Assessment of the impact of climate change on Belize's health sector: Dengue and Dengue Hemorrhagic Fever

The main goal of this assessment is to determine the present and future occurrence of dengue and Dengue Hemorrhagic Fever (DHF) and to measure its impact on the health care system and population in terms of morbidity and mortality, also to measure the socio-economic impact of adaptation measures. The method used was determined after consultation with senior staff of the National Meteorological Service, the Statistical Institute of Belize, the Ministry of Health and the Vector Control Program, in order to assess existing modeling capability and the availability of data.

Biting patterns and seasonal densities of Anopheles mosquitoes in the Cayo District, Belize, Central America with emphasis on Anopheles darlingi.

The present study utilized an experimental hut to conduct human-baited landing collections for characterizing the all-night biting patterns and seasonal densities of adult Anopheles darlingi in the centrally located Cayo District of Belize, Central America. A total of 25 all-night collections (i.e., sunset to sunrise) were conducted from January 2002 to May 2003, capturing a total of 18,878 An. darlingi females. Anopheles darlingi exhibited a bimodal nightly biting pattern with one predominate peak occurring three h after sunset and a smaller peak occurring one h prior to sunrise. Biting females were collected throughout the night in higher densities indoors (9,611) than outside (9,267) the experimental hut (O:I=1.00:1.04). Seasonal adult collections show An. darlingi densities were highest during the transitional months between the end of the wet and beginning of the dry season (January) and the end of the dry season and beginning of the wet season (May). A total of 2,010 An. darlingi females was captured in 31 two-h, human-baited landing collections performed from January to October 2002. Anopheles darlingi monthly population densities were found to have no significant associations with high or low temperatures, precipitation, or river level. However, qualitative data examination indicates an inverse relationship between river level and An. darlingi adult collections suggesting a disturbance of larval habitats. All-night biting and seasonal distribution patterns for other anopheline species are also described. None of the adult specimens collected throughout the entire study tested positive for Plasmodium spp. infection using the VecTest rapid diagnostic kit.

Distribution of Anopheles albimanus, Anopheles vestitipennis, and Anopheles crucians associated with land use in northern Belize.

Anthropogenic land use changes often alter natural patterns of disease transmission. The goal of this study was to determine whether phosphorus input from sugarcane, Saccharum officinarum L., cultivation in northern Belize could pose a significant environmental impact on malaria transmission by changing vegetation structure and composition of wetlands and associated larval habitats. Our primary focus was on the increased dominance of cattail, Typha domingensis Pers., a favored habitat for Anopheles vestitipennis Dyar & Knab. A land cover classification based on satellite imagery was used to select 20 marshes impacted by agricultural runoff and 20 marshes surrounded by forest (nonimpacted). A 100-m transect was established into each of the 40 marshes. Water, vegetation, and larval sampling were conducted at the 0-, 10-, 25-, 50-, and 100-m locations along the transect. Analyses of larval density data indicated that Anopheles albimanus Wiedemann was negatively correlated with percentage of cover of Typha (R2 = 0.39, P < 0.001) but positively correlated with sparse Eleocharis cellulosa Torr. (rush) cover (R2 = 0.19, P < 0.05) and presence of cyanobacterial mats (CBM) (R2 = 0.33, P < 0.0001). An. vestitipennis was found to be positively correlated with percentage of cover of Typha (R2 = 0.19, P < 0.001). Canonical correspondence analysis identified CBM and light as the variables associated with the presence of An. albimanuts larvae, Typha cover with An. vestitipennis larvae, and Eleocharis and absence of light with Anopheles crucians (Wiedemann). A positive correlation also existed between marshes adjacent to agricultural activities and presence of An. vestitipennis (R2 = 0.37, P < 0.05). These results indicate that marshes in proximity to agricultural fields are conducive for Typha growth, thereby providing habitat for the more efficient malaria vector

Evaluation of habitat management strategies for the reduction of malaria vectors in northern Belize.

Mowing and burning of emergent vegetation were evaluated as potential management strategies for the control of the malaria vector, Anopheles vestitipennis, in northern Belize, Central America. The primary aim was reduction of tall dense macrophytes (dominated by Typha domingensis) as preferred larval habitat for An. vestitipennis. Nine experimental plots were established in a Typha marsh in Orange Walk District, Belize. Three plots were burned, three were treated by subaquatic mowing, and three were unaltered controls. After treatment, Typha height was most dramatically affected by the mow treatment. Plant heights at 21 and 95 days post-treatment reflected an 89% and 48% decrease, respectively, compared to pretreatment conditions. The Typha height in the burn plots was not as severely affected. Heights at 21 days post-treatment were 39% lower than those of pre-treatment vegetation, with a return to near pre-test heights by 95 days post-treatment. Both treatments resulted in a significant reduction in the number of An. vestitipennis larvae collected as compared to control plots. Conversely, the treatments resulted in increased larval densities of several other vector and pest mosquito species. Larval population densities ofAn. albimanus, Ochlerotatus taeniorhynchus, and Culex coronator were significantly higher in burn plots. In mow plots, there were significant increases in An. albimanus and Oc. taeniorhynchus larval populations. Non-target invertebrate species affected by the treatments were adult Tropisternus collaris, larval Corythrella, and adult Parapleapuella.

Spatial correlations of mapped malaria rates with environmental factors in Belize, Central America.

BACKGROUND: The purposes of this study were to map overall malaria incidence rates from 1989 through 1999 for villages in Belize; to assess the seasonal distribution of malaria incidence by region; and to correlate malaria incidence rates with vegetation cover and rivers in villages, using geographic information system technology.Malaria information on 156 villages was obtained from an electronic database maintained by the Belize National Malaria Control Program. Average annual malaria incidence rates per 1000 population over 10 years were calculated for villages using the 1991 population census as a denominator. Malaria incidence rates were integrated with vegetation cover from a 1995 vegetation map, and with river data from a digital data set. RESULTS: Mapping malaria incidence over the 10-year period in the study villages indicated the existence of a spatial pattern: the southern and western areas of Belize had consistently higher rates of malaria than northern areas. Examination of the seasonal distribution of malaria incidence by month over 10 years indicated that a statistically significant difference existed among districts and among months (p < 0.05). Spatial analysis of malaria incidence rates and of vegetation in Belize showed villages with high malaria rates having more broadleaf hill forests, agricultural land, and wetland vegetation types (i.e. SWF-seasonally waterlogged fire-induced shrubland of the plains). Statistical and spatial analyses of malaria incidence and of river distributions in Belize determined the high 10 percentile malaria incidence villages in western and southern Belize to have more rivers within two kilometers of the center of a village and a statistically significant correlation between proximity to rivers and villages (Spearman's gamma = -0.23; p < 0.05), especially in Stann Creek District (Spearman's gamma = -0.82; p < 0.05). CONCLUSIONS: Examination of the distribution of malaria during 10 years indicated transmission varied among geographic areas and among seasons. Additional studies are needed to examine, in more detail, the association between environmental and meteorological factors and malaria transmission. Furthermore, the role of An. darlingi in malaria transmission in Stann Creek needs further study since, of the three main vectors in Belize, An. darlingi has been found strongly associated with rivers.

Spatial distribution of adult Anopheles darlingi and Anopheles albimanus in relation to riparian habitats in Belize, Central America.

Collections of Anopheles darlingi Root and An. albimanus Wiedemann from central and northern Belize were conducted as landing captures from 6:30 to 8:00 p.m. to define spatial distributions and outdoor:indoor ratios of biting during the early evening. In central Belize, collections were made at 31 houses in riparian zones (> or = 1 km from rivers) and 14 houses in upland zones (>1 km from rivers) during the dry and wet seasons of 1993 and 1994. Females of both species were abundant in houses < or = 1 km from rivers. Females were not present in houses located in upland areas during the dry season, but were present in the wet season. A total of 63 paired collections (representing 130 individual captures) from 42 houses showed An. darlingi females were more endophagic (ratio of 1:0.6) during the early evening than were An. albimanus females (ratio of 1:0.21). Paired landing collections from 22 houses in riparian zones in April-May were analyzed in an index of species abundance (ISA). ISA values rated An. darlingi as the dominant Anopheles mosquito indoors and An. albimanus was dominant outside. Although An. darlingi and An. albimanus were abundant in riparian zones, there was no association in their numerical abundance, suggesting that different environmental factors influenced their abundance. In northern Belize, one house for each of 16 villages was sampled during April and May 1994. Large numbers ofAn. albimanus were captured outdoors in houses located in riparian and marshland areas (means of 217.5 and 247.5/1.5 personhours outdoors, respectively). Numbers of An. albimanus were low at houses located away from rivers and marshes (12.2 per collection). Anopheles darlingi was uncommon at sites in northern Belize. Proportionally fewer An. albimanus females entered houses in the north (outdoor:indoor ratio of 1:0.16) compared to the central region (ratio of 1:0.21), which probably reflects differences in house construction, anti-mosquito behavior (i.e., closing windows and doors at sunset), and insecticide treatments. The ISA gave a quantitative assessment of vector dominance in relation to the parameters of spatial distribution and numerical abundance. The index was also sensitive to the variables of indoor and outdoor biting behaviors.