Malaria in Korea.
- Author:
Jae Chul SHIM
1
;
E Hyun SHIN
Author Information
- Publication Type:Review
- Keywords: Vivax malaria; Epidemiology; Vectorecology; Vector control; Dangerous age of mosquito; Chloroquine/pyrimethamine
- MeSH: Adolescent; Adult; Chloroquine; Culicidae; DDT; Democratic People's Republic of Korea; Epidemiology; Fever; Gangwon-do; Gyeonggi-do; Gyeongsangbuk-do; Hand; Humans; Incidence; Insecticides; Jeju-do; Korea*; Livestock; Malaria*; Malaria, Vivax; Military Personnel; Mosquito Nets; Parasites; Permethrin; Pilot Projects; Plasmodium vivax; Pyrimethamine; Republic of Korea; Seasons; Survival Rate; Tablets; Weather
- From:Korean Journal of Infectious Diseases 2002;34(2):104-135
- CountryRepublic of Korea
- Language:Korean
- Abstract: Since the national malaria eradication service (NMES) was implemented in 1959, extensive malariometric survey were conducted throughout the country. A total of 73,859 malaria cases of Plasmodium vivax were confirmed out of 268,259 blood smears through passive and active case detection (PCD and ACD) in 1960~1969 including chloroquine/ pyrimethamine combined tablets for the presumptive treatment of all of fever cases. The majority of the positive cases occurred in Gyeongsang buk-do, revealing 62,859 cases as of 85.2%, followed by Gyeonggi-do 5,844 cases (7.9%), Chungcheong buk-do 3,458 cases (4.7%), Gangwon-do 812 cases (1.1%), and 29 cases developed in Jeju-do. ACD was more sensitive and advantageous for detecting the malaria cases over PCD in the pilot study area. The high endemic area was located in the north Gyeongsang buk-do and north east Gyeonggi-do. The malaria incidence was high in the age group under 14 years in malaria foci, and that was low in non-malarious area. High parous rate (77.7%) and survival rate (91.4%) of the vector mosquitoes were shown in malaria foci, which were hilly or mountainous area. On the other hand, low parous rate (50.6%) and survival rate (42.7%) were found in non-malarious area, the rice field of south western part of the country even in abundance of vector mosquitoes. NMES had contributed the control of the malaria by carring out the residual DDT focal spray, mass drug administration, radical treatment of the positive cases, and mass blood survey in the heavy malarious area. Since then malaria disappeared rapidly, and no indigenous case was reported after 1984. In order to ascertain whether this country was malaria-free or not, mass blood survey was carried out for the juveniles, adolescents and adults in Yeongju-gun Gyeongsangbuk-do in 1986 where the highest incidence of malaria was recorded during the 1960s. The result showed no positive case at all. However vivax malaria reemerged, and made a dramatic resurgence since 1993 in the demilitarized zone (DMZ) bordering North Korea, and expanded toward eastern and southern part of the country year after year, totaling 14,089 cases including U.S. army by the end of 2000 in spite of the strong activities of antimalaria in the Republic of Korea. So vector control including the encouragement of the livestock farming in the malaria endemic area must be more sensitive and effective measure to reduce the risk of malaria transmission by the eliminating the dangerous age of mosquitoes in the points of characteristics of the Korean strain of parasites such as the mild symptoms, long-term incubation period and asymptomatic parasitaemia. Focal application of thermal fogging and mist spray of insecticides would be certainly effective in preventing the vector mosquitoes from infecting the gametocytes of malaria for the first peak of multi malaria cases in the early season of the year. All of the civilians who are in the high risk area for malaria should be forced to sleep under the permethrin impregnated mosquito nets. All of the soldiers near the DMZ are strongly recommended to take the combined tablets of chloroquine/ pyrimethamine instead of the single base of chloroquine at present to prevent the action of source of infection of the reservoirs and the completion of the sporogonic stages of the vector mosquitoes because the vector control activities are not allowed in the DMZ. The experts of entomologists and malariologist of the South and North Korea should discuss the antimalaria programme to eradicate the malaria from the Korean peninsular near future.
