Proximity of Residence to Irrigation Determines Malaria Risk and Anopheles Abundance at an Irrigated Agroecosystem in Malawi.

As countries of sub-Saharan Africa expand irrigation to improve food security and foster economic growth, it is important to quantify the malaria risk associated with this process. Irrigated ecosystems can be associated with increased malaria risk, but this relationship is not fully understood. We studied this relationship at the Bwanje Valley Irrigation Scheme (800 hectares) in Malawi. Household prevalence of malaria and indoor Anopheles density were quantified in two cross-sectional studies in 2016 and 2017 (5,829 residents of 1,091 households). Multilevel logistic regression was used to estimate the association between distance to the irrigation scheme and malaria infection and mosquito density. The prevalence of malaria infection was 50.2% (2,765/5,511) by histidine-rich protein 2-based malaria rapid diagnostic tests and 30.1% (1,626/5,403) by microscopy. Individuals residing in households within 3 km of the scheme had significantly higher prevalence of infection (adjusted odds ratio [aOR] = 1.41; 95% confidence interval [CI] 1.18, 1.68); school-aged children had the highest prevalence among age groups (aOR = 1.34; 95% CI 1.11, 1.63). Individuals who reported bed net use, and households with higher socioeconomic status and higher level of education for household head or spouse, had lower odds of malaria infection. Female Anopheles mosquitoes (2,215 total; Anopheles arabiensis, 90.5%, Anopheles funestus, 9.5%) were significantly more abundant in houses located within 1.5 km of the scheme. Proximity of human dwellings to the irrigation scheme increased malaria risk, but higher household wealth index reduced risk. Therefore, multisectoral approaches that spur economic growth while mitigating increased malaria transmission are needed for people living close to irrigated sites.

Ultimately, What is Forest Landscape Restoration in Practice? Embodiments in Sub-Saharan Africa and Implications for Future Design.

Forest landscape restoration (FLR) is gaining ground as a novel, holistic approach to sustainable environmental management across developing countries. In sub-Saharan Africa, 30 countries have joined the African Forest Landscape Restoration Initiative to advance FLR goals. Although conceptually compelling, and despite efforts articulating initial implementation guidelines, divergent discourses and interpretations confound FLR translation into practice. We propose a characterization of FLR in practice using insights from political ecology; principles of ecological restoration and landscape sustainability science; and the philosophy, principles, and objectives of the FLR paradigm. Our qualitative analysis further draws on secondary data and insights from participant observation during FLR-related workshops. We build and organize the FLR characterization around answers to ten questions: why restoration; what purpose; for what desired outcomes; where (location and land uses); what spatial extent and scale(s); who; which techniques; how (approach/strategy); when and how long; and how much to achieve. We then assess early FLR strategic priorities for interventions across nine African countries and analyze five selected actual projects to illustrate use of the proposed FLR characterization framework. The illustrative characterization of both planned interventions and actual projects does not reflect all the proposed characteristics of FLR in practice. Missing features include the initial biophysical condition, the desired target ecosystem state, and evaluation dimensions, and ill-articulated aspects include cross-sectoral integrations. We contend that any significant differences between FLR conceptualization, including its principles, and the practical manifestations can undermine coherence, the value that the FLR approach adds, and its wider adoption. The proposed characterization of FLR in practice contributes to scholarly attempts to realign FLR conceptual philosophy, principles, and rhetoric to its practical manifestations in different contexts, and can inform future design of FLR undertakings for more inclusive landscape governance.

A Survey of Program Capacity and Skills of Florida Mosquito Control Districts to Conduct Arbovirus Surveillance and Control.

Effective and efficient surveillance systems are key for preventing arthropod-borne diseases. We examined the capacity of Florida mosquito control districts (both state-approved and open programs, n = 90; 48.9% response rate). Questions centered on budgets, staffing levels, equipment, vector control measures, and staff perceptions of own agency's capacity to implement routine surveillance and vector control activities. Bivariate analyses indicate that districts with relatively large budgets have advanced capacities regarding staffing levels, employee specialties, mosquito control equipment, conduct routine surveillance and vector control yet they serve only a small proportion of the population. Independent tax districts' average annual budgets were 9 times higher than Board of County Commissioners programs in fiscal year 2017-18. Most respondents indicated that staff is appropriately trained, and has timely access to information and needed equipment for mosquito surveillance and control. Slightly more than half of respondents feel they are understaffed. Perceived understaffing may compromise mosquito surveillance and control efforts in some districts.

Analyzing spatial clustering and the spatiotemporal nature and trends of HIV/AIDS prevalence using GIS: the case of Malawi, 1994-2010.

BACKGROUND: Although local spatiotemporal analysis can improve understanding of geographic variation of the HIV epidemic, its drivers, and the search for targeted interventions, it is limited in sub-Saharan Africa. Despite recent declines, Malawi's estimated 10.0% HIV prevalence (2011) remained among the highest globally. Using data on pregnant women in Malawi, this study 1) examines spatiotemporal trends in HIV prevalence 1994-2010, and 2) for 2010, identifies and maps the spatial variation/clustering of factors associated with HIV prevalence at district level. METHODS: Inverse distance weighting was used within ArcGIS Geographic Information Systems (GIS) software to generate continuous surfaces of HIV prevalence from point data (1994, 1996, 1999, 2001, 2003, 2005, 2007, and 2010) obtained from surveillance antenatal clinics. From the surfaces prevalence estimates were extracted at district level and the results mapped nationally. Spatial dependency (autocorrelation) and clustering of HIV prevalence were also analyzed. Correlation and multiple regression analyses were used to identify factors associated with HIV prevalence for 2010 and their spatial variation/clustering mapped and compared to HIV clustering. RESULTS: Analysis revealed wide spatial variation in HIV prevalence at regional, urban/rural, district and sub-district levels. However, prevalence was spatially leveling out within and across 'sub-epidemics' while declining significantly after 1999. Prevalence exhibited statistically significant spatial dependence nationally following initial (1995-1999) localized, patchy low/high patterns as the epidemic spread rapidly. Locally, HIV "hotspots" clustered among eleven southern districts/cities while a "coldspot" captured configurations of six central region districts. Preliminary multiple regression of 2010 HIV prevalence produced a model with four significant explanatory factors (adjusted R2 = 0.688): mean distance to main roads, mean travel time to nearest transport, percentage that had taken an HIV test ever, and percentage attaining a senior primary education. Spatial clustering linked some factors to particular subsets of high HIV-prevalence districts. CONCLUSIONS: Spatial analysis enhanced understanding of local spatiotemporal variation in HIV prevalence, possible underlying factors, and potential for differentiated spatial targeting of interventions. Findings suggest that intervention strategies should also emphasize improved access to health/HIV services, basic education, and syphilis management, particularly in rural hotspot districts, as further research is done on drivers at finer scale.