When climate change couples social neglect: malaria dynamics in Panama

A major challenge of infectious disease elimination is the need to interrupt pathogen transmission across all vulnerable populations. Ethnic minorities are among the key vulnerable groups deserving special attention in disease elimination initiatives, especially because their lifestyle might be intrinsically linked to locations with high transmission risk. There has been a renewed interest in malaria elimination, which has ignited a quest to understand factors necessary for sustainable malaria elimination, highlighting the need for diverse approaches to address epidemiological heterogeneity across malaria transmission settings. An analysis of malaria incidence among the Guna Amerindians of Panama over the last 34 years showed that this ethnic minority was highly vulnerable to changes that were assumed to not impact malaria transmission. Epidemic outbreaks were linked with El Nino Southern Oscillations and were sensitive to political instability and policy changes that did not ensure adequate attention to the malaria control needs of the Gunas. Our results illustrate how the neglect of minorities poses a threat to the sustainable control and eventual elimination of malaria in Central America and other areas where ethnic minorities do not share the benefits of malaria control strategies intended for dominant ethnic groups

When climate change couples social neglect: malaria dynamics in Panamá

A major challenge of infectious disease elimination is the need to interrupt pathogen transmission across all vulnerable populations. Ethnic minorities are among the key vulnerable groups deserving special attention in disease elimination initiatives, especially because their lifestyle might be intrinsically linked to locations with high transmission risk. There has been a renewed interest in malaria elimination, which has ignited a quest to understand factors necessary for sustainable malaria elimination, highlighting the need for diverse approaches to address epidemiological heterogeneity across malaria transmission settings. An analysis of malaria incidence among the Guna Amerindians of Panamá over the last 34 years showed that this ethnic minority was highly vulnerable to changes that were assumed to not impact malaria transmission. Epidemic outbreaks were linked with El Niño Southern Oscillations and were sensitive to political instability and policy changes that did not ensure adequate attention to the malaria control needs of the Gunas. Our results illustrate how the neglect of minorities poses a threat to the sustainable control and eventual elimination of malaria in Central America and other areas where ethnic minorities do not share the benefits of malaria control strategies intended for dominant ethnic groups

Climatic fuctuations and malaria transmission dynamics, prior to elimination, in Guna Yala, República de Panamá

Background: Malaria 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 afect the Gunas, an indigenous group, which mainly live in autonomous regions of eastern Panamá. Over recent decades several malaria outbreaks have afected 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). Results: Monthly malaria cases in Guna Yala (1998–2016) were autocorrelated up to 2 months of lag, likely refecting parasite transmission cycles between humans and mosquitoes, and cyclically for periods of 4 months that might refect 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 Diference 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. Conclusion: The 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 diferences as an ethnic minorityAntecedentes: La malaria ha estado históricamente arraigada en las poblaciones indígenas de la República de Panamá. Este escenario ocurre a pesar de que se desarrollaron métodos exitosos para la eliminación de la malaria durante la creación del Canal de Panamá. En la actualidad, la mayoría de los casos de malaria en la República de Panamá afectan a los gunas, un grupo indígena que viven principalmente en las regiones autónomas del este de Panamá. En las últimas décadas se han producido varios brotes de malaria Una de las hipótesis es que estos brotes podrían haberse visto exacerbados por el cambio climático, especialmente por los patrones meteorológicos anómalos provocados por la Oscilación del Sur del Niño (ENSO). Resultados: Los casos mensuales de malaria en Guna Yala (1998-2016) estuvieron autocorrelacionados hasta 2 meses de desfase, probablemente reflejando ciclos de transmisión del parásito entre humanos y mosquitos, y cíclicamente durante períodos de 4 meses que podrían reflejar recaídas de Plasmodium vivax, el parásito dominante de la malaria transmitido en Panamá. Además, el número de casos de malaria de casos de malaria se asoció positivamente (P < 0,05) con las precipitaciones (7 meses de retardo), y negativamente con el índice de El Niño 4 (15 meses de retraso) y el Índice de Vegetación de Diferencia Normalizada, NDVI (8 meses de retraso). de estas asociaciones probablemente estén relacionadas con el impacto de los patrones climáticos y la vegetación en la ecología del Anopheles albimanus, el principal vector de la malaria en Guna Yala. Los ciclos interanuales, de aproximadamente 4 años, en el número de casos de malaria El número de casos de malaria se asoció con el índice de El Niño 4, un índice climático asociado a la dinámica del tiempo y la vegetación en Guna Yala a escala temporal estacional e interanual. Conclusiones: Los resultados mostraron que el ENSO, las precipitaciones y el NDVI se asociaron con el número de casos de malaria en Guna Yala durante el periodo de estudio. Estos resultados ponen de manifiesto la vulnerabilidad de las poblaciones de Guna a la malaria, una infección sensible al cambio climático, y exigen que se realicen más estudios sobre los impactos meteorológicos en la ecología del vector de la malaria, así como la asociación de los vectores de la malaria con los Gunas prestando atención a sus condiciones socioeconómicas de pobreza y diferencias culturales como minoría étnicaUniversidad Nacional, Costa RicaEscuela de Medicina Veterinari

Population Dynamics of <i>Anopheles albimanus</i> (Diptera: Culicidae) at Ipetí-Guna, a Village in a Region Targeted for Malaria Elimination in Panamá

Anopheles albimanus Wiedemann is a major malaria vector in Mesoamerica and the Caribbean whose population dynamics, in response to changing environments, has been relatively poorly studied. Here, we present monthly adult and larvae data collected from May 2016 to December 2017 in Ipet&#237;-Guna, a village within an area targeted for malaria elimination in the Rep&#250;blica de Panam&#225;. During the study period we collected a total of 1678 Anopheles spp. mosquitoes (1602 adults and 76 larvae). Over 95% of the collected Anopheles spp. mosquitoes were An. albimanus. Using time series analysis techniques, we found that population dynamics of larvae and adults were not significantly correlated with each other at any time lag, though correlations were highest at one month lag between larvae and adults and four months lag between adults and larvae. Larvae population dynamics had cycles of three months and were sensitive to changes in temperature with 5 months lag, while adult abundance was correlated with itself (1 month lag) and with the normalized difference vegetation index (NDVI) with three months lag. A key observation from our study is the absence of both larvae and adults of An. albimanus between January and April from environments associated with Guna population&#8217;s daily activities, which suggests this time window could be the best time to implement elimination campaigns aimed at clearing Plasmodium spp. parasites from Guna populations using, for example, mass drug administration