title: Associations between malaria and local and global climate variability in five regions in Papua New Guinea.
abstract: BACKGROUND
  Malaria is a significant public health issue in Papua New Guinea (PNG) as the burden is among the highest in Asia and the Pacific region. Though PNG's vulnerability to climate change and sensitivity of malaria mosquitoes to weather are well-documented, there are few in-depth epidemiological studies conducted on the potential impacts of climate on malaria incidence in the country.
  
  
  METHODS
  This study explored what and how local weather and global climate variability impact on malaria incidence in five regions of PNG. Time series methods were applied to evaluate the associations of malaria incidence with weather and climate factors, respectively. Local weather factors including precipitation and temperature and global climate phenomena such as El Niño-Southern Oscillation (ENSO), the ENSO Modoki, the Southern Annular Mode, and the Indian Ocean Dipole were considered in analyses.
  
  
  RESULTS
  The results showed that malaria incidence was associated with local weather factors in most regions but at the different lag times and in directions. Meanwhile, there were trends in associations with global climate factors by geographical locations of study sites.
  
  
  CONCLUSIONS
  Overall heterogeneous associations suggest the importance of location-specific approaches in PNG not only for further investigations but also public health interventions in repose to the potential impacts arising from climate change.
authors.affiliation: School of Public Health and Social Work, Queensland University of Technology, 60 Musk Avenue, Brisbane, 4064 QLD Australia ; Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523 Japan.
authors.forename: Chisato
authors.initials: C
authors.lastname: Imai
authors.affiliation: Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, 300 Cheoncheon-dong, Jangan-gu, Suwon, Gyeonggi-do 440-746 Republic of Korea.
authors.forename: Hae-Kwan
authors.initials: HK
authors.lastname: Cheong
authors.affiliation: Department of Biostatistics, Graduate School of Public Health, Seoul National University, 599 Gwanak-ro, Gwanak-gu, Seoul, Republic of Korea.
authors.forename: Ho
authors.initials: H
authors.lastname: Kim
authors.affiliation: Faculty of Health and Sport Sciences, The University of Tsukuba, Comprehensive Research Building D 709, 1-1-1 Tennoudai, Tsukuba, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Honda
authors.affiliation: Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, 300 Cheoncheon-dong, Jangan-gu, Suwon, Gyeonggi-do 440-746 Republic of Korea.
authors.forename: Jin-Hee
authors.initials: JH
authors.lastname: Eum
authors.affiliation: Department of Biostatistics, Graduate School of Public Health, Seoul National University, 599 Gwanak-ro, Gwanak-gu, Seoul, Republic of Korea.
authors.forename: Clara T
authors.initials: CT
authors.lastname: Kim
authors.affiliation: Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, 300 Cheoncheon-dong, Jangan-gu, Suwon, Gyeonggi-do 440-746 Republic of Korea.
authors.forename: Jin Seob
authors.initials: JS
authors.lastname: Kim
authors.affiliation: Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523 Japan.
authors.forename: Yoonhee
authors.initials: Y
authors.lastname: Kim
authors.affiliation: Japan Agency for Marine-Earth Science and Technology (JAMSTEC), Yokohama Institute for Earth Science, 3173-25 Showa-machi, Kanazawa-ku, Yokohama, 236-0001 Japan.
authors.forename: Swadhin K
authors.initials: SK
authors.lastname: Behera
authors.affiliation: World Health Organization Western Pacific Regional Office, P.O. Box 2932, 1000 Manila, Philippines.
authors.forename: Mohd Nasir
authors.initials: MN
authors.lastname: Hassan
authors.affiliation: World Health Organization Western Pacific Regional Office, P.O. Box 2932, 1000 Manila, Philippines.
authors.forename: Joshua
authors.initials: J
authors.lastname: Nealon
authors.affiliation: World Health Organization Western Pacific Regional Office, P.O. Box 2932, 1000 Manila, Philippines ; National Institute of Environmental Research, Hwangyong-ro 42, Seogu, Incheon Republic of Korea.
authors.forename: Hyenmi
authors.initials: H
authors.lastname: Chung
authors.affiliation: Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523 Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Hashizume
keywords: Climate; Climate change; Malaria; Papua New Guinea; Weather