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Review

Effects of Climate Change on Malaria Risk to Human Health: A Review

by
Dereba Muleta Megersa
1,2 and
Xiao-San Luo
1,*
1
International Center for Ecology, Meteorology, and Environment, School of Ecology and Applied Meteorology, Jiangsu Key Laboratory of Agriculture Meteorology, Nanjing University of Information Science & Technology, Nanjing 210044, China
2
Ethiopia Meteorological Institute, Addis Ababa P.O. Box 1090, Ethiopia
*
Author to whom correspondence should be addressed.
Atmosphere 2025, 16(1), 71; https://doi.org/10.3390/atmos16010071
Submission received: 27 November 2024 / Revised: 5 January 2025 / Accepted: 7 January 2025 / Published: 9 January 2025
(This article belongs to the Special Issue Climate Change, Air Pollution and Human Health: Past, Present and Future)
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Abstract

:
Malaria, a severe vector-borne disease, affects billions of people globally and claims over half a million lives annually. Climate change can impact lifespan and the development of vectors. There is a gap in organized, multidisciplined research on climate change’s impact on malaria incidence and transmission. This review assesses and summarizes research on the effects of change in climate on human health, specifically on malaria. Results suggest that higher temperatures accelerate larval development, promote reproduction, enhance blood feed frequency, increase digestion, shorten vector life cycles, and lower mortality rates. Rainfall provides aquatic stages, extends mosquitoes’ lifespans, and increases cases. Mosquito activity increases with high humidity, which facilitates malaria transmission. Flooding can lead to increased inhabitation development, vector population growth, and habitat diversion, increasing breeding sites and the number of cases. Droughts can increase vector range by creating new breeding grounds. Strong storms wash Anopheles’ eggs and reproduction habitat. It limits reproduction and affects disease outbreaks. The Indian Ocean Dipole (IOD) and El Nino Southern Oscillation (ENSO) indirectly alter malaria transmission. The study recommends strengthening collaboration between policymakers, researchers, and stakeholders to reduce malaria risks. It also suggests strengthening control mechanisms and improved early warnings.

Graphical Abstract

1. Introduction

A long-term statistical variation in weather patterns is recognized as climate change [1,2], which results from rising greenhouse gas concentrations by natural and human activity [3,4,5]. Extreme weather phenomena like heatwaves, flooding, torrential rains, droughts, sea level rises, wildfires, and windstorms can result from changes in climate [6,7]. It led to significant consequences, including food and water insecurity and catastrophic droughts potentially affecting about one-fifth of the earth’s land surface [8,9]. The health and lives of people are greatly impacted by extreme weather and related hazards [10]. Many studies have shown that change in climate conditions harms human health, including an increase in vector-borne illnesses, respiratory conditions, heat-related morbidity and mortality, food insecurity-related malnutrition, mental health issues, and negative health consequences from increased sociopolitical tension and conflicts [11]. Climate change impacts regional livelihoods, food security, and migration, making populations more vulnerable and reducing control measures [12]. Increased temperatures hasten the life cycle of mosquitoes and malaria parasites, resulting in more frequent and severe epidemics [13].
According to an Intergovernmental Panel on Climate Change (IPCC) assessment, vector-borne disease prevalence has risen in recent years. In the future, it is anticipated that cases of Lyme disease, dengue fever, malaria, and West Nile virus infection will increase. Therefore, it is crucial to enhance adaptive and control strategies that are stronger to effectively combat these diseases [13,14]. Despite having an uneven and disproportionate effect on different levels of communities, the health effects of climate change are becoming worse and are being seen on every continent [14,15].
Humans and female Anopheles mosquitoes are the two hosts in the complicated life cycle of the malaria parasite [16]. When an infected mosquito bites a human, sporozoites are injected into the circulation, starting the cycle. After reaching the liver, these sporozoites develop into schizonts and discharge merozoites into the blood. When red blood cells rupture, merozoites enter, reproduce, and produce the hallmark signs of malaria. Certain merozoites mature into sexual forms known as gametocytes, which mosquitoes consume when they feed on blood. Gametocytes develop into gametes in the mosquito’s gut, unite to make zygotes, and then become motile ookinetes that embed in the gut wall to form oocysts. Sporozoites released by these oocysts travel to the salivary glands of the mosquito and get ready to infect the next human host, completing the cycle [17].
The deadliest and most studied vector-borne disease that is vulnerable to climate change is malaria [18]. It is caused by five species of plasmodium, including Plasmodium falciparum (P. falciparum), Plasmodium vivax (P. vivax), Plasmodium malariae (P. malariae), Plasmodium ovale (P. ovale), and Plasmodium knowlesi (P. knowlesi) [19,20]. These species spread to humans by female Anopheles mosquitoes. Malaria outbreaks can be affected by climate, urbanization, globalization, population migration, deforestation, and human hosts [21]. In addition, factors like soil use, population expansion, and economic development can affect the distribution of malaria [22,23].
Malaria causes over half a million deaths worldwide per year [24]. Most malaria-related deaths happen in Africa among pregnant women and small children [25]. It reacts swiftly to variations in climate variables [14,26]. It also affects a country’s prosperity and well-being [27,28]. It is a significant concern due to its enormous burden and the emergence of novel diseases [29,30]. There were 241 million cases of endemic malaria in 85 countries in 2020, up from 227 million in 2019. Only five nations account for more than 50% of malaria cases, with the African Region reporting 96% of cases from 29 countries [31]. Hence, we are cautioned that the effect of climate change on malaria occurrence and transmission will continue to worsen, and an immediate international response is needed to limit climate change.
Despite the rise in studies on climate change’s impact on malaria, there is a lack of comprehensive, harmonized, multidisciplined research. Previous reviews have limited our understanding of the various global health impacts by focusing on general health impacts and restricting it to specific countries or times. This study aims to assess, evaluate, and summarize the research on the impact of climate change on human health and malaria, identifying research gaps and guiding future research to minimize health risks. The study hypothesizes that malaria transmission dynamics and distribution are greatly impacted by climate change, which results in a higher prevalence and a different geographic distribution of the disease. The findings provide valuable references to the scientific community and body of knowledge on climate change’s effect on malaria disease. It suggests adaptation and mitigation strategies to reduce malaria risks. This paper focuses on research conducted between 2013 and 2023 regarding climate change’s impacts on malaria.

2. Climate Change Effects on Human Health

Climate change affects human health directly or through indirect pathways affecting ecosystems, biodiversity, and society. It leads to undernutrition, hazardous algal blooms, mental health problems, cardiovascular and respiratory disorders, and vector-borne diseases. Scientific studies highlight the rising burden of climate-sensitive diseases and demonstrate the relationship between climate change and health. Poverty, clean air, and food supplies are socioeconomic and environmental aspects that are impacted by climate change. Although it is still difficult to determine the degree and nature of this phenomenon [29], climate change threatens all types of life on earth [32]. The global burden of sickness and early mortality will rise as the consequences worsen, especially for countries with limited resources [33].
The extent and nature of climate change’s effects on health are difficult to ascertain because they vary depending on location and are most severe in developing countries in Africa. Population changes have been induced by extreme weather, and no area is immune to the consequences of climate change. Figure 1 shows how global warming; climate change; changes in temperature, rainfall, and relative humidity conditions; related extreme weather conditions; and non-climate factors affect human health directly and indirectly. Global health is under serious concern from climate change, including its direct and indirect impacts on illness, food and water scarcity, vulnerable housing, extreme weather events, population increases, and migration [34]. All forms of life on earth are threatened by the changing global climate. Science has incorporated climate change into the public discourse and highlighted its natural causes, including anthropogenic ones, which are the primary contributors to the current environmental disaster.

3. Climate Change Effects on Malaria

Climate change significantly impacts vector development, dispersion, abundance, survival, and reproduction rates [35]. It also affects the transmission of vector-borne diseases, such as malaria, by affecting the vector’s growth, population, and biting rates [13,36,37]. Vector-borne disease development and its transmission may be affected by changes in the geographic distribution of the vectors [38]. Climate change can lead to geographic range and malaria distribution shifts and changes in development; affect malaria survival, reproduction, and biting rates; and increase infectivity [39]. Global warming and geo-climatic changes can affect the dynamics of hosts, with extreme events like strong winds increasing vector spread and decreasing biting rates [40]. The impact of the environment and climate change is also predicted to enhance in the future. Research in Portugal and the United Kingdom predicts increased local transmission rates by 2050 [11,35]. Spatial, seasonal, and long-term trends of climate variables are the strongest predictors of malaria incidence in districts [41]. Environmental factors have a significant, smoothed relationship with malaria. Monthly malaria case incidence varies with altitude, and monthly total rainfall positively affects malaria risk [42].
Climate change can impact the biology of mosquitoes, as changes in climate variables can hasten insect growth, raise metabolic rates, and affect mosquito survival and activity. It can also increase breeding grounds and population density. The development of malaria parasites within mosquitoes is extremely temperature-dependent [43]. Regions with increasing temperatures and humidity become more vulnerable to malaria due to the lack of acquired immunity in the population. Climate change complicates malaria control efforts by altering mosquito behavior and distribution patterns [44].
Climate change can also impact human behavior. This includes increased outdoor activity, shifts in daily routines, and increased agricultural activities [45]. Warmer temperatures and extended growing seasons may lead to increased outdoor activities and exposure to mosquitoes [46]. People may dress in lighter, shorter clothing depending on temperature conditions, which can increase skin exposure and the risk of mosquito bites. In other words, in extreme hot conditions, people may wear long clothing to protect against the sun, reducing the risk of bites [47,48]. Climate-induced migration can also occur, as extreme weather events and environmental conditions can force people to migrate to areas with higher malaria prevalence or introduce malaria to new regions. Changes in water management activities, including the use of irrigation, can create breeding grounds. In addition, changes in climate conditions can affect non-climate factors that can also contribute to malaria development and transmission. Table S1 summarizes climate factors and non-climatic factor effects on malaria, while Table S2 outlines the conditions, impacts, associated regions, and references related to projected effects of climate change on malaria.

3.1. Effect of Temperature on Malaria

Temperature can significantly affect malaria transmission dynamics. Higher temperatures favor malaria expansion by quickening mosquito larvae development and enhancing reproduction, increasing activity and frequency of blood feeds, and faster digestion [49]. Warm temperatures can lead to high malaria transmission during wet years. An increase in daytime surface temperature to more than optimum temperature results in a decrease in the malaria incidence ratio (PR) [50]. Increased air temperature shortens the life cycle of the Anopheles vector. Increased temperatures at time lags of 0 and 1 month result in an increase in malaria cases in riverine and highland zones [51]. Warmer ambient temperatures have been found to increase malaria incidence in densely populated highlands [38]. Rising temperatures boost the mosquito’s life cycle, lowering mortality rates. Warmer temperatures encourage ovulation and shorten the time that vector eggs take to incubate [38]. According to studies, the extrinsic incubation period of plasmodium often shortens as the temperature rises, suggesting higher infection and transmission rates [52].
The ideal temperature range for the breeding and reproduction of malarial mosquitoes is 20–30 °C. Mosquitoes are active between 20 °C and 34 °C, with peak transmission occurring at temperatures up to 29 °C [53,54]. For each 1 °C increase in maximum temperature lagged by one month, the prevalence of P. falciparum and P. vivax increases by 0.6% and 1.5%, respectively [55]. Research has found that the daily survival probability of mosquitoes is 0.82 at 9 °C, 0.90 at 20 °C, and 0.04 at 40 °C [56]. The pace of digestion rises with warmth, and it determines how frequently animals must eat, a threshold temperature for quick death, and a minimum temperature for active behavior. The optimal temperature for mosquito survival is around 25–29 °C [56,57]. Temperatures below 25 °C are associated with an extended malaria transmission season (LTS), while temperatures above 35 °C cause the LTS to decline [58].
Temperature is a reliable predictor of mosquito population dynamics, significantly impacting the speed at which pathogens develop within mosquitoes and thus affecting disease transmission [59]. Maximum temperature shows a stronger correlation with malaria prevalence than mean, minimum, or extreme temperatures. Malaria prevalence increases with maximum temperature and site species richness, though this relationship varies considerably between species and years [60].
Temperature also has an impact on malaria parasites’ development in mosquitoes [61]. Parasites develop more quickly at higher temperatures. This shortens the spreading time. It can spread more quickly to higher temperatures because of shortened time for the extraneous incubation period (EIP). Warmer conditions help mosquitoes to feed frequently and increase the frequency of blood feeding and spread of malaria. It has been determined that the spread of mosquito-borne diseases will probably happen with climate change because of the focus on the effects of temperature change in the field of mosquito-borne disease research [62]. Temperature variations also have an impact on how quickly a pathogen develops inside a mosquito, which has a significant effect on disease transmission [63]. Short rains, wet season temperatures, and clinical malaria cases are likely to increase [64]. Significant spatiotemporal shifts in the diurnal temperature range (DTR) influence malaria incidence rates, even in areas with declining trends [65]. Malaria incidence often peaks during or just after the rainy season; research in Denmark indicates that it typically peaks in May and is associated with high temperatures in July and August of the previous year [66]. Some researchers found an association between temperature changes and increased malaria cases, and some suggest that temperature’s role in malaria epidemiology has been reduced due to climate, ecosystem changes, population health, and economic conditions [67].

3.2. Effect of Rainfall on Malaria

The climatic variable with the most substantial influence on malaria is rainfall. It is important for malaria epidemiology because it provides aquatic stages and raises air moisture, which makes mosquitoes live longer. Mosquito development requires a minimum seasonal average rainfall of 1.5 mm per day [68]. Precipitation and hydrology are important environmental factors that affect malaria by affecting the breeding habitats and population dynamics of mosquitoes [69].
There is a positive relationship between minimal multi-year average rainfall and the prevalence of malaria, with Choco, the region west of the Cauca River, and the lowlands of the Pacific Ocean being places at moderate to high risk. Rainfall is positively connected with malaria prevalence in Asian and African countries [67]. There is a nonlinear relationship between precipitation and the risk of contracting a mosquito-borne disease. Therefore, it is important to take time-lagged effects, species-specific preferences, and hydrological considerations into account [70]. Some researchers indicate that there is a nonlinear relationship between precipitation and the probability of being infected by a mosquito.
Parasites exhibit higher host specificity in regions with more pronounced rainfall seasonality and wetter dry seasons [71]. The malaria season lasts about 1–2 months after the rainfall peak. Rainfall is associated with increased incidence at a time lag of 2 months, resulting in an increase in malaria transmission [50,51,53,54]. In locations far from water bodies, malaria transmission seasonality closely follows that of rainfall, with a time lag of 1 to 2 months. P. falciparum decreased by 1.6% per 1 cm increase in 6-month lagged precipitation, and P. vivax decreased by 1.1% [55]. Malaria prevalence is maximum at a rainfall rate of 4 to 6 mm per day [72].
Precipitation changes will lead to declines in the occurrence probabilities of Anopheles vectors [73]. An increase in rainfall can cause an extension of the malaria transmission season and the spread of malaria to areas close to a desert border. Vectors, such as mosquitoes, are also adapting their breeding areas in response to these changes. The climate suitability level for the transmission of malaria is moderate in the dry season but very high in the wet. Rainfall was found to be the best predictor [74]. Research indicated that an increase in rainfall is linked to an increase in malaria incidence [53].

3.3. Effect of Relative Humidity on Malaria

Relative humidity significantly influences malaria transmission by affecting mosquito survival and behavior. Research indicates that relative humidity is one of the meteorological factors that affect malaria occurrence and transmission; increasing humidity facilitates the transmission of diseases spread by insects like malaria [11]. Malaria transmission is beneficial from rising humidity, with some time lag effects [75].
Humidity with a time lag of 3 months had a significant positive effect on total malaria cases [76]. Humidity with temperature and rainfall has the most significant effect on malaria transmission [77]. Humidity (66% to 81%) with temperatures 20 °C to 33 °C maintained a warmer, wetter climate for mosquito growth, parasite development, and malaria transmission [78]. Mosquitos are favored by high humidity [79], and their activity increases with high humidity [80].

3.4. Effect of Extreme Weather on Malaria

Extreme weather events can have a substantial impact on the spread of malaria by altering mosquito populations, establishing new breeding grounds, aggravating population relocation, impairing the provision of healthcare, and raising the risk of waterborne illnesses. Climate change threatens all life forms by causing extreme weather conditions, including droughts, floods, hurricanes, cyclones, extreme temperatures, and heavy rainfall. These events can cause forest fires, melting glaciers, rising air pollution, and improper food and sanitation. These situations can increase mortality rates and an increase in infectious diseases. WHO predicted an estimated 250,000 deaths per year from malnutrition, malaria, diarrhea, and extreme temperatures [29,81]. The relationship between weather and climate elements and their extreme events is presented in Table S3. It indicates what effects weather and climate factors, and extreme events will bring on the development, abundance, and behavior of malaria [82,83].

3.4.1. Effect of Flood on Malaria

Floods brought on by extreme weather and climate conditions can have a greater impact on spread by providing alternate habitats for mosquitoes. It can lead to increased habitation development, vector population growth, and habitat diversion for larvae [84]. Floods can lead to several vector-borne illnesses, such as malaria, and flood-related stagnant water could serve as a mosquito breeding ground, increasing the number of malaria cases [85].

3.4.2. Effect of Drought on Malaria

Drought occurrences are becoming more frequent due to climate change, endangering water security, sanitation, and food production, and involving wildfires and environmental damage. Since 1990, the amount of the world’s land surface that has experienced extreme drought conditions has steadily increased, peaking at 22% in 2010–2019 [13,86]. Recently, the most affected regions have been those countries within the Horn of Africa. It is indicated that about one-fifth of the world’s land surface experienced extreme droughts in any one month in 2020 [13].
By establishing new breeding grounds, droughts can increase the range of vectors. Mosquito breeding can be facilitated by small bodies of water, human water storage, changed terrain, and more vegetation. It is possible for large amounts of water to dry up, which would make them perfect mosquito breeding grounds. Additionally, some flora types that can retain water may flourish during droughts, providing mosquitoes with microhabitats. Furthermore, people may be forced to relocate due to population displacement, which may expose them to new mosquito populations and possibly broaden the vector’s range. Droughts may initially reduce the areas where mosquitoes breed and the spread of malaria; however, their secondary effects, including population displacement, adjustments to the way water resources are managed, and weakened immune systems, may eventually cause malaria to reappear in areas affected by droughts. A drought affects malaria in a number of ways; it can expand the vector range and create an alternative habitat; it can also affect the vector lifespan and mosquito activities [87].

3.4.3. Effect of Storm on Malaria

Though the strength of the humidity obtained from extreme rainfall creates desirable conditions for the life and reproduction of Anopheles and the evolution of its larvae, strong storm rainfall will wash Anopheles’ eggs and the malaria reproduction habitat, and limit the reproduction of malaria, and negatively affect the outbreak of the disease [1].

3.5. Effect of El Nino, La Nina, and Southern Oscillation on Malaria

The IOD and ENSO can significantly impact global weather patterns, oceanic conditions, and atmospheric circulation. This phenomenon can indirectly alter malaria transmission dynamics by altering environmental variables. In densely populated locations, La Nina years present a higher risk of malaria infection, whereas El Nino years generally reduce the intensity and spread of malaria transmission. The variability in malaria transmission is becoming increasingly heterogeneous during the El Nino and La Nina years due to global warming [88]. In Tanzania, the prevalence of malaria vectors significantly declined during a drought period caused by La Niña [89]. IOD has varying effects on malaria incidence and transmission. Research in India shows that positive IOD years are associated with increased malaria transmission intensity, while negative IOD years show the opposite association. The period of 1986–2020 was indicated as witnessing a substantial decrease in malaria transmission intensity during positive IOD [88]. The patterns of malaria and precipitation are linked to the intensification or weakening of the Angola low that occurs during La Nina or El Nino events, resulting in an increase or decrease in vertically integrated moisture flux convergence and ultimately an increase or decrease in precipitation [90].

3.6. Effect of Non-Meteorological Features on Malaria

There is the need to consider additional factors, such as land use, altitude, malaria control management, population soil moisture, and socioeconomic change, that modulate disease risk rather than solely focusing on climate change. Factors other than climatic indices, such as urbanization, irrigation, and agricultural practices, also affect the occurrence and distribution of malaria. Political unrest, instability of health facilities, ecological disasters, and food insecurity have increased malaria disease transmission [91].

3.6.1. Altitude

Research indicates that in relation to climate change, there will be an increase in exposure to vector-borne disease at higher latitudes and altitudes. Likewise, an increase in the global population of malarial mosquitoes causes a high risk of locally transmitted malaria in non-endemic regions abutting endemic areas, particularly at higher altitudes [89]. Plasmodium falciparum increased by 2.6 for a one-meter increase in altitude, whereas P. vivax increased by 1.5% [55]. Climate change can cause malaria infections to increase at higher elevations and altitudinal shifts in the suitable habitats and the range contraction of Hungarian middle mountain-inhabiting populations of the mosquito in Hungary in the second half of the twenty-first century [60,92]. Generally, mosquitoes occur at low elevations and on low slopes; regarding the preference of oviposition sites, mosquitoes occur at higher rates near streams and croplands [93].

3.6.2. Land Use, Land Cover, and Land Use Change

Global warming has increased malaria risk, with land use affecting mosquito population dynamics [94]. Deforestation and malaria have bidirectional causal relationships [67] and can lead to local temperature increases, resulting in higher mosquito densities and higher malaria transmission [95]. Vegetation plays a crucial role in determining rainfall partitioning and runoff, creating breeding habitats for mosquitoes [96]. Water bodies can contribute to malaria transmission [97]. There is a greater chance of possible zoonotic infections spreading to humans, domesticated animals, and wildlife when mosquitoes from forests and the human–animal–environment interface bite [98]. A total of 4.2% more people are likely to live in a malaria cluster for every 1% increase in forest coverage, while 4.3% fewer people are likely to live in a malaria cluster for every 1% increase in aqueduct coverage [67]. The urban-to-rural gradient of the plasmodium falciparum rate (Pf PR2–10) for children aged 2–10 years is contingent upon the atmospheric conditions in a city. As population density rises, the parasite ratio decreases [99].
Land use changes can also affect malaria. Urbanization can lead to replacing vegetation and water bodies with buildings and paved surfaces, leading to a mixed impact. Deforestation and agricultural expansion can create new breeding habitats for mosquitoes, potentially increasing malaria transmission. Land use changes can also affect local climate and ecosystems, further influencing malaria vector populations [100,101].

3.6.3. Malaria Control Management

Malaria control management plays a crucial role in malaria transmission. The incidence of malaria in children decreases when bed nets are used, but not in older age groups [53]. It reduces malaria incidence in children aged 6–59 months but not in older age groups [53,102]. The spread of malaria has decreased because of the use of insecticide-treated bed nets (ITNs) and the use of artemisinin-based combination therapy (ACT) [103]. Although the efficacy of indoor residual spraying (IRS) and space spraying differs depending on the type of malaria, they are statistically linked to a decrease in malaria incidence [103]. The spray month was shown to have no impact on the overall number of incidents of malaria [76]. The malaria prevention, control action, and anti-malaria distribution can also be affected by climate [102]. Climate change can also affect malaria through early planning and prevention action; it affects anti-malarial facility distribution, with over half becoming vulnerable or threatened by the 2050s and 2070s, and despite high bed net use, cases revive [104].

3.6.4. Population Density and Socioeconomic Condition

Population density is one of the factors that affect the transmission of malaria. As population density rises, the parasite ratio falls, and mosquito prevalence tends to rise in regions with high densities of people [54,93]. Population travel hours were found to be a statistically significant determinant of malaria risk in the study, with the highest risk being recorded 150–250 min away from populated areas [105]. Malaria dynamics revealed minimal evidence in favor of the climatic change hypothesis and indications of a negative endogenous connection between the malaria infectious class and per capita population growth rate [106].
Population growth can increase malaria transmission due to increased exposure to vectors, resource strain, and reduced breeding sites. Socioeconomic conditions can also impact malaria through access to healthcare and public education and level of awareness, which can help to better understand and adopt malaria prevention practices [16,22].

3.6.5. Soil Moisture

The composition, texture, and water-holding ability of soil all directly impact adult mosquito reproduction and emergence, which in turn impacts malaria transmission [107]. Forecasts indicate that higher atmospheric CO2 concentrations raise soil wetness in the root zone, which raises the danger of malaria and the abundance of Anopheles vectors [108].

3.7. Projection of Climate Change Impacts on Malaria

Numerous scholars have projected the potential effects of future climate change on malaria. In India, it is projected that malaria transmission intensity and the length of the transmission season will increase in the future [109]. The potential range of the vector distribution and malaria-receptive areas is expected to expand over time [110]. In Nepal, an emergency of suitability and increasing in length of the season for both Anopheles stephensi and Plasmodium falciparum (ASPF) and Anopheles stephensi and Plasmodium vivax (ASPV) are expected, and a decrease in length of the season for ASPV by 2050 is projected [111].
In West Africa, mean annual malaria prevalence is projected to decrease under Representative Concentration Pathways (RCPs). Conversely, projections in Brazilian cities indicate that annual increases of >75% for malaria vectors are anticipated around 20 large Brazilian cities [112,113]. It is predicted that the number of malaria cases will decrease in the years 2021–2060 compared to 2000–2019 under both RCP2.6 and RCP8.5 scenarios in Zahedan [114].
Globally, the change in malaria infection cases resulting from the conversion from a Shared Socioeconomic Pathway (SSP) (i.e., SSP1-2.6 to SSP2-4.5, SSP3-7.0, and SSP5-8.5) is estimated to be 6.506 million, 3.655 million, and 2.823 million, respectively, from 2021 to 2040. This represents increases of 2.699%, 1.517%, and 1.171% compared to the 241 million infection cases reported in 2020 [115].
Different models predicted different occurrences of malaria by 2100; CanESM2, CMCC-CM, CMCC-CMS, INMCM4, and IPSL-CM5B models predict decreases with the RCP4.5 scenario. However, ACCESS1-3, CSIRO, NRCM-CM5, GFDL-CM3, GFDL-ESM2G, and GFDL-ESM2M predict increases in malaria under all scenarios (RCP4.5 and RCP8.5) [116].
In different parts of the world, future malaria cases are projected under different scenarios. Assessment of the potential impact of climate change on the incidence of malaria using artificial neural networking (ANN) showed an increment in the number of malaria cases in Zahedan under both scenarios (RCP 2.6 and RCP 8.5). In Nigeria’s Sahel and Sudan savannas, Anopheles gambiae sensu stricto and Anopheles arabiensis are expected to proliferate, with a 47–70% and 10–14% rise in prevalence between 2041 and 2080 [117]. In Myanmar, Thailand, India, Vietnam, Cambodia, and Laos, Anopheles dirus is predicted to be present. During the years 2021–2040, rising temperatures are expected to have a detrimental effect on malaria in these regions [118]. In Iran, it is expected to be warmer, more humid, and have more precipitation, which makes it suitable for mosquito species [114]. Climate change may also increase the spatial spread of P. vivax and P. falciparum, raising the risk of massive malaria outbreaks in northern South Korea [29,107].
Changes in weather patterns and local climate can reinforce the spread of mosquito-borne diseases, with factors such as increased average temperature, prolonged rainfall, and geographical shifts contributing to the widespread distribution of malaria.

3.8. Potential Pathways of Meteorological Factors Affecting Malaria

The mechanisms by which global warming, climate change, and related climate extremes influence malaria transmission are demonstrated in Figure 2. This figure shows that climate change can directly impact human health by affecting malaria transmission or indirectly by affecting non-climatic factors.
Potential pathways by which meteorological factors affect malaria are indicated in Figure 3. Rainfall contributes to malaria by providing aquatic stages, increasing humidity, extending mosquitoes’ lifespans, and increasing malaria cases. Though rainfall has been positively related to malaria prevalence, its relationship with the risk of vector contact is nonlinear. It is indicated that humidity facilitates the transmission of malaria disease, and temperature accelerates larval development, promotes reproduction activities, enhances blood feed frequency, increases digestion ranges, and declines malaria transmission when temperature > 35 °C. Floods will increase inhabited development. On the other hand, it can create alternative breeding sites in urban areas. Meanwhile, droughts can expand the vector range, create an alternative breeding habitat, reduce vector lifespan, and reduce mosquito activities.

3.9. Aggravation of Climate Change Effects on Human Health

Figure 4 illustrates the consequences of climate change on health, highlighting conditions that exacerbate these effects and possible solutions to mitigate the risks. Our assessment reveals that extreme weather events significantly aggravate the impact of climate change on human health, with droughts and floods being the primary contributors [119,120,121]. Additionally, extreme heatwaves, cold stress, strong storms, forest fires, air pollution, poor dietary habits, and poor sanitation all contribute to higher mortality rates associated with climate change.
The rise in infectious diseases, mainly driven by climate change, migration capacity, insufficient healthcare infrastructure, political unrest, hospital instability, and environmental disasters, can further intensify the spread of infectious diseases [119]. Food insecurity, leading to malnutrition, is a serious health problem. Moreover, hunger, malaria, diarrhea, poverty, and food security are all growing increasingly vulnerable to vector-borne disease and malaria [35].

3.10. Research Gaps

Although the number of studies on the topic has increased [122,123], findings do not provide sufficient information on to what extent climate change affects malaria. Specifically, they often fail to indicate the precise number or percentage changes in malaria cases, the number of people affected, and the specific impact of various climate variables on malaria incidence [124]. Mostly, research has focused on temperature, precipitation, and relative humidity, leaving limited knowledge about the effects of other factors, including wind, air pressure, soil moisture, and extreme events. There is a need for research to examine the combined effects of multiple climate indicators and other non-climatic factors, including population growth, migration strategies, land use (forest, urban, and aquatic areas), malaria prevention and control activities, and extreme events that threaten human health.
The findings of each research study are often specific to their study area, leading to variations in outcomes between localized and broader-scale research. Additionally, many studies do not adequately incorporate the role of investments in vector control, technology, and vaccines in risk reduction [125]. There is a gap between mechanistic and correlative modeling approaches, with studies using both approaches being rare exceptions [123]. Furthermore, there is a need for better collaboration with policymakers, practitioners, public health, and the population to develop tools and measures to identify, anticipate, assess, and mitigate risks early. The links between climate change and its impacts on health and multisectoral risk assessments are limited.

3.11. Limitations and Future Perspectives

The review aims to assess and summarize research findings on climate change’s effects on malaria. However, it has some limitations. As this review is performed at a global level, it is very general and cannot show the specific area effect. This review focuses on the impacts of climate factors on malaria, and only highlights of non-climate factors are presented. Investigating non-climatic factors and its combined effects with climate factors might also be needed. The studies did not evaluate the effects of malaria intervention activities. The studies should have indicated the potential impact of community case management initiatives.
It is important to thoroughly evaluate the effects of climate change on the emergence and spread of malaria in a thorough manner. It explores how malaria dynamics are influenced by meteorological elements directly as well as indirectly through non-climatic causes. Through a comprehensive analysis of the extant literature, the study pinpoints areas that need more research and indicates knowledge gaps. It also looks at how malaria patterns are expected to be affected by climate change in the future. The review’s goal is to serve as a useful tool for the scientific community by supplying information that will support intervention plans, early warning systems, and attempts to control malaria in the face of climate change.

4. Conclusions and Perspectives

Climate change has a significant impact on various sectors, including the environment, ecosystems, animal life, agriculture, food security, and human health. Temperature, rainfall, humidity, extreme weather events, floods, droughts, strong storms, and El Nino can all contribute to malaria transmission. Higher temperatures accelerate larval development, promote malaria reproduction, and reduce mortality rates. Rainfall provides aquatic stages for malaria reproduction, while higher humidity increases malaria activities. Extreme weather events can also affect malaria cases by affecting the climate conditions of an area. Non-climatic factors should also be considered. Research on climate change’s impact on human health and malaria has increased recently, but there is disagreement in findings. To understand the extent of climate change and related extreme events on human health and vector-borne diseases, multidisciplinary, intensified research is essential.
Malaria remains a deadly disease, mainly in less developed regions, which are more vulnerable to malaria disease risk. Rising temperatures, altered precipitation patterns, and shifts in humidity create more favorable conditions for mosquito breeding and malaria transmission. The review studies provide compelling evidence that climate change significantly affects malaria dynamics, posing a substantial threat to public health, particularly in developing countries with limited resources.
Understanding the relationship between climate factors and malaria occurrence and transmission still needs to be improved, and interdisciplinary research is necessary to fully comprehend the effects of climate change on human health through malaria disease. To effectively mitigate the impact of climate change on malaria, several strategies need to be implemented.
  • Further research should adopt a multidisciplinary approach incorporating climatic, ecological, socioeconomic, and health data to develop comprehensive models that capture the complex interactions influencing malaria transmission. Collaboration between climatologists, epidemiologists, public health experts, and policymakers is essential.
  • There is a need to bolster existing malaria control programs by incorporating climate change projections into planning and implementation, including scaling up vector control measures, such as insecticide-treated nets and indoor residual spraying, and expanding access to effective anti-malarial treatments.
  • New mosquito control tools; collaboration between policymakers, practitioners, public health, and the population; and multisectoral risk assessments to understand the link between climate change impacts, conservation strategies, and control measures against malaria vectors are crucial.
  • Continuous monitoring of climatic variables and malaria incidence is crucial for early detection and response to potential outbreaks. Integrating climate data with health surveillance systems can improve predictive modeling and timely interventions. Improved early warning and early action systems, improved forecasting of potential epidemic scenarios, and complex model simulation are important.
  • Community engagement and education and policy integration can foster local resilience and support behavior change for reduction.

Supplementary Materials

The following supporting information can be downloaded at: https://www.mdpi.com/article/10.3390/atmos16010071/s1. Table S1: Impact of climate change on malaria. Table S2: Future projected effects of climate change on malaria. Table S3: Relationships between weather or climate elements and malaria diseases.

Author Contributions

D.M.M.: Writing—original draft, review and editing; Software; Methodology; Data curation. X.-S.L.: Supervision, Conceptualization, Investigation, Writing—review and editing. All authors have read and agreed to the published version of the manuscript.

Funding

This research was funded by the National Natural Science Foundation of China (NSFC 42477467). The APC was covered by voucher discount for Prof. Xiao-San Luo.

Institutional Review Board Statement

Not applicable.

Informed Consent Statement

Not applicable.

Data Availability Statement

Data will be made available on request.

Acknowledgments

We are also grateful to Abu Reza Md. TowfiqulIslam for his support in this study.

Conflicts of Interest

We declare that we have no inappropriate relations with other people or organizations that can influence our published work.

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Figure 1. Climate change effects on human health.
Figure 1. Climate change effects on human health.
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Figure 2. Pathways of climate change affecting malaria, arrows in dark blue indicate malaria life cycle.
Figure 2. Pathways of climate change affecting malaria, arrows in dark blue indicate malaria life cycle.
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Figure 3. Effects of climate change-induced extreme weather and natural hazards (drought and flood) on malaria.
Figure 3. Effects of climate change-induced extreme weather and natural hazards (drought and flood) on malaria.
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Figure 4. Aggravation of climate effects and associated health risk reduction methods.
Figure 4. Aggravation of climate effects and associated health risk reduction methods.
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Megersa, D.M.; Luo, X.-S. Effects of Climate Change on Malaria Risk to Human Health: A Review. Atmosphere 2025, 16, 71. https://doi.org/10.3390/atmos16010071

AMA Style

Megersa DM, Luo X-S. Effects of Climate Change on Malaria Risk to Human Health: A Review. Atmosphere. 2025; 16(1):71. https://doi.org/10.3390/atmos16010071

Chicago/Turabian Style

Megersa, Dereba Muleta, and Xiao-San Luo. 2025. "Effects of Climate Change on Malaria Risk to Human Health: A Review" Atmosphere 16, no. 1: 71. https://doi.org/10.3390/atmos16010071

APA Style

Megersa, D. M., & Luo, X.-S. (2025). Effects of Climate Change on Malaria Risk to Human Health: A Review. Atmosphere, 16(1), 71. https://doi.org/10.3390/atmos16010071

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