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Table 1 Variables in climate change and malaria transmission identified from literature review and expert consultation

From: An integrated risk and vulnerability assessment framework for climate change and malaria transmission in East Africa

No

Variables

Description

Source

Biophysical variables

1

Air temperature

Air temperature suitable for malaria transmission i.e. between 16 and 34 °C

[17, 32, 48, 57–61]

2

Water temperature

Mosquito habitat temperature suitable for breeding

[60, 62–64]

3

El-Nino

Periods of extreme rainfall

[14–16, 48, 65]

4

Average rainfall/precipitation

Mean monthly rainfall of at least 150 mm; rainfall season

[9, 17, 21, 31, 48, 61, 66, 67]

5

Relative humidity

Amount of water vapour present in air

[68–71]

6

Altitude

Height/distance above sea level

[36, 48, 69, 70, 72]

7

Micro-habitat changes

Changes in mosquito habitat micro-climate due to loss of forest cover or other environmental controls such as clearing of bushes

[63, 68–70, 73–78]

8

Topography

Physical land surface including hills and valleys, elevation

[33, 48, 79, 80]

9

Topographic wetness index

Percentage of ground water saturation of at least 5% for suitable mosquito breeding site

[30, 31]

10

Wetlands and water bodies

Proximity to swamps and other stagnant water bodies

[33, 63, 68, 74, 76, 77, 81]

11

Bare areas

Land without forest cover or other vegetation

[33, 82, 83]

12

Forest edge

Human proximity to forest boundaries and potential exposure to exposed mosquito breeding sites due to deforestation

[33, 62]

13

Agriculture

Land clearance, planting, livestock and maize farming, swamp drainage and farming, and water management i.e. water conservation using shallow wells, small-scale irrigation and creation of water drainage channels

[31, 33, 48, 49, 76, 77, 84–87]

14

Vector abundance

Increase in numbers of malaria mosquitoes

[32, 60, 82, 88]

15

Vector biting

Likelihood of an infective bite from a mosquito

[48, 70, 82]

16

Vector infection rate

Efficiency of transmission and infection with the malaria parasite by the mosquito

[48, 73, 82]

17

Vector adaptive behaviour

Changes in mosquito vector behaviour such as early biting or indoor resting

Expert input

18

Population under 5 years

Number of individuals under 5 years old

[48, 49, 74]

19

Immune status

Lowered immunity to malaria due to pregnancy or inexposure; acquired immunity to malaria from long term exposure

[48, 49, 79, 89, 90]

20

Interactions

Co-infections with other diseases such as HIV increase likelihood and severity of infection

[15, 50]

21

Drug resistance

Resistance of the malaria parasite to drugs/parasite evolution

[15, 48, 50]

Socio-economic variables

22

Urbanisation

Expansion of urban areas and overcrowding in cities

[49]

23

Population migration/travel

Movement of people from low risk areas to malaria-endemic or epidemic-prone areas and vice versa

[48, 50]

24

Nutritional status

Poor health as a result of undernutrition or malnutrition

[48, 49]

25

Gender

Gender roles, expectations and cultural customs

[48, 49]

26

Poverty

Socio-economic conditions; household income, food and household assets

[15, 48, 49, 74]

27

Religious beliefs

Religion or superstitions in understanding or managing malaria and/or climate change impacts

[15, 49]

28

Perception

Knowledge and understanding of disease

[15, 33, 49]

29

Type of house

House with grass-thatched roof and mud walls (semi-permanent) or Bbrick house with tiled or aluminium roof (permanent); house with separate kitchen, house with ceiling and house with open eaves

[33, 48, 49]

30

Education level of household head

Education level of male or female head of household

[33]

31

Health-seeking behaviour

Willingness to seek treatment for malaria; households with malaria medicine in stock, self-medication, tradition/cultural norms and practices in malaria management

[48, 49]

32

Net use

Use of insecticide-treated bed nets to prevent malaria infection

[15, 33, 74]

33

Environmental controls

Keeping area around the houses cleared of shrubs and other overgrowth; safe disposal of plastics and other water-retaining containers

[15, 33]

34

Quality of health systems

Health services and policy; availability of health facilities; access to healthcare; quality of healthcare and capacity for malaria treatment

[15, 47, 48, 50]

35

Malaria vector control

Distribution and coverage of insecticide-treated bed nets by the government; coverage of households sprayed with malaria insecticide (indoor residual spraying)

[15, 48]

36

Quality of information

Reliable and easy to understand information systems for communicating weather and climate information or early warning systems for malaria epidemics

[15, 17, 50]