After the flood: Strategies to prevent malaria epidemics caused by severe flooding
Summary
The impact of climate change, including the increased frequency of weather extremes such as flooding, on the incidence of malaria and other vector-borne diseases is an issue of substantial public health importance. Therefore, there is an urgent need to develop effective mitigation and control strategies. In May 2020, a post-flood malaria chemoprevention intervention was piloted in rural western Uganda. When compared to two neighboring villages where no intervention was deployed, there was an estimated 53% reduction (aRR 0.47, 95% CI 0.34 – 0.62, p<.01) in malaria incidence in the six months following the intervention. Building on these results, the scientific aim of this proposal is to evaluate the effectiveness of a targeted, time-limited malaria chemoprevention intervention with and without larval source management (LSM) to reduce excess disease burden in a perennial, high- transmission setting following severe flooding. The premise is that the intervention will reduce the parasite reservoir during the critical “rebound” period, when vectors are re-establishing habitats thereby maintaining relatively low levels of transmission until conditions have returned to the pre-flood baseline.