Predicting risk of imported disease with demographics: Geospatial analysis of imported malaria in Minnesota, 2010-2014

Elizabeth H. Lee, Robin H. Miller, Penny Masuoka, Elizabeth Schiffman, Danushka M. Wanduragala, Robert DeFraites, Stephen J. Dunlop, William M Stauffer III, Patrick W. Hickey

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Although immigrants who visit friends and relatives (VFRs) account for most of the travel-acquired malaria cases in the United States, there is limited evidence on community-level risk factors and best practices for prevention appropriate for various VFR groups. Using 2010-2014 malaria case reports, sociodemographic census data, and health services data, we explored and mapped community-level characteristics to understand who is at risk and where imported malaria infections occur in Minnesota. We examined associations with malaria incidence using Poisson and negative binomial regression. Overall, mean incidence was 0.4 cases per 1,000 sub-Saharan African (SSA)-born in communities reporting malaria, with cases concentrated in two areas of Minneapolis-St. Paul. We found moderate and positive associations between imported malaria and counts of SSA- and Asian-born populations, respectively. Our findings may inform future studies to understand the knowledge, attitudes, and practices of VFR travelers and facilitate and focus intervention strategies to reduce imported malaria in the United States.

Original languageEnglish (US)
Pages (from-to)978-986
Number of pages9
JournalAmerican Journal of Tropical Medicine and Hygiene
Issue number4
StatePublished - 2018

Bibliographical note

Funding Information:
Centers for Disease Control and Prevention award number 1 U01 CK000357-01; sub-award N005338003.

Publisher Copyright:
Copyright © 2018 by The American Society of Tropical Medicine and Hygiene.


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