Drivers of autochthonous and imported malaria in Spain and their relationship with meteorological variables

Abstract

Since the early twentieth century, the intensity of malaria transmission has decreased sharply worldwide, although it is still an infectious disease with a yearly estimate of 228 million cases. The aim of this study was to expand our knowledge on the main drivers of malaria in Spain. In the case of autochthonous malaria, these drivers were linked to socioeconomic and hygienic and sanitary conditions, especially in rural areas due to their close proximity to the wetlands that provide an important habitat for anopheline reproduction. In the case of imported malaria, the main drivers were associated with urban areas, a high population density and international communication nodes (e.g. airports). Another relevant aspect is that the major epidemic episodes of the twentieth century were strongly influenced by war and military conflicts and overcrowding of the healthcare system due to the temporal overlap with the pandemic flu of 1918. Therefore, military conflicts and overlap with other epidemics or pandemics are considered to be drivers of malaria that can—in a temporary manner—exponentially intensify transmission of the disease. Climatic factors did not play a relevant role as drivers of malaria in Spain (at least directly). However, they did influence the seasonality of the disease and, during the epidemic outbreak of 1940–1944, the climate conditions favored or coadjuvated its spread. The results of this study provide additional knowledge on the seasonal and interannual variability of malaria that can help to develop and implement health risk control measures. Supplementary Information The online version contains supplementary material available at 10.1007/s41207-021-00245-8.

Climate Change, Aquatic Ecosystems and Human Infectious Diseases in a Globalised World

“…The authors addressed autochthonous and imported malaria separately, highlighting that the drivers of both types of malaria are different. In fact, later studies showed that the effect of temperature as a driver of the phenology of autochthonous malaria cannot be directly extrapolated to cases of imported malaria [17]. This study concluded that the main epidemic outbreaks of malaria in Spain during the 20th century were greatly influenced by military conflicts, population movements and the worsening of hygienic and sanitary conditions.…”

“…This study concluded that the main epidemic outbreaks of malaria in Spain during the 20th century were greatly influenced by military conflicts, population movements and the worsening of hygienic and sanitary conditions. Although the meteorological variables did not play a key role in these epidemic episodes, they did contribute to the latter by creating the suitable conditions for their intensification [17]. Thus, the authors of [4] asserted that modern research on this type of infectious diseases must delve into the drivers that explain the historical distribution of the disease, with the aim of differentiating the relevance of each of them in the prevalence of malaria.…”

“…In most developed countries, autochthonous malaria was eradicated during the second half of the 20th century. However, during the 21st century, the number of cases of imported malaria has continued to increase in those countries [17]. The globalization of the economy favors the globalization or, at least, spreading of some infectious diseases.…”

Survey and Analysis of Chemoprophylaxis Policies for Domestic Travel in Malaria-Endemic Countries

“…Nevertheless, there may be little doubt concerning the need for protecting MRAs from domestic travelers. Recent travel is a conspicuous risk factor for malaria acquired internationally that may occasionally result in local outbreaks in otherwise malaria-free nations [ 24 , 25 , 26 , 27 ]. Recent studies have explored domestic travel and malaria risk among residents of MRAs or nonendemic areas with MECs.…”