Impact of climate and land use/land cover changes on malaria incidence in the Ecuadorian Amazon.

Malaria transmission is influenced by climate and land use/land cover change (LULC). This study examines the impact of climate and LULC on malaria risk in the Ecuadorian Amazon. Weekly malaria surveillance data between 2008 and 2019 from Ecuador's Ministry of Public Health were combined with hydrometeorological and LULC data. Cross-correlation analyses identified time lags. Bayesian spatiotemporal models estimated annual LULC rates of change (ARC) by census area and assessed the effects on Plasmodium vivax and Plasmodium falciparum incidence. ARC for the five land cover classes (forest, agriculture, urban, shrub vegetation, water) ranged from -1 to 4% with agriculture increasing across areas. Forest and shrub vegetation ARC were significantly associated with both Plasmodium vivax and Plasmodium falciparum. Temperature and terrestrial water content showed consistent negative relationships with both species. Precipitation had varying effects on Plasmodium vivax (null) and Plasmodium falciparum (increase) incidence. Shrubs and forest expansion, increased temperature, and terrestrial water content reduced malaria incidence, while increased precipitation had varying effects. Relationships between malaria, LULC, and climate are complex, influencing risk profiles. These findings aid decision-making and guide further research in the region.