Data

20-years data (1996-

2015) of malaria

OPD cases collected

by the National

Malaria Control

Program (NMCP)

through Health

Management

Information System

(HMIS)

A Roadmap to Early Warning Systems for Climate Sensitive Diseases in Tanzania: Demonstrating the Effect of Extreme Climate Events on Malaria Burden

Susan F. Rumisha, PhD1, Frank Chacky, MSc2

1National Institute for Medical Research, P.O. Box 9653, Dar es Salaam, Tanzania; 2 National Malaria Control Program, Ministry of Health, Community Development, Gender, Elderly & Children, P.O. Box 9083, Dar es Salaam

NATIONAL

MALARIA

CONTROL

PROGRAMME

Climate sensitive diseases such as malaria are affected

with changes in climatic such as temperature/rainfall.

Certain levels favor production, or compromise survival,

of vectors and hence alter transmission.

This study analyze district level malaria data and the climate

information to study malaria seasonality and demonstrate

contribution of extreme climate events in the disease burden.

Tanzania is among East African countries affected strongly

by the extreme climate event of the El Niño that occurred in

1997/1998. A number of districts experienced malaria

epidemics which were highly associated with the event.

Recently, the Tanzania Meteorological Agency (TMA) launched a new climate service which offers access to over 30 years of gridded

rainfall and temperature data throughout the country. This is the only local climatic data which is well organized, complete and with high

spatial resolution. There is a need of putting efforts to ensure the data is utilized by right people to guide decisions in health sector

The El Niño

impacted the

climate of East

African Region

again in 2015

Seasonality:

Peak malaria

season for

Dodoma and

Iringa is March –

May, while

Babati indicated

a whole year

(holoendemic)

malaria with

slight peak on

Apr-May.Fig 1. Patterns of El Niño and La Niña 1980 -2016

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Pattern of Malaria - Babati District

1995 1996 1997

1998 1999 2000

2001 2002 2003

2004 2005 2006

2007 2013 2014

2015 10yrsaverage

Peak Malaria Season: All Year, slight peak on

Apr-May

• 1997/1998 malaria was above the

average throughout the year; a very

strong El Nino was recorded

• 1999 malaria was high in the first five

months of a year and increased sharply;

a moderate La Nina was recorded

• 1998/1999 malaria was above the

average throughout the year, in these

years there was a moderate La Nina

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Pattern of Malaria - Iringa District

1995 19961997 19981999 20002001 20022003 20042005 20062007 20082009 20102011 20122013 20142015 10yrsaverage

Peak Malaria Season: End of

March-May

Methodology and Findings

Pilot Sites/Districts (Rain)Babati - Northern (Bimodal)

Dodoma - Central (Unimodal)

Iringa - Southern Highlands

(Unimodal)

Analysis

Conducted in the

light of Oceanic Niño

Index (ONI) to detect

prominent patterns

of malaria cases that

might be associated

with El Niño

Southern Oscillation

(El Niño and La

Niña) (Fig. 1).

Babati and Dodoma

experienced malaria

epidemic in 1998/1999,

Iringa did not report

outbreak tthat time

• Malaria cases increased in times of moderate to very strong El Niño/La Niña index levels

• In some instance malaria cases increased during weak index

• Spatial variation of the effect was observed, districts are affected differently

• In all 3 districts, for all the times that index was abnormal, malaria cases went above the

expected range, not only for the peak times but also other months (Fig. 2).

• Dodoma district recorded high cases in almost all occurrences of El Niño and La Niña.

Background and Objective

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Pattern of Malaria Dodoma

1995 19961997 19981999 20002001 20022003 20042005 20062007 20082009 20102011 20122013 20142015 10yrsaverage

Peak Malaria Season: End of

March-May

• 1995 malaria was above average in the first 6

months of the year; a weak La Nina was recorded

• 1998 malaria was above the average the entire

year; a very strong El Nino was recorded

• The first 3 months of 2001 malaria was highly

above the normal range, a strong La Nina

recorded in 1999 and 2000

• The district recorded higher cases of malaria

since August 2015, that time there were already

warning of a Strong El Nino

• 1999/2000 malaria was high in the

entire year, in this year there was a

moderate La Nina

• 2007 malaria was above the

average throughout the year; a

moderate La Nina recorded

Understanding the patterns of climate extreme events can facilitate

establishment of effective early warning systems for outbreaks, and

strengthen the capacity of the system to forecast, respond and

properly manage malaria outbreaks.

Fig 2. Patterns of Malaria indicating high cases than expected

(a-c) and patterns of malaria by zones (d)

Mar, 1997

Mar, …

19992001

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Malaria in Dodoma 1995-2015

1995 1996 19971998 1999 2000

Same

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Conclusion: This pilot analysis indicates that studying patterns of extreme weather events

can be useful to inform the health system and initiate effective response to malaria epidemics.

Full analysis will utilize the high quality climate products from the TMA.

srumisha@nimr.or.tz; chackyfa@gmail.com

Acknowledgments: The authors appreciate the technical advice from International Research Institute for Climate and Society, Columbia University. The National Institute for Medical Research is thanked for logistics and

administrative support. This work received financial support from the World Health Organization under Global Framework for Climate Services Project

What do we see?

Prepared June, 2016