Incidence of Malaria in the Contiguous United States

Abstract
Geomedicine:
The branch of medicine dealing with the influence of climatic and environmental conditions on health.
This looks for a correlation between geography and health.
There are tons of data that link location with such afflictions as heart disease, cancer, respiratory disorder,
diabetes, and other lesser ailments, yet the medical establishment has historically ignored location as a medical
factor.
The root cause of community health issues can be diagnosed and also plan steps to mitigate them.

Percentage of Incidences
Year

Introduction
Malaria in humans is caused by intraerythrocytic infection with one or more of several species of the protozoa, genus
Plasmodium (P.falciparum, P.vivax, P.malariae and P.ovale and occasionally other plasmodium species). P. falciparum and P. vivax
species cause the most infections worldwide.
P. falciparum is the agent that most commonly causes severe and potentially fatal malaria.
People with malaria often experience fever, chills, and flu-like illness. Left untreated, they may develop severe complications and
die.
These parasites are transmitted by the bite of an infective female Anopheles mosquito. The majority of malaria infections in the
United States occur among persons who have traveled to regions with ongoing malaria transmission. However, malaria is also
occasionally acquired by persons who have not traveled out of the country, through exposure to infected blood products,
congenital transmission, laboratory exposure, or local mosquitoborne transmission.
Malaria surveillance in the United States is conducted to identify episodes of local transmission and to guide prevention
recommendations for travelers.

Pct_Military

Pct_Civilian

Pct_Fcivilian

Total

1970

0.96

0.02

0.01

0.00

4247

1975

0.04

0.44

0.52

0.00

448

1980

0.01

0.16

0.82

0.00

1864

1985

0.03

0.43

0.54

0.00

1045

1990

0.03

0.51

0.46

0.00

1098

1995

0.01

0.51

0.40

0.08

1167

2000

0.03

0.59

0.25

0.12

1402

2005

0.02

0.57

0.19

0.21

1528

1975

1970

This paper focuses on the study of the epidemiology and control of malaria disease in the United States of America.
Malaria is not endemic in the United States of America but it is in Africa, Asia, Central and South America, the Caribbean, Oceania
and Middle East.
The cases observed in the United States according to CDC were classified into the following groups; imported, one laboratoryacquired case, one transfusion-related case, two congenital cases, and one cryptic case.
The number of cases reported in 2011 marked the largest number of cases since 1971 (N = 3,180). Despite progress in reducing
the global burden of malaria, the disease remains endemic in many regions, and the use of appropriate prevention measures by
travelers is still inadequate.

Pct_NoStatus

Pct_Military

Pct_Civilian

Pct_Fcivilian

Pct_NoStatus

Pct_Military

Pct_Civilian

Pct_Fcivilian

Pct_NoStatus

1985

1980
The following definitions are used in malaria surveillance for the United States:
U.S. residents Persons residing in the United States, including both civilian and U.S. military personnel, regardless of legal
citizenship.
U.S. residents/civilians Any U.S. residents, excluding U.S. military personnel.
Foreign residents/civilians Persons who hold resident status in a country other than the United States.
Travelers visiting friends or relatives Immigrants, ethnically and racially distinct from the major population of the country of
residence (a country where malaria is not endemic), who return to their homeland (a country where malaria is endemic) to visit
friends or relatives. Included in the VFR category are family members (e.g., spouse or children) who were born in the country of
residence.
Both travel and inadequate prevention measures might have contributed to this findings. The majority of the U.S. cases were
acquired in sub-Saharan Africa. Despite progress in reducing the number of malaria cases in regions where malaria is endemic,
international travel appears to be growing steadily, and use of appropriate prevention measures by travelers is still inadequate.

Pct_Military

Pct_Civilian

Pct_Fcivilian

Pct_NoStatus

Pct_Military

Pct_Military

Pct_Civilian

Pct_Fcivilian

Pct_NoStatus

Pct_Military

2000

Pct_Military

Pct_Civilian

Pct_Fcivilian

Pct_Fcivilian

Pct_NoStatus

1995

1990

Discussion
The data of Malaria incidences for each state for the following years;1994,1995,1998,2005,2006, 2011 and
2012 was gotten from CDC website and were used to make maps to show the rate of malaria.
The rate(R) for each state was derived by dividing the number of incidences (i) by population estimate (p)
for the State for that year multiplied by 1000.
R= i/p x 1000.
Rate was used to normalize the data so that states with large population will not appear as having more
incidences compared to states with small population.
Two excel spread sheets were created one to show incidences for each state in the years of study, this table
was joined using ArcMap 10.2.2, to the attribute table of the base map of the United States was gotten
from one of the assignments done in class. ArcMap 10.2.2 was also used in creating the different maps and
their elements. The other spread sheet was to show the categories of affected individuals and this was
where the pie charts were derived from.
From the study there was no strict pattern found for the rate of occurrence of malaria disease across the
nation. Although Minnesota, Maryland, Virginia, Colorado, Massachusetts, New Jersey were found to be
some of the states with high rate of occurrence, which might be due to the international gate way.. The
south western states had low to very low rate of occurrences, while the south and most of the
southeastern states had low to medium rate of occurrence, most of the central states had medium to low
rates of occurrence except Illinois that had high rates in 1995 and 2005. Interestingly the rate of occurrence
in California was high in only three (1994, 1995 and 1998) out of the seven years of study and found to be
low in 2005, 2006, 2011 and 2012
From the data used for making the pie charts, in 1970 military personnel accounted for 96% of incidences
this might be due to fall out from the Vietnam War. In 1975, 1980, 1985 and 1990 foreign civilians made up
the largest percentage while U.S. civilians made up the greater percentage of people affected with malaria
in 1990, 1995, 2000 and 2005.
It was also found that people were not classified into the three other categories mentioned above were
given the No Status category.

Pct_Civilian

Pct_Civilian

Pct_Fcivilian

Pct_NoStatus

2005

Pct_NoStatus

Pct_Military

Pct_Civilian

Pct_Fcivilian

Pct_NoStatus

Conclusion
As international travel increases, prevention messages and health communication strategies becomes even
more important by protecting the traveling community from communicable diseases such as malaria.
According to Bill Davenhall physicians' diagnostic techniques can be improved by collecting each patient's
geographic and environmental data, and merging it with their medical records.
From further study from CDC reports (data not included), a lot of the patients some of whom died
unfortunately, were misdiagnosed when they first visited the hospital. Most of them were not asked where
they have been in a couple of months before they fell ill. If this question has been asked from the beginning
a lot of them will still be alive today. Location is a very vital information to diagnosing a lot of diseases
especially the non-genetic ones.
It was also found that a lot of the patients did not take prophylactic drugs, some did not follow and
adhered to the regimen, while others did.
Prevention messages directed towards travelers to endemic regions should be intensified, since there is no
vaccine for prevention of Malaria,
Geomedicine is not a destination, but a first step in a journey of integrating vast amounts of relevant
geographical information into patient care in an efficient and smart way. Making it a useful element in the
evolving electronic records that support our personal health and wellness will be the greatest challenge.
From personal experience taking prophylactic drugs, avoidance mosquito bites by using insecticide bed
nets, as well as the prevention of stagnant water that acts as breeding sites for the vector, Anopheles
mosquitoes are some of the best ways to prevent and control malaria disease.
The complexity of the malaria parasite makes development of a malaria vaccine a very difficult task. Given
this, there is currently no commercially available malaria vaccine, despite many decades of intense
research and development effort.

Sources:
1. The Free dictionary by FARLEX
2. Bill Davenhall TEDMED 2009, Esri: Your health depends on where you live
3. CDC, Morbidity and Mortality report, March 2, 2012 -Malaria Surveillance United States, 2010
4. CDC, Morbidity and Mortality report, Nov. 1, 2013 -Malaria Surveillance United States, 2011
5. www.census.gov
6. http://www.cdc.gov/malaria/
7. malaria in the United States images
8.World Health Organization

Geography 1820 , Salt Lake Community College,Utah,2015

Olamide Okikiolu

http://olamideokikiolu.weebly.com