Ecological Predictors of Human Malaria Risk During Different Phases of the Elimination: An Analysis of Historical Data.

To understand the evolutionary ecology of disease dynamics, it is crucial to identify the environmental factors that mediate the spread and abundance of parasites and their vectors. However, human-mediated changes in the biotic and abiotic environment and intervention programs are intensifying in the past 30-40 years at a rate that masks the causal effect of the original ecological predictors. In this study, we used archived epidemiological data spanning over 100 years on malaria risk in Hungary to demonstrate that different associations exist between infection risk and environmental predictors during different phases of the elimination program. In the early 20th century, when malaria was quite common in the country and no defense program was operating, as predicted, there was a positive relationship between the area of flooded habitats and the intensity of malaria infection. In contrast, this relationship was absent during middle of the century, when an effective elimination program was already in effect. Furthermore, malaria morbidity in a given year was predicted by the degree of stagnant water cover of the previous year when considering the period before the launch of a drastic mosquito control program by dichloro-diphenyl-trichloroethane (DDT), whereas such relationship could not be revealed for a latter period. Our results highlight that human-induced alterations of the socioecological environment considerably reorganizes the ecological landscape of pathogens and their vectors.