{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T22:31:10Z","timestamp":1785364270371,"version":"3.55.0"},"reference-count":62,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T00:00:00Z","timestamp":1748304000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100021638","name":"Social Sciences and Humanities Research Council","doi-asserted-by":"publisher","award":["895-2018-1011"],"award-info":[{"award-number":["895-2018-1011"]}],"id":[{"id":"10.13039\/100021638","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>Malaria remains a public health crisis in Tanzania, with persistent morbidities and mortalities. Malaria etiology is multifactorial, with environmental factors playing a vital role in mosquito development and malaria transmission. In Tanzania and most of Sub-Saharan Africa, the <jats:italic>Plasmodium falciparum<\/jats:italic> parasite remains the most prevalent and virulent malaria parasite. Using data from the Tanzania Demographic and Health Surveys and spatio-temporal analysis, we explore the environmental determinants of <jats:italic>P. falciparum<\/jats:italic> across different regions in Tanzania over the last 2 decades. The hotspots analysis showed that the Kigoma and Kagera regions in the north-west of Tanzania as well as the Lindi and Mtwara regions in southern Tanzania were consistently hotspots of <jats:italic>P. falciparum<\/jats:italic> malaria from 2000 to 2020. Our findings also reveal and reinforce the role of environmental factors in mediating malaria epidemiology in Tanzania. Factors such as the use of insecticide-treated nets, population, evapotranspiration and aridity were often adversely associated with <jats:italic>P. falciparum<\/jats:italic> incidence. In contrast, vegetative landcover, temperature, precipitation, and the number of wet days were directly associated with <jats:italic>P. falciparum<\/jats:italic> in Tanzania. However, the relationship between these environmental factors and malaria prevalence varied temporally and spatially. Our findings further showed that, the two most important environmental factors that mediate <jats:italic>P falciparum<\/jats:italic> incidence in Tanzania over the last two decades were precipitation and aridity. Other vital predictors included the use of insecticide nets and the number of wet days. The findings provide policy pointers for targeted malaria interventions in Tanzania in the context of environmental change.<\/jats:p>","DOI":"10.1371\/journal.pone.0321200","type":"journal-article","created":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T17:46:43Z","timestamp":1748368003000},"page":"e0321200","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Where environment and malaria intersect: Exploring the spatio-temporal footprints of Plasmodium falciparum in Tanzania"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0231-3142","authenticated-orcid":true,"given":"Kamaldeen","family":"Mohammed","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satveer","family":"Dhillon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4528-3086","authenticated-orcid":true,"given":"Cornelius K.A.","family":"Pienaah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isaac","family":"Luginaah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva-Maria","family":"Knoll","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gwyn","family":"Campbell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herbert","family":"Hambati","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,5,27]]},"reference":[{"key":"pone.0321200.ref001","first-page":"104366","article-title":"Increasing challenges of malaria control in sub-Saharan Africa: priorities for public health research and policymakers","volume":"81","author":"HJ Oladipo","year":"2022","journal-title":"Ann Med Surg (Lond)"},{"issue":"1","key":"pone.0321200.ref002","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1186\/s12936-021-03872-2","article-title":"Public health-relevant consequences of the COVID-19 pandemic on malaria in sub-Saharan Africa: a scoping review","volume":"20","author":"A-K Heuschen","year":"2021","journal-title":"Malar J"},{"key":"pone.0321200.ref003","doi-asserted-by":"crossref","DOI":"10.30875\/60123dd4-en","article-title":"Global trends in the burden of malaria","volume-title":"World Malaria Report 2020","author":"World Health Organization","year":"2020"},{"key":"pone.0321200.ref004","author":"World Health Organization","year":"2024"},{"issue":"1","key":"pone.0321200.ref005","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1186\/s12936-023-04738-5","article-title":"Community knowledge, attitude, practices and beliefs associated with persistence of malaria transmission in North-western and Southern regions of Tanzania","volume":"22","author":"EA Liheluka","year":"2023","journal-title":"Malar J"},{"key":"pone.0321200.ref006","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1186\/1475-2875-10-145","article-title":"Spatial variation and socio-economic determinants of Plasmodium falciparum infection in northeastern Tanzania","volume":"10","author":"BP Mmbando","year":"2011","journal-title":"Malar J"},{"key":"pone.0321200.ref007","author":"World Health Organization","year":"2023"},{"key":"pone.0321200.ref008","doi-asserted-by":"crossref","first-page":"112","DOI":"10.4269\/ajtmh.2007.77.112","article-title":"Uncertainty in malaria control in Tanzania: crossroads and challenges for future interventions","volume":"77","author":"LEG Mboera","year":"2007","journal-title":"Am J Trop Med Hyg"},{"key":"pone.0321200.ref009","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1186\/s12936-015-0905-y","article-title":"Spatial and space-time clustering of mortality due to malaria in rural Tanzania: evidence from Ifakara and Rufiji Health and Demographic Surveillance System sites","volume":"14","author":"M Selemani","year":"2015","journal-title":"Malar J"},{"issue":"1","key":"pone.0321200.ref010","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1186\/s12936-019-2960-2","article-title":"Strengthening surveillance systems for malaria elimination: a global landscaping of system performance, 2015-2017","volume":"18","author":"C Louren\u00e7o","year":"2019","journal-title":"Malar J"},{"issue":"4","key":"pone.0321200.ref011","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1007\/s10393-010-0343-9","article-title":"Environmental management for malaria control: knowledge and practices in Mvomero, Tanzania","volume":"7","author":"HF Randell","year":"2010","journal-title":"Ecohealth"},{"issue":"1","key":"pone.0321200.ref012","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1186\/s12936-022-04107-8","article-title":"Evaluating malaria prevalence and land cover across varying transmission intensity in Tanzania using a cross-sectional survey of school-aged children","volume":"21","author":"CL Mitchell","year":"2022","journal-title":"Malar J"},{"key":"pone.0321200.ref013","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1186\/1475-2875-5-98","article-title":"Spatial and temporal variation in malaria transmission in a low endemicity area in northern Tanzania","volume":"5","author":"MJAM Oesterholt","year":"2006","journal-title":"Malar J"},{"issue":"2","key":"pone.0321200.ref014","doi-asserted-by":"crossref","DOI":"10.1029\/2022GH000698","article-title":"Climate drivers of malaria transmission seasonality and their relative importance in Sub-Saharan Africa","volume":"7","author":"EI Yamba","year":"2023","journal-title":"Geohealth"},{"key":"pone.0321200.ref015","article-title":"Malaria species prevalence among asymptomatic individuals in four regions of Mainland Tanzania","author":"ZR Popkin Hall","year":"2023","journal-title":"medRxiv"},{"key":"pone.0321200.ref016","doi-asserted-by":"crossref","first-page":"100537","DOI":"10.1016\/j.sste.2022.100537","article-title":"Spatial analysis of climatic factors and plasmodium falciparum malaria prevalence among children in Ghana","volume":"43","author":"K Mohammed","year":"2022","journal-title":"Spat Spatiotemporal Epidemiol"},{"key":"pone.0321200.ref017","volume-title":"Plasmodium falciparum Malaria. StatPearls.","author":"L Zekar","year":"2024"},{"key":"pone.0321200.ref018","first-page":"1240962","article-title":"Severe malaria associated with Plasmodium falciparum and P. vivax among children in Pawe Hospital, Northwest Ethiopia","volume":"2016","author":"G Geleta","year":"2016","journal-title":"Malar Res Treat"},{"issue":"1","key":"pone.0321200.ref019","doi-asserted-by":"crossref","first-page":"14392","DOI":"10.1038\/s41598-022-18782-9","article-title":"Relationships between transmission of malaria in Africa and climate factors","volume":"12","author":"BJ Mafwele","year":"2022","journal-title":"Sci Rep"},{"issue":"1","key":"pone.0321200.ref020","doi-asserted-by":"crossref","first-page":"7367","DOI":"10.1038\/s41598-023-33868-8","article-title":"Malaria, climate variability, and interventions: modelling transmission dynamics","volume":"13","author":"A Beloconi","year":"2023","journal-title":"Sci Rep"},{"key":"pone.0321200.ref021","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1186\/1475-2875-6-162","article-title":"Climate prediction of El Ni\u00f1o malaria epidemics in north-west Tanzania","volume":"6","author":"AE Jones","year":"2007","journal-title":"Malar J"},{"issue":"4","key":"pone.0321200.ref022","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1016\/j.agrformet.2010.12.002","article-title":"Climate variability and crop production in Tanzania","volume":"151","author":"P Rowhani","year":"2011","journal-title":"Agric For Meteorol"},{"key":"pone.0321200.ref023","author":"World Health Organization","year":"2024"},{"issue":"4","key":"pone.0321200.ref024","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1038\/s41579-021-00639-z","article-title":"Infectious disease in an era of global change","volume":"20","author":"RE Baker","year":"2022","journal-title":"Nat Rev Microbiol"},{"issue":"2","key":"pone.0321200.ref025","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1097\/JS9.0000000000000160","article-title":"Impacts of environmental and climatic changes on future infectious diseases","volume":"109","author":"O Uwishema","year":"2023","journal-title":"Int J Surg"},{"issue":"2","key":"pone.0321200.ref026","first-page":"55","article-title":"Impact of climate change on emerging infectious diseases: Implications for Canada","volume":"4","author":"A Carignan","year":"2019","journal-title":"J Assoc Med Microbiol Infect Dis Can"},{"key":"pone.0321200.ref027","first-page":"123","article-title":"Urbanization and infectious diseases: general principles, historical perspectives, and contemporary challenges.","author":"R Reyes","year":"2012","journal-title":"Chall Infect Dis"},{"issue":"8","key":"pone.0321200.ref028","doi-asserted-by":"crossref","first-page":"1216","DOI":"10.1289\/ehp.9806","article-title":"Environmental determinants of infectious disease: a framework for tracking causal links and guiding public health research","volume":"115","author":"JNS Eisenberg","year":"2007","journal-title":"Environ Health Perspect"},{"issue":"9","key":"pone.0321200.ref029","doi-asserted-by":"crossref","first-page":"869","DOI":"10.1038\/s41558-022-01426-1","article-title":"Over half of known human pathogenic diseases can be aggravated by climate change","volume":"12","author":"C Mora","year":"2022","journal-title":"Nat Clim Chang"},{"key":"pone.0321200.ref030","author":"UNICEF","year":"2022"},{"key":"pone.0321200.ref031","author":"Ministry of Foreign Affairs and East African Cooperation","year":"2024"},{"key":"pone.0321200.ref032","author":"World Bank Group","year":"2021"},{"key":"pone.0321200.ref033","volume-title":"]","author":"ICID","year":"2010"},{"key":"pone.0321200.ref034","first-page":"8","volume-title":"Tanzania\u2019s vulnerability to climate change impacts","author":"R Chevallier","year":"2019"},{"issue":"12","key":"pone.0321200.ref035","doi-asserted-by":"crossref","first-page":"4736","DOI":"10.1002\/joc.6103","article-title":"Inter\u2010annual hydroclimatic variability in coastal Tanzania","volume":"39","author":"RV Rohli","year":"2019","journal-title":"Intl J Climatol"},{"issue":"7","key":"pone.0321200.ref036","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1016\/j.envsci.2008.06.002","article-title":"Livelihoods, vulnerability and adaptation to climate change in Morogoro, Tanzania","volume":"11","author":"J Paavola","year":"2008","journal-title":"Environ Sci Policy"},{"key":"pone.0321200.ref037","volume-title":"The DHS program geospatial covariate datasets manual third edition the DHS program, icf 2","author":"B Mayala","year":"2022"},{"key":"pone.0321200.ref038","volume-title":"Geographic displacement procedure and georeferenced data release policy for the Demographic and Health Surveys","author":"CR Burgert","year":"2013"},{"issue":"2","key":"pone.0321200.ref039","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1080\/20964471.2019.1625151","article-title":"Global spatio-temporally harmonised datasets for producing high-resolution gridded population distribution datasets","volume":"3","author":"CT Lloyd","year":"2019","journal-title":"Big Earth Data"},{"issue":"1","key":"pone.0321200.ref040","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1038\/s41597-020-0453-3","article-title":"Version 4 of the CRU TS monthly high-resolution gridded multivariate climate dataset","volume":"7","author":"I Harris","year":"2020","journal-title":"Sci Data"},{"issue":"3","key":"pone.0321200.ref041","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1111\/j.1538-4632.1992.tb00261.x","article-title":"The analysis of spatial association by use of distance statistics","volume":"24","author":"A Getis","year":"1992","journal-title":"Geogr Anal"},{"issue":"3","key":"pone.0321200.ref042","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1080\/00031305.1989.10475644","article-title":"The Equality of the ordinary least squares estimator and the best linear unbiased estimator","volume":"43","author":"S Puntanen","year":"1989","journal-title":"Am Stat"},{"issue":"1","key":"pone.0321200.ref043","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/s12942-020-00204-6","article-title":"Targeting the spatial context of obesity determinants via multiscale geographically weighted regression","volume":"19","author":"TM Oshan","year":"2020","journal-title":"Int J Health Geogr"},{"issue":"4","key":"pone.0321200.ref044","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1111\/j.1538-4632.1996.tb00936.x","article-title":"Geographically weighted regression: a method for exploring spatial nonstationarity","volume":"28","author":"C Brunsdon","year":"1996","journal-title":"Geogr Anal"},{"issue":"6","key":"pone.0321200.ref045","first-page":"1247","article-title":"Multiscale geographically weighted regression (MGWR)","volume":"107","author":"AS Fotheringham","year":"2017","journal-title":"Ann Am Assoc Geogr"},{"key":"pone.0321200.ref046","author":"W Yang","year":"2014"},{"issue":"6","key":"pone.0321200.ref047","article-title":"Malaria risk factors in North West Tanzania: the effect of spraying, nets and wealth","volume":"8","author":"PA West","year":"2013","journal-title":"PLoS One"},{"issue":"1","key":"pone.0321200.ref048","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1186\/s12936-020-03369-4","article-title":"Risk factors for malaria infection prevalence and household vector density between mass distribution campaigns of long-lasting insecticidal nets in North-western Tanzania","volume":"19","author":"JF Mosha","year":"2020","journal-title":"Malar J"},{"issue":"9085","key":"pone.0321200.ref049","doi-asserted-by":"crossref","first-page":"1180","DOI":"10.1016\/S0140-6736(05)63830-5","article-title":"Malaria catastrophe in east Africa","volume":"350","author":"A Carlstedt","year":"1997","journal-title":"Lancet"},{"issue":"1","key":"pone.0321200.ref050","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1186\/s12936-021-03950-5","article-title":"An urban-to-rural continuum of malaria risk: new analytic approaches characterize patterns in Malawi","volume":"20","author":"PS Larson","year":"2021","journal-title":"Malar J"},{"key":"pone.0321200.ref051","first-page":"37","article-title":"Retrospective analysis of malaria cases in a potentially high endemic area of Morogoro Rural District, Eastern Tanzania","volume":"11","author":"JN Aikambe","year":"2020","journal-title":"Res Rep Trop Med"},{"key":"pone.0321200.ref052","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1186\/s12936-015-0977-8","article-title":"High-level Plasmodium falciparum sulfadoxine-pyrimethamine resistance with the concomitant occurrence of septuple haplotype in Tanzania","volume":"14","author":"V Baraka","year":"2015","journal-title":"Malar J"},{"issue":"1","key":"pone.0321200.ref053","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1186\/s12936-020-03513-0","article-title":"Evaluation of a single screen and treat strategy to detect asymptomatic malaria among pregnant women from selected health facilities in Lindi region, Tanzania","volume":"19","author":"C Kitojo","year":"2020","journal-title":"Malar J"},{"issue":"1","key":"pone.0321200.ref054","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1186\/s12936-018-2601-1","article-title":"Nationwide school malaria parasitaemia survey in public primary schools, the United Republic of Tanzania","volume":"17","author":"F Chacky","year":"2018","journal-title":"Malar J"},{"key":"pone.0321200.ref055","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1186\/1475-2875-6-162","article-title":"Climate prediction of El Ni\u00f1o malaria epidemics in north-west Tanzania","volume":"6","author":"AE Jones","year":"2007","journal-title":"Malar J"},{"key":"pone.0321200.ref056","doi-asserted-by":"crossref","first-page":"32","DOI":"10.4269\/ajtmh.16-0696","article-title":"Using rainfall and temperature data in the evaluation of national malaria control programs in Africa","volume":"97","author":"MC Thomson","year":"2017","journal-title":"Am J Trop Med Hyg"},{"key":"pone.0321200.ref057","author":"WHO","year":"2020"},{"issue":"2","key":"pone.0321200.ref058","first-page":"84","article-title":"Insecticide-treated nets for malaria control: real gains","volume":"82","author":"C Lengeler","year":"2004","journal-title":"Bull World Health Organ"},{"issue":"1","key":"pone.0321200.ref059","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1111\/ele.12015","article-title":"Optimal temperature for malaria transmission is dramatically lower than previously predicted","volume":"16","author":"EA Mordecai","year":"2013","journal-title":"Ecol Lett"},{"key":"pone.0321200.ref060","doi-asserted-by":"crossref","first-page":"148606","DOI":"10.1016\/j.scitotenv.2021.148606","article-title":"Keep your natural enemies close - native predators can maintain low mosquito densities in temporary ponds in a malaria expansion area in Northern Tanzania","volume":"794","author":"GR Mataba","year":"2021","journal-title":"Sci Total Environ"},{"key":"pone.0321200.ref061","first-page":"1","volume-title":"The SAGE Handbook of Spatial Analysis","author":"PA Rogerson","year":"2008"},{"issue":"1","key":"pone.0321200.ref062","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1068\/a160017","article-title":"Ecological fallacies and the analysis of areal census data","volume":"16","author":"S Openshaw","year":"1984","journal-title":"Environ Plan A"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0321200","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T17:46:57Z","timestamp":1748368017000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0321200"}},"subtitle":[],"editor":[{"given":"David Zadock","family":"Munisi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,5,27]]},"references-count":62,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,5,27]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0321200","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,27]]}}}