INTEGRATED SURVEILLANCE AND CONTROL SYSTEM FOR …indico.ictp.it/event/a10167/session/57/contribution/38/material/0/0.pdf · INTEGRATED SURVEILLANCE AND CONTROL SYSTEM FOR MALARIA

INTEGRATED SURVEILLANCE AND CONTROL SYSTEM FOR MALARIA

IN COLOMBIA

DANIEL RUIZ CARRASCALC.E., M.Sc., M.A., M.Phil, PhD(c)

School of Engineering in Antioquia, Colombia

International Research Institute for Climate and SocietyLamont-Doherty Earth Observatory

Columbia University in the City of New York, USA

SUMMER SCHOOL ON CLIMATE IMPACTS MODELLING FOR DEVELOPING COUNTRIES: WATER, AGRICULTURE AND HEALTH

OUTLINE

DYNAMICAL MODELS AND MULTI-MODEL ENSEMBLE

OBJECTIVES AND CURRENT/POTENTIAL CAPABILITIES

WHY DYNAMICAL MODELS ARE USEFUL?

WHAT DO WE HAVE IN THE MULTI-MODEL ENSEMBLE?

WHAT ARE WE DOING WITH THE MATHEMATICAL MODELS?

ECO-EPIDEMIOLOGICAL SCENARIOSHOW DO WE PROCEED AND WHAT DO WE HAVE SO FAR?

ENVIRONMENTAL HEALTH AND PUBLIC HEALTH

OUTLINE








CLIMATE CHANGE

OZONE DEPLETION

DIRECTThermal stress

INDIRECT

Ecologically mediated

Vector-borne diseasesMarine-borne diseases

Food productivity

Air pollution

Weather disasters

Sea-level rise

Cardiovascular and respiratory morbidity

and mortality

Malaria, dengue, ...

Toxic algae and cholera

Malnutrition

Asthma and cardio-respiratory disorders

Deaths, injuries, damage to health

infrastructure, conflicts

Skin cancers, cataracts, immunosuppression

(From Martens 1997)

GONOTROPHIC CYCLE LENGTH UNDER CONTROLLED LABORATORY CONDITIONS

1,5

2,0

2,5

3,0

3,5

4,0

4,5

5,0

5,5

1,5

2,0

2,5

3,0

3,5

4,0

4,5

5,0

5,5

23,0 24,0 25,0 26,0 27,0 28,0 29,0 30,0 31,0 32,0 33,0

Feeding interval or gonotrophic cycle length [days]

Air temperature [°C]

Feeding interval or gonotrophic cycle length[days]Integrated National Adaptation Pilot

( INAP project )

Previous research projects conducted in Colombia

Scientificliterature

As of 2004, approx. 264 M individuals, out of estimated 869 M inhabitants of the Americas (i.e. 30% ), lived in areas at ecological risk of malaria transmission

Source: Regional Strategic Plan for Malaria in the Americas 2006-2010 (PAHO) and processed by Ruiz (2011) and Malaria Control in the Americas 1958 1999 (Mendez-Galvan, 2006)

MALARIA IN THE AMERICAS

1959

1961

1971

1981

1991

2001

2004

Year

Num

ber o

f cas

es [i

n th

ousa

nds]

600

200

400

800

1,000

1,200

1,400

Plasmodium falciparum malaria Plasmodium vivax malaria Total positive cases

300

250

200

150

100

50

0

Inve

stm

ent i

n m

alar

ia p

rogr

ams

[US

milli

on d

olla

rs]

Total investment

EAST AFRICAN HIGHLANDS

0

200

400

600

800

1000

1200

1978

1979

1980

1981

1982

1983

1984

1985

1986

1987

1988

1989

1990

1991

1992

1993

1994

1995

1996

1997

1998

1999

Date [mm/yy]

Tota

l Pos

itive

Cas

es [i

ndiv

idua

ls]

KDH village, Kisii District, Western Kenya

1910

LONG FREE OF MALARIA

1920 1950

SPORADIC MALARIA OUTBREAKS

1960 1980

OUTBREAKS WERE NOT REPORTED

MALARIA ERADICATION CAMPAIGN

EPIDEMICS HAVE FREQUENTLY BEEN REPORTED

Current patternIncreased incidences, expanded geographic

areas, and higher case-fatality rates

0

50

100

150

200

250

300

350

1950

1960

1970

1980

1990

2000

Year

Tota

l num

ber o

f day

s per

yea

r

0

50

100

150

200

250

300

350

Tota

l num

ber o

f day

s per

yea

r

16.0 C 18.0 C 21.5 C

Normal El Nino1957/58


Strong El Nino1972/73




Normal El Ninos1991/92/93/94/95



Strong La Nina1955/56

Strong La Nina1973/74 and 75/76

Strong La Nina1988/89

Normal La Nina1998/99

TOTAL NUMBER OF DAYS PER YEAR WHEN MEAN AMBIENT TEMPERATURES, OBSERVED AT 1,310 masl, WERE ABOVE 16.0 C (GREY SOLID LINE), 18.0 C (BLUE SOLID LINE), AND

21.5 C (RED SOLID LINE)

EPIDEMIOLOGICAL SURVEILLANCE

EARLY WARNING SYSTEMS

FRAMEWORK

DIAGNOSIS OF PRIMARY CASES

ENTOMOLOGICAL SURVEILLANCE

CLIMATIC SCENARIOS MONITORING AND

FORECASTING

Climate change and climate variability

Climate-independent components

Human macro-factors

Relevant entomological-biological variables

Institutional networksand financial strategies

Education, local expertise, process maintenance and

continuity

Primary cases

COLOMBIAN INTEGRATED SURVEILLANCE AND CONTROL SYSTEM

OUTLINE








MULTI-MODEL ENSEMBLEAPPROACH TO MALARIA MODELLING

MAC (1957)

CDE-I (1998)

CDE-II (1998)

CDE-III (2003)

YANG (2000)

MAR (1997)

WCT (2007)

RUIZ (2002)

RESULTS

COMMUNITY-BASED

ENVIRONMENTAL

HUMAN HOST (INDIVIDUAL)

HM (2004)

STABILITY ANALYSIS

GNM (2001)

PARASITE

MOSQUITO VECTOR

CHGD (2007)

GOM (2008)

LMM (2010)

ABP (2010)

RUIZ et al. (2002)

tCtStRtSBtS H

tEtEtStE H

tItItIrtCtItE1tI H

tRtRtIrtR H

tCtCtCtCtItEtC H

tKkPktK EA

tLdtLtK

tLtKtWtVtXftL LL

tLdtXtXtyactX LM

tVtVtXtyactV MP

tWtVtW MP

ABP

2010

HUMAN

HOSTS

MOSQUITOES

SEVEN (7) INTERACTIVE PLATFORMSSimulMal - PowerSim

WCT PowerSim & MS Excel versions

WCT IRI online tool

MME09 Exe and Full versions

MAR PowerSim

WCT Microsoft Office Excel 2007 (for Microsoft Windows Vista Home Basic®)

(From Ruiz 2008)

(From Ruiz 2008)

COMMUNITY-BASED VARIABLES

DEMOGRAPHIC CENSUS

DESCRIPTION OF PARTICULARITIES

DESCRIPTION OF SURVEILLANCE

ACTIVITIES

TOTAL HUMAN POPULATION AT RISK

HUMAN POPULATION GROWTH RATE

LEVEL OF UNDERSTANDING

POOR PARTIAL GOOD( ) ( ) ( )

Total individuals living in rural areas

Total individuals living in urban areas

TOTAL MALARIA POSITIVE CASES

CONDUCTED (OR ABSENT) CONTROL

CAMPAIGNS

DESCRIPTION OF PREVAILING SEC

(source: Ruiz and Gellers, 2007)

INDICATIVE REVIEW OF SOCIOECONOMIC FACTORSBanguero (1984) Castilla & Sawyer (1993) Koram et al. (1995)

USE OF NETS/DRUGS

PERSONS IN HOUSEHOLD

AGE

FREQUENCY OF DDT SPRAYING

WAGE INCOME

OCCUPATIONAL STATUS

WATER SOURCE

WASTE DISPOSAL

OUTLINE








UNDERSTAND COMPLEXITY

ESTIMATE TIMING AND SEVERITY

ANALYZE KEY-VARIABLES

POSE AND ANSWER "WHAT IF" QUESTIONS

INVESTIGATE CURRENT DECISION MAKING PROCESS AND PROVIDE QUANTITATIVE GOALS FOR EFFECTIVE INTERVENTIONS

HELP DECISION MAKERS LEARN

CURRENT CAPABILITIES

FORESEEABLE FUTURE CLIMATE FORECASTS

DECISION-MAKING PROCESSES

EXPERIMENTATION-VALIDATION-ANALYSIS

BA

SIC

RE

PR

OD

UC

TIO

N R

ATE

(Ro)

0

50

40

30

20

10

LOW RISKINTERMEDIATE RISK

HIGH RISK( LEVEL OF CONTACT )

0.075

0.0820.13

1.11.2

1.9

0.350.38

0.62

2.0 2.2

3.4

5.35.7

8.7

1.92.0

3.3

18

28

30

46

5

GOOD DETERIORATINGINTERMEDIATE

SEC AMBIENT TEMPERATURES

LOW INTERMEDIATE HIGH

0.430.46

0.7

MALARIA-FREE

1211

LOW-ENDEMIC

INTERMEDIATE

HIGH

(From Yang 2000 and Ruiz 2008)

OUTLINE








NUQUÍ, COLOMBIAN

PACIFIC COAST

EL BAGRE, COLOMBIAN

CARIBBEAN COAST

DISTRICT OF KISII, KENYAN HIGHLANDS

DISTRICT OF CHOBE, NORTHERN

BOTSWANA

1998 1999 2000 2001 2002 2003 2004 2005 2006

MUNICIPALITIES OF MONTELIBANO, PUERTO

LIBERTADOR, BUENAVENTURA, AND SAN JOSE DEL GUAVIARE

DISTRICT OF CHOBE, NORTHERN

BOTSWANA

2006 2007 2008 2009 2010 2011 DISTRICT OF KERICHO, KENYAN HIGHLANDS

CAUCASIA, NECHI, TIERRALTA, TURBO,

VIGIA DEL FUERTE, AND YONDO

RETROSPECTIVE ANALYSES

CHANGING CLIMATE SCENARIOS

CHANGING NON-CLIMATIC FACTORS

FUTURE SCENARIOS

BASE SCENARIO

CHANGES IN INITIAL CONDITIONS

SENSITIVITY ANALYSIS

UNCERTAINTIES

PR

ES

EN

TANALYSIS OF LOCAL CONDITIONS

EAST AFRICAN HIGHLANDS, KERICHO TEA STATE, KENYA

0,0000

0,0050

0,0100

0,0150

0,0200

0,0250

0,0300

01/1

979

02/1

980

03/1

981

04/1

982

05/1

983

06/1

984

07/1

985

08/1

986

09/1

987

10/1

988

11/1

989

12/1

990

01/1

992

02/1

993

03/1

994

04/1

995

05/1

996

06/1

997

07/1

998

08/1

999

09/2

000

10/2

001

11/2

002

12/2

003

01/2

005

02/2

006

03/2

007

04/2

008

05/2

009

P.fa

lcip

arum

mal

aria

pre

vale

nce

Date [mm/yyyy]

Observed Malaria Incidence

Prev (sim) C-Conditions

Prev (sim) C-Conditions (Detrended)

-0,0100

-0,0050

0,0000

0,0050

0,0100

0,0150

0,0200

0,0250

01/1

979

02/1

980

03/1

981

04/1

982

05/1

983

06/1

984

07/1

985

08/1

986

09/1

987

10/1

988

11/1

989

12/1

990

01/1

992

02/1

993

03/1

994

04/1

995

05/1

996

06/1

997

07/1

998

08/1

999

09/2

000

10/2

001

11/2

002

12/2

003

01/2

005

02/2

006

03/2

007

04/2

008

05/2

009

P.fa

lcip

arum

mal

aria

ano

mal

y

Date [mm/yyyy]

Inc Anomaly (obs) C-Conditions

Prev Anomaly (sim) C-Conditions

Prev Anomaly (sim) C-Conditions (Detrended)

MEDIUM-TERM CLIMATE FORECAST EXPERIMENTS

MUNICIPALITY OF MONTELÍBANO

0,0000

0,0050

0,0100

0,0150

0,0200

0,0250

0,0300

01/0

1/15

11/0

1/15

21/0

1/15

31/0

1/15

10/0

2/15

20/0

2/15

02/0

3/15

12/0

3/15

22/0

3/15

01/0

4/15

11/0

4/15

21/0

4/15

01/0

5/15

11/0

5/15

21/0

5/15

31/0

5/15

10/0

6/15

20/0

6/15

30/0

6/15

10/0

7/15

20/0

7/15

30/0

7/15

09/0

8/15

19/0

8/15

29/0

8/15

08/0

9/15

18/0

9/15

28/0

9/15

08/1

0/15

18/1

0/15

28/1

0/15

07/1

1/15

17/1

1/15

27/1

1/15

07/1

2/15

17/1

2/15

27/1

2/15

Date [dd/mm/yy]

P. fa

lcip

arum

mal

aria

inci

denc

e

0,0000

0,0050

0,0100

0,0150

0,0200

0,0250

0,0300

P. fa

lcip

arum

mal

aria

inci

denc

eWCT /month Exp 1

WCT /month Exp 2

WCT /month Exp 3

Historical incidence (annual cycle)

Monthly Plasmodium falciparum malaria incidence suggested by the WCT model for the forecast horizon spanning from January 01, 2015 through December 31, 2015

INCREASED INCIDENCE

0,0000

0,0100

0,0200

0,0300

1 - 2000 1 - 2001 1 - 2002 1 - 2003 1 - 2004 1 - 2005 1 - 2006 1 - 2007Epidemiological Period (EP)

P.fa

lcip

arum

mal

aria

pre

vale

nce Inc (obs)/EP Prev (sim)/EP 'Moderate' Prev (sim)/EP 'Critical'R=0.377; MSE=3E-06

R=0.373; MSE=1E-04

-0,0150

-0,0050

0,0050

0,0150

1 - 2000 1 - 2001 1 - 2002 1 - 2003 1 - 2004 1 - 2005 1 - 2006 1 - 2007

Epidemiological Period (EP)

P.fa

lcip

arum

mal

aria

ano

mal

y

Inc Anomaly (obs)/EP Prev Anomaly (sim)/EP 'Moderate' Prev Anomaly (sim)/EP 'Critical'

SAN JOSE GUAVIARE - WCT model (MODERATE AND CRITICAL CONDITIONS)

Programa en Ingeniería AmbientalEscuela de Ingeniería de Antioquia, Colombia

[email protected]

International Research Institute for Climate and SocietyLamont-Doherty Earth Observatory, USA

[email protected]

Department of Earth and Environmental SciencesColumbia University in the City of New York, USA

[email protected]

Daniel Ruiz Carrascal

mailto:[email protected]



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INTEGRATED SURVEILLANCE AND CONTROL SYSTEM FOR …indico.ictp.it/event/a10167/session/57/contribution/38/material/0/0.pdf · INTEGRATED SURVEILLANCE AND CONTROL SYSTEM FOR MALARIA