title: Modelling entomological-climatic interactions of Plasmodium falciparum malaria transmission in two Colombian endemic-regions: contributions to a National Malaria Early Warning System.
abstract: BACKGROUND
  Malaria has recently re-emerged as a public health burden in Colombia. Although the problem seems to be climate-driven, there remain significant gaps of knowledge in the understanding of the complexity of malaria transmission, which have motivated attempts to develop a comprehensive model.
  
  
  METHODS
  The mathematical tool was applied to represent Plasmodium falciparum malaria transmission in two endemic-areas. Entomological exogenous variables were estimated through field campaigns and laboratory experiments. Availability of breeding places was included towards representing fluctuations in vector densities. Diverse scenarios, sensitivity analyses and instabilities cases were considered during experimentation-validation process.
  
  
  RESULTS
  Correlation coefficients and mean square errors between observed and modelled incidences reached 0.897-0.668 (P > 0.95) and 0.0002-0.0005, respectively. Temperature became the most relevant climatic parameter driving the final incidence. Accordingly, malaria outbreaks are possible during the favourable epochs following the onset of El Niño warm events. Sporogonic and gonotrophic cycles showed to be the entomological key-variables controlling the transmission potential of mosquitoes' population. Simulation results also showed that seasonality of vector density becomes an important factor towards understanding disease transmission.
  
  
  CONCLUSIONS
  The model constitutes a promising tool to deepen the understanding of the multiple interactions related to malaria transmission conducive to outbreaks. In the foreseeable future it could be implemented as a tool to diagnose possible dynamical patterns of malaria incidence under several scenarios, as well as a decision-making tool for the early detection and control of outbreaks. The model will be also able to be merged with forecasts of El Niño events to provide a National Malaria Early Warning System.
authors.affiliation: Escuela de Geociencias y Medio Ambiente, Facultad de Minas, Universidad Nacional de Colombia Sede Medellín, Medellín, Colombia. pfcarlos@eia.edu.co
authors.forename: Daniel
authors.initials: D
authors.lastname: Ruiz
authors.forename: Germán
authors.initials: G
authors.lastname: Poveda
authors.forename: Iván D
authors.initials: ID
authors.lastname: Vélez
authors.forename: Martha L
authors.initials: ML
authors.lastname: Quiñones
authors.forename: Guillermo L
authors.initials: GL
authors.lastname: Rúa
authors.forename: Luz E
authors.initials: LE
authors.lastname: Velásquez
authors.forename: Juan S
authors.initials: JS
authors.lastname: Zuluaga
mesh_terms: D000818:Animals; D000852:Anopheles / Q000469:parasitology / Q000502:physiology*; D002980:Climate; D003105:Colombia / Q000453:epidemiology; D017753:Ecosystem; D005260:Female; D006801:Humans; D016778:Malaria, Falciparum / Q000175:diagnosis / Q000453:epidemiology* / Q000635:transmission*; D008954:Models, Biological; D009313:National Health Programs / Q000458:organization & administration*; D010963:Plasmodium falciparum / Q000502:physiology; D011157:Population Dynamics; D011891:Rain; D013696:Temperature; D013997:Time Factors