Deforestation inhibits malaria transmission in Lao PDR: a spatial epidemiology using Earth observation satellites

BACKGROUND: The present study aimed to analyze the impact of deforestation on the malaria distribution in the Lao People’s Democratic Republic (Lao PDR), with consideration of climate change. METHODS: Malaria distribution data from 2002 to 2015 were obtained from the Ministry of Health of Lao PDR and each indicator was calculated. Earth observation satellite data (forested area, land surface temperature, and precipitation) were obtained from the Japan Aerospace Exploration Agency (JAXA). Structured equation modeling (SEM) was conducted to clarify the relationship between the malaria incidence and Earth observation satellite data. RESULTS: As a result, SEM identified two factors that were independently associated with the malaria incidence: area and proportion of forest. Specifically, malaria was found to be more prevalent in the southern region, with the malaria incidence increasing as the percentage of forested land increased (both p < 0.01). With global warming steadily progressing, forested areas are expected to play an important role in the incidence of malaria in Lao PDR. This is believed because malaria in Lao PDR is mainly forest malaria transmitted by Anopheles dirus. CONCLUSION: To accelerate the elimination of malaria in Lao PDR, it is important to identify, prevent, and intervene in places with increased forest coverage (e.g., plantations) and in low-temperature areas adjacent to malaria-endemic areas, where the vegetation is similar to that in malaria-endemic areas.