Table 1.

Variables in climate change and malaria transmission identified from literature review and expert consultation

No	Variables	Description	Source
Biophysical variables
1	Air temperature	Air temperature suitable for malaria transmission i.e. between 16 and 34 °C	[17, 32, 48, 57–61]
2	Water temperature	Mosquito habitat temperature suitable for breeding	[60, 62–64]
3	El-Nino	Periods of extreme rainfall	[14–16, 48, 65]
4	Average rainfall/precipitation	Mean monthly rainfall of at least 150 mm; rainfall season	[9, 17, 21, 31, 48, 61, 66, 67]
5	Relative humidity	Amount of water vapour present in air	[68–71]
6	Altitude	Height/distance above sea level	[36, 48, 69, 70, 72]
7	Micro-habitat changes	Changes in mosquito habitat micro-climate due to loss of forest cover or other environmental controls such as clearing of bushes	[63, 68–70, 73–78]
8	Topography	Physical land surface including hills and valleys, elevation	[33, 48, 79, 80]
9	Topographic wetness index	Percentage of ground water saturation of at least 5% for suitable mosquito breeding site	[30, 31]
10	Wetlands and water bodies	Proximity to swamps and other stagnant water bodies	[33, 63, 68, 74, 76, 77, 81]
11	Bare areas	Land without forest cover or other vegetation	[33, 82, 83]
12	Forest edge	Human proximity to forest boundaries and potential exposure to exposed mosquito breeding sites due to deforestation	[33, 62]
13	Agriculture	Land clearance, planting, livestock and maize farming, swamp drainage and farming, and water management i.e. water conservation using shallow wells, small-scale irrigation and creation of water drainage channels	[31, 33, 48, 49, 76, 77, 84–87]
14	Vector abundance	Increase in numbers of malaria mosquitoes	[32, 60, 82, 88]
15	Vector biting	Likelihood of an infective bite from a mosquito	[48, 70, 82]
16	Vector infection rate	Efficiency of transmission and infection with the malaria parasite by the mosquito	[48, 73, 82]
17	Vector adaptive behaviour	Changes in mosquito vector behaviour such as early biting or indoor resting	Expert input
18	Population under 5 years	Number of individuals under 5 years old	[48, 49, 74]
19	Immune status	Lowered immunity to malaria due to pregnancy or inexposure; acquired immunity to malaria from long term exposure	[48, 49, 79, 89, 90]
20	Interactions	Co-infections with other diseases such as HIV increase likelihood and severity of infection	[15, 50]
21	Drug resistance	Resistance of the malaria parasite to drugs/parasite evolution	[15, 48, 50]
Socio-economic variables
22	Urbanisation	Expansion of urban areas and overcrowding in cities	[49]
23	Population migration/travel	Movement of people from low risk areas to malaria-endemic or epidemic-prone areas and vice versa	[48, 50]
24	Nutritional status	Poor health as a result of undernutrition or malnutrition	[48, 49]
25	Gender	Gender roles, expectations and cultural customs	[48, 49]
26	Poverty	Socio-economic conditions; household income, food and household assets	[15, 48, 49, 74]
27	Religious beliefs	Religion or superstitions in understanding or managing malaria and/or climate change impacts	[15, 49]
28	Perception	Knowledge and understanding of disease	[15, 33, 49]
29	Type of house	House with grass-thatched roof and mud walls (semi-permanent) or Bbrick house with tiled or aluminium roof (permanent); house with separate kitchen, house with ceiling and house with open eaves	[33, 48, 49]
30	Education level of household head	Education level of male or female head of household	[33]
31	Health-seeking behaviour	Willingness to seek treatment for malaria; households with malaria medicine in stock, self-medication, tradition/cultural norms and practices in malaria management	[48, 49]
32	Net use	Use of insecticide-treated bed nets to prevent malaria infection	[15, 33, 74]
33	Environmental controls	Keeping area around the houses cleared of shrubs and other overgrowth; safe disposal of plastics and other water-retaining containers	[15, 33]
34	Quality of health systems	Health services and policy; availability of health facilities; access to healthcare; quality of healthcare and capacity for malaria treatment	[15, 47, 48, 50]
35	Malaria vector control	Distribution and coverage of insecticide-treated bed nets by the government; coverage of households sprayed with malaria insecticide (indoor residual spraying)	[15, 48]
36	Quality of information	Reliable and easy to understand information systems for communicating weather and climate information or early warning systems for malaria epidemics	[15, 17, 50]