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Opinion — tropical infectious diseases

Urbanization, malaria transmission and disease burden in Africa

Nature Reviews Microbiology volume 3, pages 81–90 (2005)Cite this article

Abstract

Many attempts have been made to quantify Africa's malaria burden but none has addressed how urbanization will affect disease transmission and outcome, and therefore mortality and morbidity estimates. In 2003, 39% of Africa's 850 million people lived in urban settings; by 2030, 54% of Africans are expected to do so. We present the results of a series of entomological, parasitological and behavioural meta-analyses of studies that have investigated the effect of urbanization on malaria in Africa. We describe the effect of urbanization on both the impact of malaria transmission and the concomitant improvements in access to preventative and curative measures. Using these data, we have recalculated estimates of populations at risk of malaria and the resulting mortality. We find there were 1,068,505 malaria deaths in Africa in 2000 — a modest 6.7% reduction over previous iterations. The public-health implications of these findings and revised estimates are discussed.

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Figure 1: Population totals from 1950–2050.
Figure 2: Mean population density (persons per km2) in 2000 of the 37 urban agglomerations (UA) in Africa.
Figure 3: Bar plots of APfEIR by land-use category (a) and APfEIR by dry or wet ecozone (b).
Figure 4: Plot of PR by log10APfEIR.
Figure 5: Childhood mortality in Africa.
Figure 6: The MARA model14 of fuzzy climate suitability (FCS) for P. falciparum malaria transmission.
Figure 7: Plot of PR by log10 APfEIR.

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References

  1. United Nations. World population monitoring 2001: population, environment and development. [online], (United Nations, New York, 2001).

  2. United Nations. World urbanization prospects: the 2001 revision. Data, tables and highlights. [online], (United Nations, New York, 2002).

  3. Omran, A. R. The epidemiologic transition theory revisited thirty years later. World Health Stat. Q. 51, 99–199 (1998).

    Google Scholar 

  4. Omran, A. R. Epidemiologic transition: a theory of the epidemiology of population change. Milbank Mem. Fund Q. 49, 509–538 (1971).

    Article  CAS  PubMed  Google Scholar 

  5. Omran, A. R. Epidemiologic transition: a preliminary update. J. Trop. Pediatr. 29, 305–316 (1983).

    Article  CAS  PubMed  Google Scholar 

  6. Phillips, D. R. Urbanization and human health. Parasitology 106 (Suppl.), S93–S107 (1993).

    Article  PubMed  Google Scholar 

  7. Harpham, T. & Tanner, M. (eds). Urbanisation Health in Developing Countries: Progress and Prospects. 256 (Earthscan, London, 1995).

    Google Scholar 

  8. Harpham, T. Urbanisation and health in transition. Lancet 349, 11–13 (1997).

    Article  Google Scholar 

  9. Walker, N., Schwartlander, B. & Bryce, J. Meeting international goals in child survival and HIV/AIDS. Lancet 360, 284–289 (2002).

    Article  PubMed  Google Scholar 

  10. United Nations. World urbanization prospects: the 2003 revision. Data, tables and highlights [online], (United Nations, New York, 2004).

  11. Service, M. W. & Townson, H. in Essential Malariology (eds Warrell, D. A. & Gilles, H. M.) 59–84 (Arnold, London, 2002).

    Google Scholar 

  12. Dobson, M. J. The malaria centenary. Parassitologia 41, 21–32 (1999).

    CAS  PubMed  Google Scholar 

  13. Snow, R. W. & Gilles, H. M. in Essential Malariology (eds Warrell, D. A. & Gilles, H. M.) 85–106 (Arnold, London, 2002).

    Google Scholar 

  14. Craig, M. H., Snow, R. W. & Le Sueur, D. A climate-based distribution model of malaria transmission in sub-Saharan Africa. Parasitology Today 15, 105–111 (1999).

    Article  CAS  PubMed  Google Scholar 

  15. Rogers, D. J., Randolph, S. E., Snow, R. W. & Hay, S. I. Satellite imagery in the study and forecast of malaria. Nature 415, 710–715 (2002).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Snow, R. W., Marsh, K. & Le Sueur, D. The need for maps of transmission intensity to guide malaria control in Africa. Parasitology Today 12, 455–457 (1996).

    Article  Google Scholar 

  17. Hay, S. I., Guerra, C. A., Tatem, A. J., Noor, A. M. & Snow, R. W. The global distribution and population at risk of malaria: past, present and future. Lancet Infect. Dis. 4, 327–336 (2004).

    Article  PubMed  PubMed Central  Google Scholar 

  18. WHO. International Travel and Health: Situation as on 1 January 2003. 193 (World Health Organization, Geneva, 2003).

  19. WHO/UNICEF. The African malaria report 2003. [online], (World Health Organization/United Nations Children's Fund, Geneva/New York, 2003).

  20. Snow, R. W. & Marsh, K. The epidemiology of clinical malaria among African children. Bull. Inst. Pasteur 96, 15–23 (1998).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Sachs, J. & Malaney, P. The economic and social burden of malaria. Nature 415, 680–685 (2002).

    Article  CAS  PubMed  Google Scholar 

  22. Sachs, J. D. et al. Macroeconomics and health: investing in health for economic development. Report of the Commission on Macroeconomics and Health, World Health Organization). [online], (WHO, Geneva, 2001).

  23. WHO. The world health report 1999. Making a difference — Rolling Back Malaria. [online], World Health Organization, Geneva, 1999).

  24. Birley, M. H. & Lock, K. Health and peri-urban natural resource production. Environ. Urban. 10, 89–106 (1998).

    Article  Google Scholar 

  25. McMichael, A. J. in Human Frontiers, Environments and Disease: Past Patterns, Uncertain Futures. 250–282 (Cambridge Univ. Press, Cambridge, 2001).

    Book  Google Scholar 

  26. Hinrichsen, D., Salem, R. & Blackburn, R. Meeting the Urban Challenge. Population Reports, Series M, No. 16. (Population Information Program, The Johns Hopkins Bloomberg School of Public Health, Baltimore, 2002).

    Google Scholar 

  27. Woods, R. Urban–rural mortality differentials: an unresolved debate. Popul. Dev. Rev. 29, 29(2003).

    Article  Google Scholar 

  28. Mott, K. E., Desjeux, P., Moncayo, A., Ranque, P. & De Raadt, P. Parasitic diseases and urban development. Bull. World Health Organ. 68, 691–698 (1990).

    CAS  PubMed  PubMed Central  Google Scholar 

  29. Knudsen, A. B. & Slooff, R. Vector-borne disease problems in rapid urbanization: new approaches to vector control. Bull. World Health Organ. 70, 1–6 (1992).

    CAS  PubMed  PubMed Central  Google Scholar 

  30. Lines, J., Harpham, T., Leake, C. & Schofield, C. Trends, priorities and policy directions in the control of vector-borne diseases in urban environments. Health Policy Plan. 9, 113–129 (1994).

    Article  CAS  PubMed  Google Scholar 

  31. Bruce-Chwatt, L. J. Paludisme et urbanisation. Bull. Soc. Pathol. Exot. 76, 243–249 (1983) (in French).

    CAS  Google Scholar 

  32. Gazin, P. Le paludisme en Afrique au Sud du sahara: comparison entre les milieux urbains et ruraux. Cahiers Santé 13, 33–38 (1991) (in French).

    Google Scholar 

  33. Warren, M., Billig, P., Bendahmane, D. & Wijeyaratne, P. Malaria in urban and peri-urban areas in sub-Saharan Africa, Environmental Health Project Activity, report no. 71. (USAID, Washington DC, 1999).

    Google Scholar 

  34. Robert, V. et al. Malaria transmission in urban sub-Saharan Africa. Am. J. Trop. Med. Hyg. 68, 169–176 (2003).

    Article  PubMed  Google Scholar 

  35. Keiser, J. et al. Urbanization in sub-Saharan Africa and implication for malaria control. Am. J. Trop. Med. Hyg. 71, 118–127 (2004).

    Article  PubMed  Google Scholar 

  36. Holtz, T. H. et al. Insecticide-treated bednet use, anaemia, and malaria parasitaemia in Blantyre District, Malawi. Trop. Med. Int. Health 7, 220–230 (2002).

    Article  PubMed  Google Scholar 

  37. Guyatt, H. L., Noor, A. M., Ochola, S. A. & Snow, R. W. Use of intermittent presumptive treatment and insecticide treated bed nets by pregnant women in four Kenyan districts. Trop. Med. Int. Health 9, 255–261 (2004).

    Article  CAS  PubMed  Google Scholar 

  38. Monasch, R. et al. Child coverage with mosquito nets and malaria treatment from population-based surveys in African countries: a baseline for monitoring progress in Roll Back Malaria. Am. J. Trop. Med. Hyg. 71, 232–238 (2004).

    Article  PubMed  Google Scholar 

  39. UNDP. Human Development Report 2003. Millennium Development Goals: A Compact Among Nations To End Human Poverty 367 (Oxford Univ. Press, Oxford, 2003).

  40. Malaney, P., Spielman, A. & Sachs, J. The malaria gap. Am. J. Trop. Med. Hyg. 71, 141–146 (2004).

    Article  PubMed  Google Scholar 

  41. Molyneux, C. S., Mung'ala-Odera, V., Harpham, T. & Snow, R. W. Maternal responses to childhood fevers: a comparison of rural and urban residents in coastal Kenya. Trop. Med. Int. Health 4, 836–845 (1999).

    Article  CAS  PubMed  Google Scholar 

  42. Noor, A. M., Zurovac, D., Hay, S. I., Ochola, S. & Snow, R. W. Defining equity in physical access to clinical services using geographical information systems as part of malaria planning and monitoring in Kenya. Trop. Med. Int. Health 8, 917–926 (2003).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Noor, A. M., Gikandi, P. W., Hay, S. I., Muga, R. O. & Snow, R. W. Creating spatially defined databases for equitable health service planning in low-income countries: the example of Kenya. Acta Tropica 91, 239–251 (2004).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. UN Habitat. The Challenge of the Slums: Global Report on Human Settlements, 2003. 310 (Earthscan, London, 2003).

  45. Trape, J. F. et al. Malaria and urbanization in Central Africa: the example of Brazzaville. Part V. Pernicious attacks and mortality. Trans. R. Soc. Trop. Med. Hyg. 81, 34–42 (1987).

    Article  PubMed  Google Scholar 

  46. Trape, J. F. Malaria and urbanization in Central Africa: the example of Brazzaville. Part I: Description of the town and review of previous surveys. Trans. R. Soc. Trop. Med. Hyg. 81, 1–9 (1987).

    Article  PubMed  Google Scholar 

  47. Trape, J. F. & Zoulani, A. Malaria and urbanization in Central Africa: the example of Brazzaville. Part II: results of entomological surveys and epidemiological analysis. Trans. R. Soc. Trop. Med. Hyg. 81, 10–18 (1987).

    Article  PubMed  Google Scholar 

  48. Trape, J. F. & Zoulani, A. Malaria and urbanization in Central Africa: the example of Brazzaville. Part III: Relationships between urbanization and the intensity of malaria transmission. Trans. R. Soc. Trop. Med. Hyg. 81, 19–25 (1987).

    Article  PubMed  Google Scholar 

  49. Trape, J. F. Malaria and urbanization in Central Africa: the example of Brazzaville. Part IV. Parasitological and serological surveys in urban and surrounding rural areas. Trans. R. Soc. Trop. Med. Hyg. 81, 26–33 (1987).

    Article  PubMed  Google Scholar 

  50. Akogbéto, M., Chippaux, J. P. & Coluzzi, M. Le paludisme urbain côtier à Cotonou (République du Bénin). Étude entomologique. Revue Epidém Santé Publique 40, 233–239 (1992) (in French).

    Google Scholar 

  51. Rossi, P., Belli, A., Mancini, L. & Sabatinelli, G. Enquête entomologique longitudinale sur la transmission du paludisme à Ouagadougou (Burkina Faso). Parassitologia 28, 1–15 (1986).

    CAS  PubMed  Google Scholar 

  52. Sabatinelli, G., Bosman, A., Lamizana, L. & Rossi, P. Prévalence du paludisme à Ouagadougou et dans le milieu rural limitrophé en periode de transmission maximale. Parassitologia 28, 17–31 (1986) (in French).

    CAS  PubMed  Google Scholar 

  53. Robert, V., Gazin, P., Ouédraogo, V. & Carnevale, P. Le paludisme urbain à Bobo-Dioulasso (Burkina Faso). 1. Étude entomologique de la transmission. Cahiers ORSTOM. Série Entomol. Méd. Parasitol. 24, 121–128 (1986) (in French).

    Google Scholar 

  54. Rihet, P., Abel, L., Traore, Y., Aucan, C. & Fumoux, F. Human malaria: segregation analysis of blood infection levels in a suburban area and a rural area in Burkina Faso. Genet. Epidemiol. 15, 435–450 (1998).

    Article  CAS  PubMed  Google Scholar 

  55. Modiano, D. et al. Severe malaria in Burkina Faso, influence of age and transmission level on clinical presentation. Am. J. Trop. Med. Hyg. 59, 539–542 (1998).

    Article  CAS  PubMed  Google Scholar 

  56. Modiano, D. et al. Severe malaria in Burkina Faso: urban and rural environment. Parasitologia 41, 251–254 (1999).

    CAS  Google Scholar 

  57. Lindsay, S. W. et al. Malaria in a peri-urban area of The Gambia. Ann. Trop. Med. Parasitol. 84, 553–562 (1990).

    Article  CAS  PubMed  Google Scholar 

  58. Biggar, R. J. et al. Malaria, sex, and place of residence as factors in antibody-response to Epstein–Barr Virus in Ghana, West Africa. Lancet 2, 115–118 (1981).

    Article  CAS  PubMed  Google Scholar 

  59. Gardiner, C., Biggar, R. J., Collins, W. E. & Nkrumah, F. K. Malaria in urban and rural areas of southern Ghana: a survey of parasitemia, antibodies, and antimalarial practices. Bull. World Health Organ. 62, 607–613 (1984).

    CAS  PubMed  PubMed Central  Google Scholar 

  60. Afari, E. A., Akanmori, B. D., Nakano, T. & Oforiadjei, D. Plasmodium falciparum sensitivity to chloroquine in vivo in 3 ecological zones in Ghana. Trans. R. Soc. Trop. Med. Hyg. 86, 231–232 (1992).

    Article  CAS  PubMed  Google Scholar 

  61. Appawu, M. et al. Malaria transmission dynamics at a site in northern Ghana proposed for testing malaria vaccines. Trop. Med. Int. Health 9, 164–170 (2004).

    Article  PubMed  Google Scholar 

  62. Hedman, P., Brohult, J., Forslund, J., Sirleaf, V. & Bengtsson, E. A pocket of controlled malaria in a holoendemic region of region of West Africa. Ann. Trop. Med. Parasitol. 73, 317–325 (1979).

    Article  CAS  PubMed  Google Scholar 

  63. Brohult, J. et al. The working capacity of Liberian males: a comparison between rural and urban populations in relation to malaria. Ann. Trop. Med. Parasitol. 75, 487–494 (1981).

    Article  CAS  PubMed  Google Scholar 

  64. Lebras, M. et al. Urban and rural malaria in Niger. Bull. Soc. Pathol. Exot. 79, 695–706 (1986).

    CAS  Google Scholar 

  65. Awolola, T. S., Okwa, O., Hunt, R. H., Ogunrinade, A. F. & Coetzee, M. Dynamics of the malaria-vector populations in coastal Lagos, south-western Nigeria. Ann. Trop. Med. Parasitol. 96, 75–82 (2002).

    Article  CAS  PubMed  Google Scholar 

  66. Fondjo, E., Robert, V., LeGoff, G., Toto, J. C. & Carnevale, P. Le paludisme urbain à Yaoundé (Cameroun). 2. Étude entomologique dans deux quartiers peu urbanisés. Bull. Soc. Pathol. Exot. 85, 57–63 (1992) (in French).

    CAS  PubMed  Google Scholar 

  67. Robert, V. et al. Anthropophilic mosquitoes and malaria transmission at Edea, Cameroon. Trop. Med. Parasitol. 44, 14–18 (1993).

    CAS  PubMed  Google Scholar 

  68. Coene, J. Malaria in urban and rural Kinshasa: the entomological input. Med. Vet. Entomol. 7, 127–137 (1993).

    Article  CAS  PubMed  Google Scholar 

  69. Karch, S., Asidi, N., Manzambi, Z. M. & Salaun, J. J. La faune anophélienne et la transmission du paludisme humain à Kinshasa (Zaïre). Bull. Soc. Pathol. Exot. 85, 304–309 (1992) (in French).

    CAS  PubMed  Google Scholar 

  70. Elissa, N. et al. Malaria transmission in a region of savanna-forest mosaic, Haut-Ogooue, Gabon. J. Am. Mosq. Control Assoc. 15, 15–23 (1999).

    CAS  PubMed  Google Scholar 

  71. Krafsur, E. S. The bionomics and relative prevalence of Anopheles species with respect to the transmission of Plasmodium to man in western Ethiopia. J. Med. Entomol. 14, 180–194 (1977).

    Article  CAS  PubMed  Google Scholar 

  72. Yohannes, M. & Petros, B. Urban malaria in Nazareth, Ethiopia: parasitological studies. Ethiop. Med. J. 34, 83–91 (1996).

    CAS  PubMed  Google Scholar 

  73. Omumbo, J. A., Guerra, C. A., Hay, S. I. & Snow, R. W. The influence of urbanisation on measures of Plasmodium falciparum infection prevalence in East Africa. Acta Tropica (in the press).

  74. El Sayed, B. B. et al. A study of the urban malaria transmission problem in Khartoum. Acta Tropica 75, 163–171 (2000).

    Article  CAS  PubMed  Google Scholar 

  75. Drakeley, C. et al. An estimation of the entomological inoculation rate for Ifakara: a semi-urban area in a region of intense malaria transmission in Tanzania. Trop. Med. Int. Health 8, 767–774 (2003).

    Article  CAS  PubMed  Google Scholar 

  76. Thomson, J. Anaemia in pregnant women in eastern Caprivi, Namibia. S. Afr. Med. J. 87, 1544–1547 (1997).

    CAS  PubMed  Google Scholar 

  77. Mbizvo, M. T. et al. Maternal mortality in rural and urban Zimbabwe — social and reproductive factors in an incident case-referent study. Soc. Sci. Med. 36, 1197–1205 (1993).

    Article  CAS  PubMed  Google Scholar 

  78. Watts, T. E., Wray, J. R., Ng'andu, H. & Draper, C. C. Malaria in an urban and rural area of Zambia. Trans. R. Soc. Trop. Med. Hyg. 84, 196–200 (1990).

    Article  CAS  PubMed  Google Scholar 

  79. Lowenthal, M. N. Malaria in an urban and a rural area of Zambia. Trans. R. Soc. Trop. Med. Hyg. 85, 137–137 (1991).

    Article  CAS  PubMed  Google Scholar 

  80. Akogbéto, M. Le paludisme côtier lagunaire à Cotonou: données entomologiques. Cahiers Santé 10, 267–275 (2000) (in French).

    PubMed  Google Scholar 

  81. Smith, D. L., Dushoff, J. & McKenzie, F. E. The risk of a mosquito-borne infection in a heterogeneous environment. PLoS Biol. 2, e368 (2004).

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  82. Snow, R. W., Craig, M., Deichmann, U. & Marsh, K. Estimating mortality, morbidity and disability due to malaria among Africa's non-pregnant population. Bull. World Health Organ. 77, 624–640 (1999).

    CAS  PubMed  PubMed Central  Google Scholar 

  83. Snow, R. W., Craig, M. H., Newton, C. R. J. C. & Steketee, R. W. The public health burden of Plasmodium falciparum malaria in Africa: deriving the numbers. The Disease Control Priorities Project Working Paper Number 11. [online], (DCPP, Washington DC, 2003).

  84. Omumbo, J. A., Hay, S. I., Guerra, C. A. & Snow, R. W. The relationship between the Plasmodium falciparum parasite ratio in childhood and climate estimates of malaria transmission in Kenya. Malaria J. 3, 17 (doi:10.1186/1475-2875-3-17) (2004).

    Article  Google Scholar 

  85. Beier, J. C., Killeen, G. F. & Githure, J. I. Short report: Entomologic inoculation rates and Plasmodium falciparum malaria prevalence in Africa. Am. J. Trop. Med. Hyg. 61, 109–113 (1999).

    Article  CAS  PubMed  Google Scholar 

  86. Vlahov, D. & Galea, S. Urbanization, urbanicity and health. J. Urban Health 79, 1–12 (2002).

    Article  PubMed Central  Google Scholar 

  87. Tatem, A. J. & Hay, S. I. Measuring urbanization pattern and extent for malaria research: a review of remote sensing approaches. J. Urban Health 81, 363–376 (2004).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  88. Tatem, A. J., Noor, A. M. & Hay, S. I. Defining approaches to settlement mapping for public health management in Kenya using medium spatial resolution satellite imagery. Remote Sensing Environ. 93, 42–52 (2004).

    Article  Google Scholar 

  89. CIESIN/IPFRI/CIAT. Global Rural–Urban Mapping Project (GRUMP): Gridded Population of the World, version 3, with urban reallocation (GPW-UR). (Center for International Earth Science Information Network, International Food Policy Research Institute, World Bank and Centro Internacional de Agricultura Tropical, 2004).

  90. Balk, D., Pozzi, F., Yetman, G., Nelson, A. & Diechmann, U. The distribution of people and the dimension of places: methodologies to improve global population estimatation of urban extents. (CIESIN, Columbia University, New York, 2004).

  91. Sutton, P., Roberts, D., Elvidge, C. & Baugh, K. Census from Heaven: an estimate of the global human population using night-time satellite imagery. Int. J. Remote Sensing 22, 3061–3076 (2001).

    Article  Google Scholar 

  92. Mika, A. M. Three decades of Landsat instruments. Photogrammet. Engineer. Remote Sensing 63, 839–852 (1997).

    Google Scholar 

  93. Danko, D. M. The digital chart of the world project. Photogrammet. Engineer. Remote Sensing 58, 1125–1128 (1992).

    Google Scholar 

  94. Schneider, A., Friedl, M. A., McIver, D. K. & Woodcock, C. E. Mapping urban areas by fusing multiple sources of coarse resolution remotely sensed data. Photogrammet. Engineer. Remote Sensing 69, 1377–1386 (2003).

    Article  Google Scholar 

  95. Elvidge, C. et al. in Remotely Sensed Cities (ed. Mesev, V.) 281–299 (Taylor and Francis, London, 2003).

    Google Scholar 

  96. Sutton, P. A scale-adjusted measure of 'urban sprawl' using nighttime satellite imagery. Remote Sensing Environ. 86, 353–369 (2003).

    Article  Google Scholar 

  97. CIESIN/CIAT. Gridded population of the world (GPW), version 3. [online], (CIESIN, Columbia University; CIAT, New York, 2004).

  98. Hay, S. I., Rogers, D. J., Toomer, J. F. & Snow, R. W. Annual Plasmodium falciparum entomological inoculation rates (EIR) across Africa: literature survey, internet access and review. Trans. R. Soc. Trop. Med. Hyg. 94, 113–127 (2000).

    Article  CAS  PubMed  Google Scholar 

  99. Lines, J. D., Curtis, C. F., Wilkes, T. J. & Njunwa, K. J. Monitoring human-biting mosquitos (Diptera: culicidae) in Tanzania with light-traps hung beside mosquito nets. Bull. Entomol. Res. 81, 77–84 (1991).

    Article  Google Scholar 

  100. Port, G. R., Boreham, P. F. L. & Bryan, J. H. The relationship of host size to feeding by mosquitoes of the Anopheles gambiae Giles complex (Diptera: Culicidae). Bull. Entomol. Res. 70, 133–144 (1980).

    Article  Google Scholar 

  101. Smith, D. L. & McKenzie, F. E. Statics and dynamics of malaria infection in Anopheles mosquitoes. Malaria J. 3, 13 (doi:10.1186/1475-2875-3-13) (2004).

    Article  Google Scholar 

  102. Hay, S. I. An overview of remote sensing and geodesy for epidemiology and public health application. Adv. Parasitol. 47, 1–35 (2000).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  103. Hay, S. I., Omumbo, J. A., Craig, M. H. & Snow, R. W. Earth observation, geographic information systems and Plasmodium falciparum malaria in sub-Saharan Africa. Adv. Parasitol. 47, 173–215 (2000).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  104. Burkot, T. R. & Graves, P. M. The value of vector-based estimates of malaria transmission. Ann. Trop. Med. Parasitol. 89, 125–34 (1995).

    Article  CAS  PubMed  Google Scholar 

  105. Snow, R. W. & Marsh, K. Will reducing Plasmodium falciparum transmission alter malaria mortality among African children. Parasitology Today 11, 188–190 (1995).

    Article  Google Scholar 

  106. Trape, J. F. Which strategy for malaria control in Africa? Parasitology Today 13, 125–126 (1997).

    Article  Google Scholar 

  107. Smith, T. A., Leuenberger, R. & Lengeler, C. Child mortality and malaria transmission intensity in Africa. Trends Parasitol. 17, 145–149 (2001).

    Article  CAS  PubMed  Google Scholar 

  108. Snow, R. W. & Marsh, K. The consequences of reducing transmission of Plasmodium falciparum in Africa. Adv. Parasitol. 52, 235–264 (2002).

    Article  PubMed  Google Scholar 

  109. Smith, T., Killeen, G., Lengeler, C. & Tanner, M. Relationships between the outcome of Plasmodium falciparum infection and the intensity of transmission in Africa. Am. J. Trop. Med. Hyg. 71, 80–86 (2004).

    Article  CAS  PubMed  Google Scholar 

  110. Snow, R. W., Korenromp, E. L. & Gouws, E. Paediatric mortality in Africa: Plasmodium falciparum malaria as a cause or risk? Am. J. Trop. Med. Hyg. 71, 16–24 (2004).

    Article  PubMed  Google Scholar 

  111. Snow, R. W. et al. Severe childhood malaria in two areas of markedly different falciparum transmission in East Africa. Acta Tropica 57, 289–300 (1994).

    Article  CAS  PubMed  Google Scholar 

  112. Trape, J. -F. & Rogier, C. Combating malaria morbidity and mortality by reducing transmission. Parasitol. Today 12, 236–240 (1996).

    Article  CAS  PubMed  Google Scholar 

  113. Breman, J. G., Alilio, M. S. & Mills, A. Conquering the intolerable burden of malaria: what's new, what's needed: a summary. Am. J. Trop. Med. Hyg. 71, 1–15 (2004).

    Article  PubMed  Google Scholar 

  114. Hay, S. I., Noor, A. M., Nelson, A. & Tatem, A. J. Demography for epidemiology: the precision of large-area human population maps. Int. J. Epidemiol. (in the press).

  115. Hay, S. I. et al. Climate change and the resurgence of malaria in the East African highlands. Nature 415, 905–909 (2002).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  116. Small, J., Goetz, S. J. & Hay, S. I. Climatic suitability for malaria transmission in Africa, 1911 - 1995. Proc. Natl Acad. Sci. USA 100, 15341–15345 (2003).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  117. Reiter, P. et al. Global warming and malaria: a call for accuracy. Lancet Infect. Dis. 4, 323–324 (2004).

    Article  PubMed Central  Google Scholar 

  118. Thomas, C. J., Davies, G. & Dunn, C. E. Mixed picture for changes in stable malaria distribution with future climate in Africa. Trends Parasitol. 20, 216–220 (2004).

    Article  PubMed  Google Scholar 

  119. Thomas, C. Malaria — a changed climate in Africa? Nature 427, 690–691 (2004).

    Article  CAS  PubMed  Google Scholar 

  120. Brockerhoff, M. Urban growth in developing countries: a review of projections and predictions. Popul. Dev. Rev. 25, 757 (1999).

    Article  Google Scholar 

  121. Cohen, J. E. Human population: the next half century. Science 302, 1172–1175 (2003).

    Article  CAS  PubMed  Google Scholar 

  122. Sharma, V. P. in The Contextual Determinants of Malaria (eds Casman, E. A. & Dowlatabadi, H.) 110–132 (Resources for the Future Press, Washington DC, 2002).

    Google Scholar 

  123. Gramiccia, G. Anopheles claviger in the Middle East. Bull. World Health Organ. 15, 816–821 (1956).

    CAS  PubMed  PubMed Central  Google Scholar 

  124. Beljaev, A. E. in The Contextual Determinants of Malaria (eds Casman, E. A. & Dowlatabadi, H.) 137–166 (Resources for the Future Press, Washington DC, 2002).

    Google Scholar 

  125. Anonymous. Medical and Sanitation Department Annual reports. (Government of Kenya, Nairobi municipality, 1930–1967).

  126. Central Bureau of Statistics. 1999 population and housing census: counting our people for development. Volume 1: population distribution by administrative areas and urban centres, (CBS, Ministry of Finance and Planning, Government of Kenya, Nairobi, 2001).

  127. Hay, S. I., Snow, R. W. & Rogers, D. J. From predicting mosquito habitat to malaria seasons using remotely sensed data: practice, problems and perspectives. Parasitol. Today 14, 306–313 (1998).

    Article  CAS  PubMed  Google Scholar 

  128. Hay, S. I., Snow, R. W. & Rogers, D. J. Predicting malaria seasons in Kenya using multitemporal meteorological satellite sensor data. Trans. R. Soc. Trop. Med. Hyg. 92, 12–20 (1998).

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

We are grateful to C. Fanello and C. Drakeley for discussion and for sharing unpublished reports. C. Mbogo is thanked for providing geo-referencing information from his published APfEIR and PR data. A. Wilson is also acknowledged for help in constructing the Nairobi time-series data. We similarly thank A. Graham, D. Rogers and S. Randolph for comments on earlier drafts of the manuscript. S.I.H. is funded by a Research Career Development Fellowship from the Wellcome Trust. R.W.S. is a Wellcome Trust Senior Research Fellow and acknowledges the support of the Kenyan Medical Research Institute (KEMRI). This paper is published with the permission of the director of KEMRI.

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Authors and Affiliations

  1. TALA Research Group in the Department of Zoology, University of Oxford, South Parks Road, Oxford, OX1 3PS, UK

    Simon I. Hay

  2. Public Health Group, KEMRI–Wellcome Trust Collaborative Programme in Nairobi, Kenya

    Simon I. Hay

  3. TALA Research Group in the Department of Zoology, University of Oxford, South Parks Road, Oxford, OX1 3PS, UK

    Carlos A. Guerra & Andrew J. Tatem

  4. School of Geography, University of Southampton, Southampton, SO17 1BJ, UK

    Peter M. Atkinson

  5. Public Health Group, KEMRI–Wellcome Trust Collaborative Programme in Nairobi, Kenya

    Robert W. Snow

  6. Centre for Tropical Medicine, University of Oxford, Oxford, OX3 7LJ, UK

    Robert W. Snow

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  1. Simon I. Hay
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Correspondence to Simon I. Hay.

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FURTHER INFORMATION

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World Population Prospects database

Glossary

ANNUAL P. FALCIPARUM ENTOMOLOGICAL INOCULATION RATE

The number of P. falciparum positive mosquito bites per person per year.

FUZZY CLIMATE SUITABILITY

The suitability of local climate to support P. falciparum malarial transmission in an average year. It is represented as a value between 1 and 0, where 1 is completely suitable and 0 completely unsuitable.

PARASITE PREVALENCE RATIO

The proportion of a sampled population who have P. falciparum in their blood.

PERI-URBAN

Defined here for Africa as locations with 250–1,000 persons per km2.

RURAL

Defined here for Africa as locations with fewer than 250 persons per km2. This is further subdivided into rural 1 (100–250 persons per km2) and rural 2 (<100 persons per km2).

SPATIAL DEPENDENCE

The tendency for observations close in space to be more highly correlated than those further apart.

URBAN

Defined here for Africa as locations with more than 1,000 persons per km2.

URBAN AGGLOMERATION

An area with population within the contours of contiguous territory inhabited at urban levels of residential density without regard to administrative boundaries of 1 million inhabitants or more in 2003.

VARIOGRAM

A function used to represent spatial dependence.

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Hay, S., Guerra, C., Tatem, A. et al. Urbanization, malaria transmission and disease burden in Africa. Nat Rev Microbiol 3, 81–90 (2005). https://doi.org/10.1038/nrmicro1069

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