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Durham E-Theses Durham E-Theses Do local environmental changes resulting from the construction of microdams lead to increased malaria transmission in Tigray, Ethiopia? Fisiha, Mekonnen Yohannes How to cite: Fisiha, Mekonnen Yohannes (2002) Do local environmental changes resulting from the construction of microdams lead to increased malaria transmission in Tigray, Ethiopia?, Durham theses, Durham University. Available at Durham E-Theses Online: http://etheses.dur.ac.uk/3867/ Use policy The full-text may be used and/or reproduced, and given to third parties in any format or medium, without prior permission or charge, for personal research or study, educational, or not-for-prot purposes provided that: • a full bibliographic reference is made to the original source • a link is made to the metadata record in Durham E-Theses • the full-text is not changed in any way The full-text must not be sold in any format or medium without the formal permission of the copyright holders. Please consult the full Durham E-Theses policy for further details. Academic Support Oce, Durham University, University Oce, Old Elvet, Durham DH1 3HP e-mail: e-theses.admin@dur.ac.uk Tel: +44 0191 334 6107 http://etheses.dur.ac.uk 2 Do Local Environmental Changes Resulting From The Construction Of Microdams Lead To Increased Malaria Transmission In Tigray, Ethiopia? The copyright of this thesis rests with the author. No quotation from it shoul d be published without his prior written consent and information derived from it should be acknowledged. A thesis submitted to the University of Durham For the award of the degree of Doctor of Philosophy Aptil 2002 By Mekonnen Y ohannes Fisiha B.Sc. (Biology), MSc (Zoology) School of Biological and Biomedical Sciences University of Durham Durham DHl 3LE United kingdom 7 ~ SEP 200 ~ ; Abstract To investigate the impact of microdams on local microclimate and malaria transmission and in order to develop appropriate methods for the control of this disease, a longitudinal microclimatic, entomological, and clinical study was conducted. The study took place in two topographically similar villages: Deba, near a microdam and Maisheru, 3-4km away, in Tigray, northern Ethiopia, where an extensive dam construction is in progress in epidemic prone areas. The weather was recorded in both villages, on the dam embankment and at different mosquito habitats. A community-led larval intervention study followed the impact assessment phase in the dam village. There was a 3.1 times greater prevalence of an enlarged spleen and 2-5.5 times higher incidence of falciparum malaria in children under 10 years of age in the dam village compared to the remote village, indicating a greater level of exposure experienced in the dam village. Anopheles arabiensis, which was highly anthropophilic, partially exophilic, and showed early biting peak (19:00-20:00hr), was 6.5-8 times more abundant in the dam village compared to the remote village and this was even higher during the dry season (x16) when a second peak in density was observed in the former. This corresponded to when the fields were irrigated indicating that transmission of malaria was no longer restricted to the rainy season in the dam village compared to the remote village. Despite DDT spraying and prompt treatment of clinical cases with Fansidar at a community level, the findings demonstrated that dams have the potential to increase transmission of malaria parasites. The dam not only created abundant mosquito breeding sites throughout the year, but also resulted in significant microclimate changes; notably elevated minimum atmospheric temperature, the influence weakening with distance from the dam. The dam site was 1.5 °C warmer than the dam village and that of the dam village was 1.3 °C higher than the remote village and was especially pronounced (>3.5 °C) in the cool/dry season. Mean air temperature recorded under vegetation was 1. 7 °C lower than outside and the dam provided numerous cool and humid microhabitats elsewhere by raising the water table, increasing water seepage, saturating the soil and promoting abundant growth of vegetation. Indoor temperature was relatively stable with higher minima and lower maxima than outdoors and on the average 2.8-3.4 °C warmer than outdoors. The warming effect of the dam, together with profuse breeding sites, suitable indoor and outdoor resting microhabitats may have contributed to the extended and dramatic increased risk of malaria observed in near dam communities in the Ethiopian highlands in Tigray. Most importantly the ii larval intervention study, which involved minimal community participation, showed a 49% relative reduction in An. arabiensis abundance in the dam village compared with the pre-intervention period. Thus, if dams could be constructed further away from settlements and if serious and sustainable community-led environmental management measures could be introduced as a package, it would be possible to mitigate the impact of microdams to an appreciable extent and calls for an integrated approach to malaria control, in fringe areas of malaria, such as the Tigray highlands, particularly near microdams. Key words: Dams, microclimate, mosquito ecology, Ethiopia, Tigray, malaria, Anopheles arabiensis, highland fringes. iii Dedication This work is dedicated to the direct victims of the Ethio-Eritrean war and its aftermath; the Agame-Irob-Zalambessa-Adiabo people and other communities at the border area, the cluster-bombed school children at Ayder in Mekelle, and to all those who sacrificed their precious lives defending their country. iv Declaration and Copyright The material contained within this thesis has not been previously been submitted for a degree at the University of Durham or any other Institution. The research reported in this thesis has been conducted entirely by the author unless indicated otherwise. The copyright of this thesis rests with the author. No quotation from it should be published nor any methodology implemented without the prior consent of the author. Any information derived from this thesis should be appropriately acknowledged. V Acknowledgement I am indebted to my advisors Professor S.W. Lindsay and Dr Mitiku Haile for their invaluable support and supervision of my work. I would like to thank the WHO Special Programme for Research and Training in Tropical Diseases (TDR) in Geneva and Sida I SAREC in Stockholm, Sweden, for funding the study and my home base University of Mekelle and staff for all rounded help, especially for relieving me of my administrative duties in order to fully dwell upon my research activities. My appreciation goes to the Tigray Regional State Bureau of Health, the Malaria and Other Vector Borne Diseases Control Unit Staff, especially Dr Tedros Adhanom, Dr Karen H. Witten , Mr Asefaw Getachew, Mr Hailu Tsehaye and Mr Mussie as well as Dr Peter Byass (School of Community Health Sciences, University of Nottingham), for helping me in various ways. I am especially grateful for the contributions made by the village-based enumerators, the inhabitants of the villages and the local administration. Thanks to the Bureau of Agriculture, Commission for Sustainable Agricultural and Environmental Rehabilitation in Tigray, Mr Teshale Yihdego and Dr Tesfay Mebrahtu (Head of GTZ in western Tigray), Mr Zekarias Gebremedhin, Mr Nigus and Mr Salih (REST), Mr Taha Siraj, Mrs Hanna Ali and many other friends in Mekelle who provided me with important information about Tigray and the study area and helped me in many other ways. I would also like to thank friends and colleagues, Fiona Cameron Shenton, Katie Hamilton (for doing the PCR), Nabie Bayoh, Matt Kirby and Rob Hutchinson who helped me in many ways during my stay at the University. vi Contents Title page Abstract ii Dedication iv Declaration and Copyright V Acknowledgement vi Contents vii List of plates xi List of tables xii List of figures xiv Abbreviations used xviii Chapter 1: Introduction 1 General background 1 Major environmental determinants of malaria 8 Climate 8 Physical landscape 15 Cultural impact 16 Genetic factors 17 Malaria surveys 20 Malaria in Ethiopia 27 General background 27 Distribution of malaria 28 Vectors 33 Malaria parasites 36 History of malaria control 38 Factors aggravating the transmission of malaria in Ethiopia 44 Malaria's reach is spreading 44 Human activities 45 Malaria in Tigray 53 General background of Tigray 53 The malaria situation in Tigray 56 Research objectives 60 vii Chapter 2. Impact of microdams on local microclimate and its relevance to malaria transmission in northern Ethiopia 62 Abstract 63 Introduction 63 Materials and methods 65 The study area 65 Monitoring the microclimate 68 Results 70 Discussion 86 Chapter 3. The microclimate of mosquito resting and breeding habitats near a microdam and its relevance to malaria transmission in Tigray, northern Ethiopia 94 Abstract 95 Introduction 96 Materials and methods 98 The study area 98 Monitoring the microclimate 100 Outdoor microclimate 100 Indoor microclimate 102 Results 103 Outdoor and indoor temperature and relative humidity 103 Breeding site temperature 111 Discussion 120 Chapter 4. Impact of microdams on local microclimate and its relevance to malaria transmission in Tigray, Northern Ethiopia: Pre-intervention entomological and clinical surveys. 128 Abstract 129 Introduction 130 Materials and methods 131 The study area 131 Clinical surveys 133 Entomological surveys 134 House selection 134 viii Space spray and exit trap collections 135 Light trap collections 135 Human-landing catches
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