Malaria Landscape: Examining the Role of Land-Cover/Land-Use Nexus in Malaria Transmission in Myanmar

Myanmar is an emerging democracy that bears by far the heaviest malaria burden in Southeast Asia, the region that has been the historical gateway for the global dissemination of drug-resistant malaria.  Malaria infection and spread is a highly complex process driven by a host of ecological, meteorological, biological, and epidemiological drivers which are in turn influenced by a range of socio-economic conditions, network flows of population, military conflicts, and the state of the national and local healthcare systems.  This process functions within a closed loop of human-mosquito-human transfer of Plasmodium parasites where the presence of human host is as much of a driver in malaria spread as mosquitoes.  Historically satellite-data-driven malaria models primarily focused on mosquito habitat suitability assessments which were proven to be insufficient predictors of malaria parasite prevalence.  In the context of the closed-loop human-mosquito-human parasite transfer, knowledge of dynamics of human exposure to biting mosquitoes on the landscape is of crucial importance for malaria modeling.  For almost fifty years, Myanmar has been mostly closed to outside influences and economic interactions. Although the socio-economic landscape of Myanmar has seen considerable change in the past decade with a dramatic acceleration of those changes in the last decade, there is still considerable lack of data availability on human presence, activity, and their dynamics across the country.  In this work, we use satellite remote sensing in combination with medical surveys of subclinical malaria and entomological surveys to explore the role of land cover and land use as indicators of both human presence and activity and mosquito habitat suitability to support dynamic monitoring of malaria risk potential in support of the World Health Organization’s Global Malaria elimination agenda.