Projecting the risk of mosquito-borne diseases in a warmer and more populated world: a multi-model, multi-scenario intercomparison modelling study

TLDR

Background: combine two background sentences: "Mosquito-borne diseases are expanding their range, and re-emerging in areas where they had subsided for decades. The extent to which climate change influences the transmission suitability and population at risk of mosquito-borne diseases across different altitudes and population densities has not been investigated." Summarize: "Mosquito-borne diseases are expanding and re‑emerging, yet the impact of climate change on their transmission suitability and population at risk across altitudes and densities remains unexplored." Purpose: from [Purpose, Mechanism] sentence: "The aim of this study was to quantify the extent to which climate change will influence the length of the transmission season and estimate the population at risk of mosquito-borne diseases in the future, given different population densities across an altitudinal gradient." Summarize: "The study aims to quantify how climate change will alter transmission season length and future population at risk of malaria and dengue across altitudinal gradients and population densities." Mechanism: from [Mechanism, Findings] sentence: "We generated projections from six mosquito-borne disease models, driven by four global circulation models, using four representative concentration pathways, and three shared socioeconomic pathways." Also earlier: "Using a multi-model multi-scenario framework, we estimated changes in the length of the transmission season and global population at risk of malaria and dengue for different altitudes and population densities for the period 1951–99." So mechanism: "Using a multi‑model, multi‑scenario framework that combined six disease models, four climate models, four RCPs, and three SSPs, the authors projected transmission season length and population at risk for 1951–99 across altitudes and densities." Need concise. Findings: many findings sentences. Summarize key results: malaria suitability increases by 1.6 months in tropical highlands of Africa, Eastern Mediterranean, Americas; dengue increases 4 months in lowlands of Western Pacific and Eastern Mediterranean; increases greater in rural than urban; epidemic belt expands to temperate; population at risk could rise by up to 4.7 billion by 2070 relative to 1970‑99, especially lowlands and urban; expansion to higher altitudes and temperate regions suggests outbreaks in naive populations and unprepared health systems. Summarize: "Projections show malaria suitability will rise by ~1.6 months in tropical highlands, dengue by ~4 months in lowland regions, with greater gains in rural areas, an expansion of the epidemic belt into temperate zones, and a potential increase of up to 4.7 billion people at risk by 2070, highlighting heightened vulnerability in naïve populations and unprepared health systems." Other: content: [Findings, Other] sentence: "The population at risk of malaria and dengue will be higher in densely populated urban areas in the WHO African region, South-East Asia region, and the region of the Americas, although we did not account for urban-heat island effects, which can further alter the risk of disease transmission." Also Funding line: "FundingUK Space Agency, Royal Society, UK National Institute for Health Research, and Swedish Research Council." The Other label includes that sentence and funding.

Abstract

BackgroundMosquito-borne diseases are expanding their range, and re-emerging in areas where they had subsided for decades. The extent to which climate change influences the transmission suitability and population at risk of mosquito-borne diseases across different altitudes and population densities has not been investigated. The aim of this study was to quantify the extent to which climate change will influence the length of the transmission season and estimate the population at risk of mosquito-borne diseases in the future, given different population densities across an altitudinal gradient.MethodsUsing a multi-model multi-scenario framework, we estimated changes in the length of the transmission season and global population at risk of malaria and dengue for different altitudes and population densities for the period 1951–99. We generated projections from six mosquito-borne disease models, driven by four global circulation models, using four representative concentration pathways, and three shared socioeconomic pathways.FindingsWe show that malaria suitability will increase by 1·6 additional months (mean 0·5, SE 0·03) in tropical highlands in the African region, the Eastern Mediterranean region, and the region of the Americas. Dengue suitability will increase in lowlands in the Western Pacific region and the Eastern Mediterranean region by 4·0 additional months (mean 1·7, SE 0·2). Increases in the climatic suitability of both diseases will be greater in rural areas than in urban areas. The epidemic belt for both diseases will expand towards temperate areas. The population at risk of both diseases might increase by up to 4·7 additional billion people by 2070 relative to 1970–99, particularly in lowlands and urban areas.InterpretationRising global mean temperature will increase the climatic suitability of both diseases particularly in already endemic areas. The predicted expansion towards higher altitudes and temperate regions suggests that outbreaks can occur in areas where people might be immunologically naive and public health systems unprepared. The population at risk of malaria and dengue will be higher in densely populated urban areas in the WHO African region, South-East Asia region, and the region of the Americas, although we did not account for urban-heat island effects, which can further alter the risk of disease transmission.FundingUK Space Agency, Royal Society, UK National Institute for Health Research, and Swedish Research Council.