on ponds and rainfall events from the Tropical Rainfall Measuring Mission were combined with in-situ entomological and limnimetric measurements, and the localization of vulnerable ruminant hosts (data derived from QuickBird satellite). Since "Ae. vexans productive events" are dependent on the timing of rainfall for their embryogenesis (six days without rain are necessary to trigger hatching), the dynamic spatio-temporal distribution of Ae. vexans density was based on the total rainfall amount and pond dynamics. Detailed ZPOM mapping was obtained on a daily basis and combined with aggressiveness temporal profiles. Risks zones, i.e. zones where hazards and vulnerability are combined, are expressed by the percentages of parks where animals are potentially exposed to mosquito bites. This new approach, simply relying upon rainfall distribution evaluated from space, is meant to contribute to the implementation of a new, operational early warning system for RVF based on environmental risks linked to climatic and environmental conditions.

Mapping of zones potentially occupied by Aedes vexans and Culex poicilipes mosquitoes, the main vectors of Rift Valley fever in Senegal.

A necessary condition for Rift Valley fever (RVF) emergence is the presence of Aedes (Aedimorphus) vexans and Culex (Culex) poicilipes mosquitoes carrying the arbovirus and responsible for the infection. This paper presents a detailed mapping in the Sahelian region of Senegal of zones potentially occupied by these mosquitoes (ZPOMs) whose population density is directly linked to ecozones in the vicinity of small ponds. The vectors habitats and breeding sites have been characterized through an integrated approach combining remote sensing technology, geographical information systems, geographical positioning systems and field observations for proper geo-referencing. From five SPOT-5 images (approximately 10 m spatial resolution) with appropriate channels, a meridional composite transect of 290 x 60 km was first constructed at the height of the summer monsoon. Subsequent ZPOMs covered major ecozones from north to south with different hydrological environments and different patterns pond distributions. It was found that an overall area of 12,817 ha +/- 10% (about 0.8% of the transect) is occupied by ponds with an average ZPOM 17 times larger than this (212,813 ha +/- 10% or about 14% of the transect). By comparing the very humid year of 2003 with 2006 which had just below normal rainfall, the ZPOMs inter-annual variability was analyzed in a sandy-clayey ecozone with an important hydrofossil riverbed within the Ferlo region of Senegal. Very probably contributing to an increased abundance of vectors by the end of August 2003, it was shown that the aggregate pond area was already about 22 times larger than in August 2006, corresponding to an approximately five times larger total ZPOM. The results show the importance of pin-pointing small ponds (sizes down to 0.1 ha) and their geographical distribution in order to assess animal exposure to the RVF vectors.

Rainfall patterns and population dynamics of Aedes (Aedimorphus) vexans arabiensis, Patton 1905 (Diptera: Culicidae), a potential vector of Rift Valley Fever virus in Senegal.

The importance of rainfall for the development of Aedes vexans arabiensis populations, one of the potential vectors of Rift Valley Fever in West Africa, was demonstrated in a two-year follow-up study conducted in the Ferlo region of Senegal. In 2003, the rainy season began with heavy rains and, as a result, temporary ponds, the breeding places for mosquitoes, were flooded at their maximum level immediately. In such conditions, Aedes vexans arabiensis populations are abundant at the very beginning of the season, when the majority of eggs in quiescence are flooded. Females, hatching from eggs laid the year before, quickly lay eggs on the pond's wet soil, which will undergo dormancy as the water level goes down. Rainless periods longer than seven days, the time needed for embryogenesis, followed by significant rainfall, will result in the hatching of very large numbers of new eggs. Thus, several generations of adults may exist during the same rainy season. Because of potential vertical transmission of Rift Valley Fever virus in Aedes species, viral transmission and disease risk can appear as early as the beginning of the rainy season and if late rains occur, at the end of the season. This dynamic maximizes the virus' chance to persist from one year to another, thus facilitating endemisation of Rift Valley Fever in areas where Aedes vexans arabiensis exists.