“…Similarly, the lack of association with temperature might be an artifact of the geographical scale of the study, given that at small geographical scales temperature is important for mosquito biology and the parasite vector interaction [ 41 , 75 ]. There is the pervasive problem of ignoring other contextual drivers of malaria transmission such as poverty [ 8 , 78 , 79 ], parasite invasion through unplanned migration [ 19 , 80 ], and the understudied socio-cultural barriers to accept and implement malaria control measures among the Gunas [ 10 ].…”
Section: Discussionmentioning
confidence: 99%
“…Information on the potential impact of climate factors on malaria incidence might be helpful to guide malaria prevention programmes aimed at the eventual elimination of this disease, from República de Panamá and Mesoamerica. For example, strategic interventions in the vulnerable region of Guna Yala, should include comprehensive health impact assessments [ 21 , 79 , 83 ] with a focus in areas foreseen to see large influx of climate change triggered Guna migration, such as Carti, a site already chosen for island Guna population relocation following the disappearance of the Caribbean Islands currently serving as home for most of the Gunas living in Guna Yala.…”
BackgroundMalaria has historically been entrenched in indigenous populations of the República de Panamá. This scenario occurs despite the fact that successful methods for malaria elimination were developed during the creation of the Panamá Canal. Today, most malaria cases in the República de Panamá affect the Gunas, an indigenous group, which mainly live in autonomous regions of eastern Panamá. Over recent decades several malaria outbreaks have affected the Gunas, and one hypothesis is that such outbreaks could have been exacerbated by climate change, especially by anomalous weather patterns driven by the EL Niño Southern Oscillation (ENSO).ResultsMonthly malaria cases in Guna Yala (1998–2016) were autocorrelated up to 2 months of lag, likely reflecting parasite transmission cycles between humans and mosquitoes, and cyclically for periods of 4 months that might reflect relapses of Plasmodium vivax, the dominant malaria parasite transmitted in Panamá. Moreover, malaria case number was positively associated (P < 0.05) with rainfall (7 months of lag), and negatively with the El Niño 4 index (15 months of lag) and the Normalized Difference Vegetation Index, NDVI (8 months of lag), the sign and magnitude of these associations likely related to the impacts of weather patterns and vegetation on the ecology of Anopheles albimanus, the main malaria vector in Guna Yala. Interannual cycles, of approximately 4-year periods, in monthly malaria case numbers were associated with the El Niño 4 index, a climatic index associated with weather and vegetation dynamics in Guna Yala at seasonal and interannual time scales.ConclusionThe results showed that ENSO, rainfall and NDVI were associated with the number of malaria cases in Guna Yala during the study period. These results highlight the vulnerability of Guna populations to malaria, an infection sensitive to climate change, and call for further studies about weather impacts on malaria vector ecology, as well as the association of malaria vectors with Gunas paying attention to their socio-economic conditions of poverty and cultural differences as an ethnic minority.Electronic supplementary materialThe online version of this article (10.1186/s12936-018-2235-3) contains supplementary material, which is available to authorized users.
“…Similarly, the lack of association with temperature might be an artifact of the geographical scale of the study, given that at small geographical scales temperature is important for mosquito biology and the parasite vector interaction [ 41 , 75 ]. There is the pervasive problem of ignoring other contextual drivers of malaria transmission such as poverty [ 8 , 78 , 79 ], parasite invasion through unplanned migration [ 19 , 80 ], and the understudied socio-cultural barriers to accept and implement malaria control measures among the Gunas [ 10 ].…”
Section: Discussionmentioning
confidence: 99%
“…Information on the potential impact of climate factors on malaria incidence might be helpful to guide malaria prevention programmes aimed at the eventual elimination of this disease, from República de Panamá and Mesoamerica. For example, strategic interventions in the vulnerable region of Guna Yala, should include comprehensive health impact assessments [ 21 , 79 , 83 ] with a focus in areas foreseen to see large influx of climate change triggered Guna migration, such as Carti, a site already chosen for island Guna population relocation following the disappearance of the Caribbean Islands currently serving as home for most of the Gunas living in Guna Yala.…”
BackgroundMalaria has historically been entrenched in indigenous populations of the República de Panamá. This scenario occurs despite the fact that successful methods for malaria elimination were developed during the creation of the Panamá Canal. Today, most malaria cases in the República de Panamá affect the Gunas, an indigenous group, which mainly live in autonomous regions of eastern Panamá. Over recent decades several malaria outbreaks have affected the Gunas, and one hypothesis is that such outbreaks could have been exacerbated by climate change, especially by anomalous weather patterns driven by the EL Niño Southern Oscillation (ENSO).ResultsMonthly malaria cases in Guna Yala (1998–2016) were autocorrelated up to 2 months of lag, likely reflecting parasite transmission cycles between humans and mosquitoes, and cyclically for periods of 4 months that might reflect relapses of Plasmodium vivax, the dominant malaria parasite transmitted in Panamá. Moreover, malaria case number was positively associated (P < 0.05) with rainfall (7 months of lag), and negatively with the El Niño 4 index (15 months of lag) and the Normalized Difference Vegetation Index, NDVI (8 months of lag), the sign and magnitude of these associations likely related to the impacts of weather patterns and vegetation on the ecology of Anopheles albimanus, the main malaria vector in Guna Yala. Interannual cycles, of approximately 4-year periods, in monthly malaria case numbers were associated with the El Niño 4 index, a climatic index associated with weather and vegetation dynamics in Guna Yala at seasonal and interannual time scales.ConclusionThe results showed that ENSO, rainfall and NDVI were associated with the number of malaria cases in Guna Yala during the study period. These results highlight the vulnerability of Guna populations to malaria, an infection sensitive to climate change, and call for further studies about weather impacts on malaria vector ecology, as well as the association of malaria vectors with Gunas paying attention to their socio-economic conditions of poverty and cultural differences as an ethnic minority.Electronic supplementary materialThe online version of this article (10.1186/s12936-018-2235-3) contains supplementary material, which is available to authorized users.
“…In this respect, the present study has suggested malaria reemergence has been unequivocally related with weakening the Malaria Control Programme, either following funding disruptions, administrative re-organization and other policy changes that form part of structural adjustment programs encouraged by multilateral financial institutions [ 59 ]. For instance, the dissolution of the global eradication campaign in 1969 and the subsequent political neglect of malaria, saw a huge decrease in mosquito control in Panamá investment, dropping from $1.20 per capita per year to just 19 cents [ 27 , 60 ].…”
Background: The present study provides a countrywide perspective of the malaria situation in Panamá over a longterm framework, with the purpose of identifying historical malaria resurgence events and their potential causes. Methods: A descriptive-ecological study was conducted by analysing demographic and epidemiological annual malaria time series data in Panamá (1884-2019) using several data sources. Malaria intensity indicators were calculated during the study period. The effects of El Niño Southern Oscillation on malaria transmission were also analysed using a retrospective analysis of malaria cases between 1957 and 2019. Results: Several factors were identified responsible for malaria resurgence in Panamá, mostly related with Malaria Control Programme weakening. During the past 20 years (2000-2019) malaria has progressively increased in prevalence within indigenous settlements, with a predominance of male cases and a high proportion (15% of total cases) in children less than 5 years old. During this period, a significant and increasing proportion of the Plasmodium falciparum cases were imported. Retrospective analysis (1957-2019) evidenced that ENSO had a significant impact on malaria transmission dynamics in Panamá. Conclusions: Data analysis confirmed that although authorities have been successful in focalizing malaria transmission in the country, there are still neglected issues to be solved and important intercultural barriers that need to be addressed in order to achieve elimination of the disease by 2022. This information will be useful for targeting strategies by the National Malaria Elimination Programme.
“…Pioneering microbiological and epidemiological studies have clarified these upstream causes of emerging epidemics, whose effects we now are confronting every day. 1 – 6 In addition to viral epidemics, these and similar agricultural practices also deepen the parallel crises of multi-drug-resistant bacterial infections (through overuse of antibiotics in industrial meat and fish production), climate change (by destruction of rainforest habitats and long-distance transportation of food that requires burning of petroleum), plastic pollution (by agricultural packaging methods), and other severe environmental problems.…”
The upstream causes of the COVID-19 pandemic have received little attention so far in public health and clinical medicine, as opposed to the downstream effects of mass morbidity and mortality. To resolve this pandemic and to prevent even more severe future pandemics, a focus on upstream causation is essential. Convincing evidence shows that this and every other important viral epidemic emerging in the recent past and predictably into the future comes from the same upstream causes: capitalist agriculture, its destruction of natural habitat, and the industrial production of meat. International and national health organizations have obscured the upstream causes of emerging viral epidemics. These organizations have suffered cutbacks in public funding but have received increased support from international financial institutions and private philanthropies that emphasize the downstream effects rather than upstream causes of infectious diseases. Conflicts of interest also have impacted public health policies. A worldwide shift has begun toward peasant agricultural practices: Research so far has shown that peasant agriculture is safer and more efficient than capitalist industrial agricultural practices. Without such a transformation of agriculture, even more devastating pandemics will result from the same upstream causes.
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