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Background  Malaria has been endemic in Linzhi Prefecture in the Tibet Autonomous Region (TAR) over the past 20 years, especially in Motou County with a highest incidence in the country in recent years. Meteorological factors, such as rainfall, temperature and relative humidity in Motou County were unique compared to other areas in Tibet as well as other parts of China, thus the objective of this work was to analyse the temporal correlation between malaria incidence and meteorological factors in Motou County, in order to seek the particular interventions for malaria control.    Methods  The meteorological and malaria data during 1986-2009 in Motuo County were studied to analyse the statistical relationship between meteorological data time series and malaria incidence data series. Temporal correlation between malaria incidence and meteorological factors were analyzed using several statistical methods. Spearman correlation analysis was conducted to examine the association between monthly malaria incidence and meteorological variables. Cross-correlation analysis of monthly malaria incidence series and monthly meteorological data time series revealed the time lag(s) of meteorological factors preceding malaria at which the series showed strongest correlation. Multiplicative seasonal auto-regressive integrated moving average (SARIMA) models were used in the cross-correlation analysis with pre-whitening which remove seasonality and auto-correlation of meteorological data series. Differenced data analysis which called inter-annual analysis was carried out to find underlying relationship between malaria data series and meteorological data series.    Results  It has been revealed that meteorological variables, such as temperature, relative humidity and rainfall were the important environmental factors in the transmission of malaria. Spearman correlation analysis demonstrated relative humidity was greatest relative to malaria incidence and the correlation coefficient was 0.543( P  < 0.01). Strong positive correlations were found for malaria incidence time series lagging one to three months behind rainfall ( r  > 0.4) and lagging zero to two months behind temperature and relative humidity ( r  > 0.5) by the cross-correlation. Correlations were weaker with pre-whitening than without. The cross-correlograms between malaria incidence and various meteorological variables were entirely different. It was fluctuated randomly for temperature but with trend for the other two factors, which showed positive correlated to malaria when lag was from 0 to 5 months and negative from 6 to 12 months. Besides, the inter-annual analysis showed strong correlation between differenced annual malaria incidence and differenced meteorological variables (annual average maximum temperature, annual average relative humidity and annual average rainfall). The correlations coefficients were -0.668 ( P  < 0.01), 0.451( P  < 0.05) and 0.432( P  < 0.05), respectively.    Conclusion  Meteorological variables play important environmental roles in malaria transmission in Motou County. Relative humidity was the greatest influence factors, which affected the mosquito survival directly. The relationship between malaria incidence and rainfall was complex and it was not directly and linearly. The lags of temperature and relative humidity were similar and smaller than that of rainfall. Since the lags of meteorological variables affecting malaria transmission were short, it was difficult to do accurate long-term malaria incidence prediction using meteorological variables.

Temporal correlation analysis between malaria and meteorological factors in Motuo County, Tibet