A Spatial Analysis of Individual- and Neighborhood-Level Determinants of Malaria Incidence in Adults, Ontario, Canada

Emerging Infectious Diseases Journal, Volume 18, Number 5—May 2012

Rose Eckhardt, Lea Berrang-Ford, Nancy A. Ross, Dylan R. Pillai, and David L. Buckeridge

“Malaria, once endemic in Canada, is now restricted to imported cases. Imported malaria in Canada has not been examined recently in the context of increased international mobility, which may influence incidence of imported and autochthonous cases. Surveillance of imported cases can highlight high-risk populations and help target prevention and control measures. To identify geographic and individual determinants of malaria incidence in Ontario, Canada, we conducted a descriptive spatial analysis. We then compared characteristics of case-patients and controls.

Percentage of residents in a neighborhood reporting immigration from malaria-endemic areas, greater Toronto area, Ontario, Canada, 2008–2009.

Percentage of residents in a neighborhood reporting immigration from malaria-endemic areas, greater Toronto area, Ontario, Canada, 2008–2009. Red dots, malaria case-patients (positive test results); blue circles, controls (negative test results).

“Case-patients were significantly more likely to be male and live in low-income neighborhoods that had a higher proportion of residents who had emigrated from malaria-endemic regions. This method’s usefulness in clarifying the local patterns of imported malaria in Ontario shows its potential to help identify areas and populations at highest risk for imported and emerging infectious disease.”