ArticleScientific reports2021
Tuberculosis case notifications in Malawi have strong seasonal and weather-related trends.
Article in Scientific reports, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.
- Understanding the mechanisms of climate change impact on tuberculosis: a complex systems approach.BMC public health · 2025Pooled it
- Potential health impacts and costs of active case finding guided by Mycobacterium tuberculosis immunoreactivity survey results in Blantyre, Malawi: A mathematical modeling study.PLoS medicine · 2026Article
- Transgression of planetary boundaries and the effects on child health through an infectious diseases lens.Current opinion in pediatrics · 2025Review
- Analysis of Tuberculosis Epidemiological Distribution Characteristics in Fujian Province, China, 2005-2021: Spatial-Temporal Analysis Study.JMIR public health and surveillance · 2024Article
- Effects of meteorological factors on tuberculosis and potential modifiers in Zhejiang Province, China.Scientific reports · 2024Article
- Analyzing the seasonality of tuberculosis case notifications in the UK, 2000-2018.Epidemiology and infection · 2024Article
- Spatial and temporal analysis and forecasting of TB reported incidence in western China.BMC public health · 2024Article
- The effects of meteorological factors and air pollutants on the incidence of tuberculosis in people living with HIV/AIDS in subtropical Guangxi, China.BMC public health · 2024Article
- Community-based active-case finding for tuberculosis: navigating a complex minefield.BMC global and public health · 2024Review
- Machine Learning Prediction Model of Tuberculosis Incidence Based on Meteorological Factors and Air Pollutants.International journal of environmental research and public health · 2023Article
- Application of ARIMA, and hybrid ARIMA Models in predicting and forecasting tuberculosis incidences among children in Homa Bay and Turkana Counties, Kenya.PLOS digital health · 2023Article
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Authors and funding
10 authors at 5 institutions in 3 countries.
Funding
Abstract
Seasonal trends in tuberculosis (TB) notifications have been observed in several countries but are poorly understood. Explanatory factors may include weather, indoor crowding, seasonal respiratory infections and migration. Using enhanced citywide TB surveillance data collected over nine years in Blantyre, Malawi, we set out to investigate how weather and seasonality affect temporal trends in TB case notification rates (CNRs) across different demographic groups. We used data from prospective enhanced surveillance between April 2011 and December 2018, which systematically collected age, HIV status, sex and case notification dates for all registering TB cases in Blantyre. We retrieved temperature and rainfall data from the Global Surface Summary of the Day weather station database. We calculated weekly trends in TB CNRs, rainfall and temperature, and calculated 10-week moving averages. To investigate the associations between rainfall, temperature and TB CNRs, we fitted generalized linear models using a distributed lag nonlinear framework. The estimated Blantyre population increased from 1,068,151 in April 2011 to 1,264,304 in December 2018, with 15,908 TB cases recorded. Overall annual TB CNRs declined from 222 to 145 per 100,000 between 2012 and 2018, with the largest declines seen in HIV-positive people and adults aged over 20 years old. TB CNRs peaks occurred with increasing temperature in September and October before the onset of increased rainfall, and later in the rainy season during January-March, after sustained rainfall. When lag between a change in weather and TB case notifications was accounted for, higher average rainfall was associated with an equivalent six weeks of relatively lower TB notification rates, whereas there were no changes in TB CNR associated with change in average temperatures. TB CNRs in Blantyre have a seasonal pattern of two cyclical peaks per year, coinciding with the start and end of the rainy season. These trends may be explained by increased transmission at certain times of the year, by limited healthcare access, by patterns of seasonal respiratory infections precipitating cough and care-seeking, or by migratory patterns related to planting and harvesting during the rainy season.
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