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Time-series of coarse-resolution greenness values derived through remote sensing have been used as a surrogate environmental variable to help monitor and predict occurrences of a number of vector-borne and zoonotic diseases, including malaria. Often, relationships between a remotely-sensed index of greenness, e.g. the normalized difference vegetation index (NDVI), and disease occurrence are established using temporal correlation analysis. However, the strength of these correlations can vary depending on type and change of land cover during the period of record as well as inter-annual variations in the climate drivers (precipitation, temperature) that control the NDVI values. In this paper, the correlation between a long (260 months) time-series of monthly disease case rates and NDVI values derived from the Global Inventory Modeling and Mapping Studies (GIMMS) data set were analysed for two departments (administrative units) located in the Atlantic Forest biome of eastern Paraguay. Each of these departments has undergone extensive deforestation during the period of record and our analysis considers the effect on correlation of active versus quiescent periods of case occurrence against a background of changing land cover. Our results show that timeseries data, smoothed using the Fourier Transform tool, showed the best correlation. A moving window analysis suggests that four years is the optimum time frame for correlating these values, and the strength of correlation depends on whether it is an active or a quiescent period. Finally, a spatial analysis of our data shows that areas where land cover has changed, particularly from forest to non-forest, are well correlated with malaria case rates.

Correlation between normalized difference vegetation index and malaria in a subtropical rain forest undergoing rapid anthropogenic alteration