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Conservation efforts and malaria in the Brazilian Amazon
Micah B Hahn1, Sarah H Olson, Amy Y Vittor
1Nelson Institute for Environmental Studies, Center for Sustainability and the Global Environment (SAGE), Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, Wisconsin; Wildlife Conservation Society-Canada, Nanaimo British Columbia, Canada; Division of Infectious Diseases, Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Pathology, University of Texas, Galveston, Texas; Health Information Research Department, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil; Nicholas School of the Environment, Duke University, Durham, North Carolina.
None:
We respond to Valle and Clark, who assert that "conservation efforts may increase malaria burden in the Brazilian Amazon," because the relationship between forest cover and malaria incidence was stronger than the effect of the deforestation rate. We contend that their conclusion is flawed because of limitations in their methodology that we discuss in detail. Most important are the exclusion of one-half the original data without a discussion of selection bias, the lack of model adjustment for either population growth or migration, and the crude classifications of land cover and protected areas that lead to aggregation bias. Of greater significance, we stress the need for caution in the interpretation of data that could have profound effects on regional land use decisions.
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