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Early Warning System for
Emerging Infectious Diseases
in South-western Amazonia:
technological innovation
aiming at adaptation to
the negative impacts of
Global Climate Change
on Human Health
Professor Manuel CesarioMD, PhD, FLS
UNIFRAN
PFPMCG Workshop
11-12 MAY 2011
EARLY WARNING SYSTEM FOR EMERGING INFECTIOUS DISEASES
IN SOUTH-WESTERN AMAZONIA:
ADAPTATION TO THE NEGATIVE IMPACTS OF GLOBAL CLIMATE CHANGE
ON HUMAN HEALTH
PI:
Prof. Dr. Manuel Cesario – UNIFRAN (Franca-SP)
Co-PIs:
Prof. Dr. Luis Marcelo Aranha Camargo – ICB5USP (Monte Negro-RO)
Prof. Dr. Maria Emília Bavia – UFBA (Salvador-BA)
Prof. Dr. Antônio Sérgio Ferraudo – UNESP (Jaboticabal-SP)
Prof. Dr. Mônica Andrade-Morraye – UNIFRAN (Franca-SP)
Associated Researchers:
Raquel Rangel Cesario, MSc; PhD Proponent on Health Promotion at UNIFRAN (Franca-SP)
Prof. Dr. Fernando Dias de Ávila Pires – FIOCRUZ e UFSC (Florianópolis-SC)
Technicians and Students:
Michelle Andrade Furtado, MSc ; GIS Technician at UNIFRAN (Franca-SP)
Patrícia Pellegrino Colugnati – MSc Student on Health Promotion at UNIFRAN (Franca-SP)
Mateus Ribeiro – MSc Student on Health Promotion at UNIFRAN (Franca-SP)
Natália Gonçalves Amâncio – MSc Student on Health Promotion at UNIFRAN (Franca-SP)
Graduate Programme on Health Promotion
Global Environmental Change and Human Health (2007) Science Plan and Implementation Strategy, ESSP Retort No. 4.
RONDONIABRAZIL
BOLIVIA
PERU
ACRE
SOUTH-WESTERN
AMAZONIA
N
Tri-national
Frontier
Acre River
Beni
CobijaRONDONIA PANDO
Lago Titicaca
ACREUHE
St. Antonio
3,600 MW
UHE Jirau
3,900 MW
UHE
Bi-national
3,000 MW10 GW
US$ 5.5 Billion
Guayaramerin-
La Paz Highway
US$460 MillionPuertoMaldonado
4,000 km of
navigable rivers
Rio Branco
Assis Brasil
MADRE DE DIÓS
BR 364
BR 317
Sena Madureira
On-going Mega-infrastructure projects in the South-Western Amazon regionSources: NASA, M. Steininger, CI, CAF- IIRSA
More than 30 million people live in a radius of 750 Km of Acre State
ROAD PAVING HAS BEEN A VERY IMPORTANT DRIVER FOR LUCC IN AMAZONIA
LAND USE/COVER CHANGE IN AMAZONIA:
DEFORESTATION/FOREST FIRES, LOGGING AND FARMING,
MOSTLY ALONG ROADS
The effect of road paving on deforestation in Amazonia
(by WHRC/IPAM, after Britaldo Soarez, with data from PRODES)
“For each 1%
increase in
deforestation, the
amount of
A. darlingi
increases 8%”Jonathan Patz apud Amy Victor, 2003
Lutzomyia sp.
Cutaneous Leishmaniasis
in Brazil
Bartonellosis in Peru
Visceral Leishmaniasis
in Brazil
Spatial Distribution of
Visceral Leishmaniasis cases,
according to place of residence.
Brasil, 1983-2006
Source: SVS/MS1983-1988
1989-1994
1995-2000
2000-2006
1 dot = 1 caseExample of expansion of
Visceral Leishmaniasistransmission area
RONDONIABRAZIL
BOLIVIA
PERUACRE
SOUTH-WESTERN
AMAZONIA
N
BARTONELOSIS
Vector-borne Zoonosis
LUCC (deforestation)
Human Migration
Climate Variability
Large Infrastructure Projects (roads)
HUACO (pottery) representing the
millenary known Peruvian Wart (Bartonellosis chronic form)
The Lima – La Oroya Railway,
known as the highest railway in the world,
was built in the years 1870-1875 and 1890-1893,
resulting in 152 km, 61 bridges and 65 tunnels,
as well as in
7,000 deaths only during the
La Oroya Fever 1871 outbreak.
CARRION`S DISEASE(BARTONELLOSIS,
Bartonella baciliformis)
NUMBER OF ANNUAL CASES AND INCIDENCE OF BARTONELLOSIS IN PERU, 1997-2005
0
2000
4000
6000
8000
10000
12000
1 2 3 4 5 6 7 8 9
YEARS
CA
SE
S
0
5
10
15
20
25
30
35
40
45
IN
CID
EN
CE
1997 1998 1999 2000 2001 2002 2003 2004 2005
Source: OFICINA GENERAL DE EPIDEMIOLOGIA
MINISTERIO DE SALUD - PERU.
INC
IDE
NC
E P
ER
100,0
00 I
NH
AB
ITA
NT
S
NU
MB
ER
OF
CA
SE
S P
ER
YE
AR
BARTONELLOSIS IN PERU, FROM 1997 TO 2005
NUMBER OF CASES PER YEAR AND INCIDENCE PER 100,000 INHABITANTS
YEARS
CUSCOCAJAMARCA
BAGUACAJAMARCA
PIURA ICAJAMARCA
JAENANCASH
AMAZONASHUANUCO
LA LIBERTADLAMBAYEQULIMA NORTE
LIMA SUR
DISA
0 5 10 15 20
Letalidad (%)GRUPO DE TAREA PATOGENOS ESPECIALESOFIC INA GENERAL DE EPIDEMIOLOGIA* HASTA LA S.E. 32
Tasa de letalidad de la bartonelosis. Perú 2004.
RONDONIABRAZIL
BOLIVIA
PERUACRE
SOUTH-WESTERN
AMAZONIA
N
LEISHMANIASIS
Vector-borne Zoonosis
LUCC (deforestation)
Human Migration
Climate Variability
Large Infrastructure Projects (roads)
Cutaneous Leishmaniasis Detection Coeficient
Source: Brazilian Health Ministry,
2007 data.
CASE DENSITY AND CIRCUITS OF
LEISHMANIASIS PER MUNICIPALITY
( AVERAGE 2003-2005 )
Density
(Cases/Km²)
Cutaneous
Leishmaniasis
Detection
Coeficient
(number of cases
per 100,000
inhabitants)
Scales
18 Average in Brazil, in the last 20 years
13 to 40 Average in Peru, from 1985 to 1994
71 Level of very high risk of transmission,
according to the Brazilian Ministry of
Health
93 Brazilian Northern Region
(average in the last 20 years)
126 Acre State (average 2000-2007)
1,232 Assis Brasil (average 2000-2007)
198 to 1,622 Variation between the six Bolivian
municipalities along the tri-national
borders (2004)
Phlebotomines collected
during 5 days field-work, in 2008:
3,334 male individuals
distributed in 59 species, of which
12 not yet registered in Acre;
2 unknown/new.
OBJECTIVES
The General Objective of this project is to develop adaptation
strategies and tools to face the negative impacts of Global
Climate Change on Human Health.
The Specific Objectives are:
•to monitor and map changes in the eco-epidemiology of
Cutaneous Leishmaniasis and Bartonellosis (Carrión Disease) at
the tri-national frontier;
•to monitor and map local/regional climatic- (temperature, rainfall,
air humidity, wind, altitude) and land use/cover changes;
•to identify the sand fly vectors (Diptera: Psychodidae:
Phlebotominae) involved with the transmission of both diseases in
the tri-national region and map their occurrence;
•to develop the Early Warning System for Emerging Infectious
Diseases in Southwestern Amazonia;
• to broadly disseminate the results/achievements.
SPECIFIC OBJECTIVES and METHODS
•to monitor and map changes in the eco-epidemiology of Cutaneous
Leishmaniasis and Bartonellosis (Carrión Disease) at the tri-national
frontier (2000-2012);
•to monitor and map local/regional climatic- (temperature, rainfall, air
humidity, wind, altitude) and land use/cover changes (2000-2012);
•to identify the sand fly vectors (Diptera: Psychodidae: Phlebotominae)
involved with the transmission of both diseases in the tri-national region
and map their occurrence.
In the first two years the following tasks will be performed:
Serum-epidemiological inquires;
Laboratorial analysis of blood samples and vectors;
Vectors’ identification and ecology assessment;
Mapping changes in land use/cover in the region;
GIS databank building.
SPECIFIC OBJECTIVES and METHODS
•to develop the Early Warning System for Emerging Infectious
Diseases in South-western Amazonia;
• to broadly disseminate the results/achievements.
By the end of the fourth year, this project will have produced the Early
Warning System for Emerging Infectious Diseases in Southwestern
Amazonia using techniques of : Spatial Epidemiology, Univariate and
Multivariate Analysis, Cluster Analysis, Principal Components Analysis,
Discriminate Analysis, Correspondence Analysis, and Neural
Networks/Artificial Intelligence for assessing infectious diseases.
It will have communicated its results to the relevant scientific
communities through scientific and media publications, and through the
scientific meetings attended. Moreover, the results/achievements will be
multiplied by means of workshops for health-service managers and
policy-makers, as well as by training courses for students.
Preliminarily identified needs for collaboration
and/or data interchange within the FAPESP
Global Climate Change Research Programme:
• access to local/regional climate data: temperature,
precipitation, air and soil humidity, winds, ENSO,
etc. (2000-2012);
• access to local/regional satellite imagery and data
on land use/cover change (2000-2012).
“When I was a child, there was a lot of
forest, a lot of game, many fruits; our river was
large and very deep.
Today we can`t even swim, the water level
is under my knees; the fruits are scarce, little
fish and little game; the weather changed a lot.
I am getting old, more and more concerned
with the future of my grandchildren ...”
Report from an
Amazonian rubber tapper:
THANK YOU FOR YOUR ATTENTION