Abstract The study aims to identify the relative impact of meteorological and socio-demographic variables on malaria incidence in India since their combined role is crucial for 2030 elimination target. While climate change influences the spatial and temporal patterns of transmission, its exact effect varies due to development efforts and malaria control strategies, which have significantly reduced the incidence. Mapping the decline in incidence over two decades shows persistence of hotspots (Central India, from borders of Rajasthan Gujrat to Odisha, Jharkhand, Chhattisgarh, and eastern Madhya Pradesh and North-East) and areas of significant reduction. Statistical models delineate the role of temperature and rainfall (annual, seasonal and variability). Exposure to a minimum rainfall (60-120mm; IRR= 1.001) and warm temperature (IRR= 1.037) is necessary for transmission but a 1°C temperature increase during the summer months leads to a 13% reduction in cases. The variability from long-term average in temperature contributes to incidence (IRR=1.3) but precipitation thwarts (IRR=0.98). Integrating socioeconomic factors emphasise the vulnerability of historically marginalised social groups (ST) and enhanced adaptive capacity due to improved water sources and female education. It curtails the odds of high malaria incidence by 5.6% and 4·7% respectively. The role of last-mile health access is noted in better reporting. CART model also recognizes ST and Female education as dominant determinants of malaria prevalence. With the success of Micro-level strategies like DAMaN and MEDP the persistence of (“tribal”) Malaria can be addressed with women’s capacity building, education, integration with national nutrition schemes for equitable malaria elimination.
Suri et al. (Mon,) studied this question.