Climate change and infectious

diseases: predictive modelling

Aronrag Meeyai, Mahidol University, Thailand: aronrag.coo@mahidol.ac.th

Kraichat Tantrakarnapa, Mahidol University: kraichat.tan@mahidol.ac.th

Impacts assessment
IMPACTS

EMISSIONS
& Land-use Change

Source: The Fifth Assessment Report. Intergovernmental Panel on Climate Change (IPCC).

Aronrag Meeyai, Mahidol University, Thailand: aronrag.coo@mahidol.ac.th

Kraichat Tantrakarnapa, Mahidol University: kraichat.tan@mahidol.ac.th

Impacts assessment
IMPACTS

EMISSIONS
& Land-use Change

Source: The Fifth Assessment Report. Intergovernmental Panel on Climate Change (IPCC).

Impacts assessment
IMPACTS

EMISSIONS
& Land-use Change

Source: ECLAC, UN 2011. An assessment of the economic impact of climate change on the health sector in Saint Lucia.

Climate change and infectious diseases: predictive modelling

Dengue as a case study

Interaction between environment, vectors, and DENV

Source: Cory W. Morin, Andrew C. Comrie, and Kacey Ernst. Environmental Health Perspectives, 2013.

Interaction between environment, vectors, and DENV

Source: Cory W. Morin, Andrew C. Comrie, and Kacey Ernst. Environmental Health Perspectives, 2013.

Dengue distribution models and projections

Types of models:
The main types of models used to forecast future climatic
influences on infectious diseases (each type of model
addresses somewhat different questions) include:

- Statistical models, and landscape-based models

- Process-based models (mechanistic models)

Statistical models & landscape-based models:

The derivation of a statistical relationship between the distribution
of the disease and the climatic conditions. This describes the
climatic influence on the actual distribution of the disease, given
current levels of human intervention (disease control,
environmental management, etc.).
Then applying this statistical equation to future climate scenarios,
the actual distribution of the disease in future is estimated.
The effects of both climatic and other environmental factors (e.g.
different vegetation types: landscape-based models) can be
included in the models.

Linear regression models

Colon-Gonzalez et al. used multiple linear regression models to examine the associations between
changes in the climate variability and dengue incidence in the warm and humid regions of Mexico
for the years 19852007.

Time series/wavelet time series models

Gharbi et al. fitted a SARIMA model of dengue incidence and climate variables including
temperature, rainfall and relative humidity in French West Indies for the period 20002006.

Hu et al. used a SARIMA model to examine the impact of El-Nio on dengue in Queensland,
Australia for the period 19932005.
Johansson et al. used wavelet time series analysis has been applied to examine the associations
between El-Nio Southern Oscillation (ENSO), local weather, and dengue incidence in Puerto Rico,
Mexico, and Thailand, with the aim of identifying time- and frequency-specific associations.
Castells et al. used a wavelet time series analysis to demonstrate a strong non-stationary association
between dengue incidence and El-Nio in Thailand for the years 1986 to 1992.
Thai et al. used a wavelet time series analysis to investigate the associations between climate
variables including mean temperature, humidity and rainfall, and ENSO indices and dengue
incidence in Vietnam during the period 1994 to 2009.
Chowell et al. used wavelet time series analysis to determine the relationship between climatic
factors including mean, maximum and minimum temperature and rainfall and dengue incidence for
the period 19942008 in jungle and coastal regions of Peru.

Poisson regression models

Earnest et al. used Poisson regression model to determine the association between climate
variables (temperature, humidity, rainfall), ENSO indices and dengue in Singapore.
Pinto et al. used Poisson regression model to determine the impact of climate variables (temperature,
rainfall and relative humidity) on dengue cases in Singapore.
Chen et al. applied Poisson regression using a GAM model to examine the relationship between
precipitation and dengue in Taiwan for the period 19942008.

Bayesian models
Hu et al. applied Bayesian spatial conditional autoregressive modelling to demonstrate the
impact of climatic, social and ecological factors on dengue in Queensland, Australia.

Non-linear models
Descloux et al. developed an early warning system using a long-term data set (39 years)
including dengue cases and meteorological data (mean temp, min and max temperature,
relative humidity, precipitation and ENSO indices) in New Caledonia, using multivariate nonlinear models.

The statistical models & landscape-based models employed

for evaluating the relationship between climate variables
and dengue have been typically different with respect to the
distributional assumptions (e.g., normal, Poisson), the
nature of the relationship (linear and non-linear) and the
spatial and/or temporal dynamics of the response.
Overall, the models reveal variability in the relationship
between dengue and climate variables, related to country,
but the methods identified an association with temperature
followed by rainfall in the majority of research.
Source: Naish S et al. BMC Infectious Diseases 2014, 14:167

Projections using statistical & landscape-based models:

Estimated population at risk of dengue in 1990 (baseline) and 2050 (projection).

[using logistic regression model with humidity as the predictor]

Source: Hales S et al. Potential effect of population and climate changes on global distribution of dengue fever:
an empirical model. Lancet 360, 830834 (2002).

Estimated population at risk of dengue in 2050 (projection).

[based on climate change and socioeconomic development (GDPpc)]

Source: Astrom, C. et al. Potential distribution of dengue fever under scenarios of climate change and economic
development. Ecohealth 9, 448454 (2012).

Process based (mechanistic) models:

Process-based models use equations that express the scientifically
relationship between climatic variables and biological parameters
e.g., vector breeding, survival, and biting rates.
In their simplest form, such models express, via a set of equations,
how climate variables would affect vector and, therefore, disease
transmission. The conditioning effects of human interventions and
social contexts can also be incorporated.

Process based (mechanistic) models:

Projected global distribution of dengue in 2050.

[under scenarios of a 1.16 C temperature increase from 3 GCMs]
The specific GCMs yielded the
following increases: GFDL89, 45% (3569%); ECHAM 1-A, 47% (37-74%); and
UKTR, 31% (24-47%).
Globally, the largest change would
occur in temperate regions. Tropical
and subtropical regions would
experience an increase in epidemic
potential to a lesser extent or would
remain unchanged.
For developing countries, these maps
indicate upward changes in potential
infectious disease transmission. On
aggregate, this increase in potential
risk varied between 31 and 47% for
these regions.
Source: Patz, J. A et al. Dengue fever epidemic
potential as projected by general circulation
models of global climate change. Environ. Health
Perspect. 106, 147153 (1998).

Projected transmission intensity of dengue for simulated 2C rises in temperature.

The areas where the potential

transmission intensity is greater
than 1 correspond fairly well to
areas where recent dengue activity
has been
observed or areas susceptible to
dengue transmission (top: baseline).
At a global temperature increase of
2C, the model shows possible
transmission of dengue in some
parts of southern Europe and of
southern US. But the changes in
areas where endemic dengue
already occurs are limited.
Source: Jetten, T. H. & Focks, D. A. Potential changes in
the distribution of dengue transmission under climate
warming. Am. J. Trop. Med. Hyg. 57, 285297 (1997).

Lessons learned from model projections:

All of the studies conducted to date project an increase in the
overall global extent of dengue transmission.
The results do not agree with regard to the specific geographical
areas where expansion or intensification is likely to occur.
As projecting the global distribution of dengue involves the
inclusion of multiple covariates, the comparison of new projections
would require projecting changes in population, climate and
economic factors on an agreed set of future dates.

A minimum spatial resolution would also be require for such a

comparison.
Source: Messina et al. NATURE REVIEWS . MICROBIOLOGY. VOLUME 13 , APRIL 2015.

Source: Messina et al. NATURE REVIEWS . MICROBIOLOGY. VOLUME 13 , APRIL 2015.