Malaria in Burkina Faso: A comprehensive analysis of spatiotemporal distribution of incidence and environmental drivers, and implications for control strategies

PLoS One. 2023 Sep 13;18(9):e0290233. doi: 10.1371/journal.pone.0290233. eCollection 2023.

Abstract

Background: The number of malaria cases worldwide has increased, with over 241 million cases and 69,000 more deaths in 2020 compared to 2019. Burkina Faso recorded over 11 million malaria cases in 2020, resulting in nearly 4,000 deaths. The overall incidence of malaria in Burkina Faso has been steadily increasing since 2016. This study investigates the spatiotemporal pattern and environmental and meteorological determinants of malaria incidence in Burkina Faso.

Methods: We described the temporal dynamics of malaria cases by detecting the transmission periods and the evolution trend from 2013 to 2018. We detected hotspots using spatial scan statistics. We assessed different environmental zones through a hierarchical clustering and analyzed the environmental and climatic data to identify their association with malaria incidence at the national and at the district's levels through generalized additive models. We also assessed the time lag between malaria peaks onset and the rainfall at the district level. The environmental and climatic data were synthetized into indicators.

Results: The study found that malaria incidence had a seasonal pattern, with high transmission occurring during the rainy seasons. We also found an increasing trend in the incidence. The highest-risk districts for malaria incidence were identified, with a significant expansion of high-risk areas from less than half of the districts in 2013-2014 to nearly 90% of the districts in 2017-2018. We identified three classes of health districts based on environmental and climatic data, with the northern, south-western, and western districts forming separate clusters. Additionally, we found that the time lag between malaria peaks onset and the rainfall at the district level varied from 7 weeks to 17 weeks with a median at 10 weeks. Environmental and climatic factors have been found to be associated with the number of cases both at global and districts levels.

Conclusion: The study provides important insights into the environmental and spatiotemporal patterns of malaria in Burkina Faso by assessing the spatio temporal dynamics of Malaria cases but also linking those dynamics to the environmental and climatic factors. The findings highlight the importance of targeted control strategies to reduce the burden of malaria in high-risk areas as we found that Malaria epidemiology is complex and linked to many factors that make some regions more at risk than others.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Burkina Faso / epidemiology
  • Cluster Analysis
  • Humans
  • Incidence
  • Malaria* / epidemiology
  • Meteorology

Grants and funding

The project leading to this publication has received funding from the Excellence Initiative of Aix-Marseille University - A*Midex, a French “Investissements d’Avenir programme”. It was supported by a grant from the Aix-Marseille Institute of Public Health Sciences – ISSPAM as well as financial and technical support from the association Prospective et Coopération. C.B received a PhD scholarship from the French Embassy in Burkina Faso and NGO Prospective et Coopération. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.