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  1. Fulltext The effect of vaccination coverage and climate on Japanese encephalitis in Sarawak, Malaysia
    Impoinvil DE, Ooi MH, Diggle PJ, Caminade C, Cardosa MJ, Morse AP, et al.
    PLoS Negl Trop Dis, 2013;7(8):e2334.
    PMID: 23951373 DOI: 10.1371/journal.pntd.0002334
    BACKGROUND: Japanese encephalitis (JE) is the leading cause of viral encephalitis across Asia with approximately 70,000 cases a year and 10,000 to 15,000 deaths. Because JE incidence varies widely over time, partly due to inter-annual climate variability effects on mosquito vector abundance, it becomes more complex to assess the effects of a vaccination programme since more or less climatically favourable years could also contribute to a change in incidence post-vaccination. Therefore, the objective of this study was to quantify vaccination effect on confirmed Japanese encephalitis (JE) cases in Sarawak, Malaysia after controlling for climate variability to better understand temporal dynamics of JE virus transmission and control.

    METHODOLOGY/PRINCIPAL FINDINGS: Monthly data on serologically confirmed JE cases were acquired from Sibu Hospital in Sarawak from 1997 to 2006. JE vaccine coverage (non-vaccine years vs. vaccine years) and meteorological predictor variables, including temperature, rainfall and the Southern Oscillation index (SOI) were tested for their association with JE cases using Poisson time series analysis and controlling for seasonality and long-term trend. Over the 10-years surveillance period, 133 confirmed JE cases were identified. There was an estimated 61% reduction in JE risk after the introduction of vaccination, when no account is taken of the effects of climate. This reduction is only approximately 45% when the effects of inter-annual variability in climate are controlled for in the model. The Poisson model indicated that rainfall (lag 1-month), minimum temperature (lag 6-months) and SOI (lag 6-months) were positively associated with JE cases.

    CONCLUSIONS/SIGNIFICANCE: This study provides the first improved estimate of JE reduction through vaccination by taking account of climate inter-annual variability. Our analysis confirms that vaccination has substantially reduced JE risk in Sarawak but this benefit may be overestimated if climate effects are ignored.

  2. Navigating global health futures under the Shared Socioeconomic Pathways
    Green C, Andrijevic M, Hess JJ, Pachauri S, Sellers S, van Ruijven B, et al.
    Lancet Planet Health, 2026 Sep;10(9):101514.
    PMID: 42833239 DOI: 10.1016/j.lanplh.2026.101514
    The Shared Socioeconomic Pathways (SSPs) provide valuable insights to understand how future socioeconomic changes could alter the magnitude and pattern of climate-related risks across sectors, which might facilitate or hinder adaptation and mitigation responses. Many sectors have created SSP narrative extensions to specify insights for their domains. In this Viewpoint, we created health narrative extensions for the SSPs, considering socioeconomic and demographic drivers and population health and health-system drivers. The projected health-relevant trajectories diverge substantially over the course of the 21st century. The SSP3 and SSP4 narratives detail changes that could contribute considerable risks to health, whereas the SSP1 and SSP5 narratives highlight the role of effective governance and adequate resourcing in reducing climate-sensitive population health outcomes and health-system drivers. Given that climate forcing is considered exogenous to these narrative extensions, SSP5's favourable health driver paths do not account for the potential adverse impacts of this high-emissions pathway. The narratives elaborate population health drivers that can improve the policy relevance of population health and health-system risk projections associated with climate change across a range of possible pathways, and link these drivers with relevant cross-sectoral issues (eg, water and energy). Further research is required to quantify key drivers of population health and health-system risks at global to local scales.
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