1. Participants: Ulisses E.C. Confalonieri, MD; DVM; DSc (Principal Investigator) Mércia E. Arruda, DSc (Co-PI) Brazil

2. Activities: Research Activities: Field data collection and organization. Analysis of correlation between ENSO parameters and malaria index in northern Amazon. Preliminary analysis of malaria incidence as related to precipitation and land cover variation in a municipality in the Amazon. Brazil

3. Field Records of Malaria from Pará Brazil

4. Findings and Achievements: Characterization of a natural decrease in malaria incidence during ENSO years in northern Amazonia, Brazil. Organization of a large data set on meteorological data (precipitation) and epidemiological data on tropical diseases, especially malaria and dengue fever. Brazil

5. Students Involved: Roberta Costa Dias (Doctoral Program in Public Health, FIOCRUZ, Brazil). Helen da Costa Gurgel (Doctoral Program in Geography, University of Paris X, France). Mariana G. Camponovo (Doctoral Program in Public Health, FIOCRUZ, Brazil). Aline Nobre (MSc. Program on Biostatistics, Federal University of Rio de Janeiro, Brazil). Daniele Nogueira (Undergraduate in Meteorology, Federal University of Pará, Brazil). Brazil

6. IPA for Malaria and SOI in Roraima 1980-1985 IPA for Malaria and SOI in Roraima 1980-1985 Brazil

7. Cases of Malaria in the State of Roraima Northern Brazil (1995–1996–1997) Brazil

8. Landsat Image for Castanhal, Pará Brazil

9. Land Cover Classification for Castanhal, Pará Brazil

10. Vegetation Cover in Roraima Source: IBGE, 1998. Brazil

11. (a) Averaged NDVI from AVHRR/NOAA (1982-2000) Source: EMBRAPA Monitoramento por Satélite. (b) Mosaic of Images Brazil

12. Monthly NDVI for Roraima (1982-2000) Brazil

13. Cases of Malaria and Monthly Precipitation in Roraima Source: FUNASA E ANEEL. Brazil

14. Adjustments (Objectives/Workplan): Reduction in the duration of the entomological field work due to a budget cut. Expansion of data collection (malaria/precipitation) and analysis to another Amazonian state in Brazil, due to poor data quality and poor institutional support. Brazil

15. Contributions: Demonstration of a linkage between a tropical infectious disease (malaria) and the ENSO phenomenon, in a specific area, as a subsidy to the development of a climate-health early warning system. Development of a conceptual model on the social vulnerability of the population to the health impacts of climate variability in tropical America. Assemblage, in digital format, of large time series of malaria data (up to 40 years), on a monthly basis, that otherwise would be lost. Brazil

16. Publications: CONFALONIERI, U.E.C., 2003. Climate Variability, Social Vulnerability and Human Health in Brazil. Proc. V Brazilian Congress on Geographic Climatology (in press). COSTA-DIAS, R.; CONFALONIERI, U.E.C.; HARTMAN, J., 2003. The influence of precipitation on the incidence of malaria in the State of Roraima, Northern Amazonia, Brazil. Submitted to the XXXIX Brazilian Congress of Tropical Medicine, Belém, Pará (16-21, March, 2003). NOBRE, A.A.; LOPES, H.F., 2002. Spatial analysis of the relationships between malaria and rainfall in the State of Pará. First National Symp. Probability and Statistics, A. Lindóia, Brazil, July 2002. Brazil

17. Related Activities: Co-chair of the scoping meeting on “Global Environmental Change and Health”, organized by DIVERSITAS/IGBP/IHDP/WCRP (Paris, February 2003). Organizer of the first Interamerican Workshop on “Applications of Remote Sensing Technologies to the Control of Infectious Diseases”, sponsored by the U.S. Department of State (Rio de Janeiro, November 2003). Coordinating Lead Author of the chapter on “Human Infectious Diseases”, Conditions and Trends Working Group of the MILLENNIUM ECOSYSTEM ASSESSMENT (UNEP/FAO/WHO). Brazil