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Comment
. 2014 Apr;90(4):591-4.
doi: 10.4269/ajtmh.13-0323. Epub 2013 Nov 25.

Conservation efforts and malaria in the Brazilian Amazon

Micah B Hahn  1 , Sarah H Olson, Amy Y Vittor, Christovam Barcellos, Jonathan A Patz, William Pan
Affiliations
Comment

Conservation efforts and malaria in the Brazilian Amazon

Micah B Hahn et al. Am J Trop Med Hyg. 2014 Apr.

Abstract

We respond to Valle and Clark, who assert that "conservation efforts may increase malaria burden in the Brazilian Amazon," because the relationship between forest cover and malaria incidence was stronger than the effect of the deforestation rate. We contend that their conclusion is flawed because of limitations in their methodology that we discuss in detail. Most important are the exclusion of one-half the original data without a discussion of selection bias, the lack of model adjustment for either population growth or migration, and the crude classifications of land cover and protected areas that lead to aggregation bias. Of greater significance, we stress the need for caution in the interpretation of data that could have profound effects on regional land use decisions.

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Figures

Figure 1.
Figure 1.
Valle and Clark study locations. This map shows the cities used in the study by Valle and Clark with 20-km buffers as used in their analysis. The yellow areas outline the extent of the Legal Brazilian Amazon and show the large area (> 95%) of the Brazilian Amazon that was not included in their analysis. Protected areas (PAs) referenced in the study by Valle and Clark and this article are shown in green.
Figure 2.
Figure 2.
Map of Manaus with a 20-km buffer. This map uses Manaus, the largest city in the Amazon, as an example of one of the study areas in the work by Valle and Clark to show the potential issues with their analytical approach. The 20-km buffer that they used in their analysis covers almost the entire urban area (grey) and some of the rural area. The city has a large forest reserve (PA limits shown with a yellow dotted line), which is within the 20-km buffer. According to the analysis by Valle and Clark, they would likely find a high number of malaria cases associated with high forest cover because of the forest reserve. However, the malaria cases that would be reported to the health department in Manaus would not originate in the city or the forest reserve (which is not inhabited). The cases would occur in the rural populations along the rivers and creeks outside the 20-km buffer.
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References

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