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Improved prediction, prevention, and control of epidemics is a key technical element of the Roll Back Malaria partnership. We report a methodology for assessing the importance of climate as a driver of inter-annual variability in malaria in Botswana, and provide the evidence base for inclusion of climate information in a national malaria early warning system. The relationships of variability in rainfall and sea surface temperatures (SSTs) to malaria incidence are assessed at the national level after removing the impact of non-climatic trends and a major policy intervention. Variability in rainfall totals for the period December–February accounts for more than two-thirds of the inter-annual variability in standardized malaria incidence in Botswana (January–May). Both rainfall and annual malaria anomalies in December–February are significantly related to SSTs in the eastern Pacific, suggesting they may be predictable months in advance using seasonal climate forecasting methodologies.
Received December 1, 2004. Accepted for publication January 11, 2005.
Acknowledgments: We thank the World Health Organization Southern Africa Inter-Country Programme in Zimbabwe and the National Malaria Control Unit in Botswana for their help with this study. We also thank Francisco Doblas-Reyes, Renate Hagedorn, Andrew Morse, and Tim Palmer for helpful discussions.
Financial support: This work was initially supported by the United Kingdom’s Department for International Development subsequently Malaria Knowledge Programme, the Liverpool School of Tropical Medicine, and a cooperative agreement with the National Oceanic and Atmospheric Administration (NOAA) (NA07GP0213).
Disclaimer: The views herein contained are those of the authors and do not necessarily reflect the views of either the Department for International Development, NOAA, or any of their sub-agencies.
* Address correspondence to Madeleine C. Thomson, International Research Institute for Climate Prediction, The Earth Institute at Columbia University, Monell Building, 61 Route 9W, Lamont Campus, Palisades, NY 10964-8000. E-mail: mthomson{at}iri.columbia.edu
Authors’ addresses: Madeleine C. Thomson, Simon J. Mason, and Stephen J. Connor, International Research Institute for Climate Prediction, The Earth Institute at Columbia University, Monell Building, 61 Route 9W, Lamont Campus, Palisades, NY 10964-8000, Telephone: 845-680-4413, Fax: 845-680-4864, E-mails: mthomson{at}iri.columbia.edu, simon{at}iri.columbia.edu, and sjconnor{at}iri.columbia.edu. Thandie Phindela, National Malaria Control Programme, Epidemiology and Disease Control Unit, Ministry of Health, Private Bag 00269, Gaborone, Botswana, E-mail: phindela{at}info.bw
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