Under the current epidemiological conditions as found in Korea, and considering the limited funds available for the malaria project, passive case detection proved to be the only practical mechanism to obtain reliable data required for the delimitation of malarious areas. The malaria map of the country was completed at the end of 1965. The high SPRs found among the blood smears reported by the PCD undts are due to the fact that the Korean farmer is able to recognize the clinical symptoms of the disease. The "fever case" reports are therefore actually "suspect malaria case" reports. The consistently high SPR has resulted in the detection of a large number of parasite carriers with the number of smears to be examined being reduced to a minimum. Although the medical group gave an important contribution to the success of the PCD service in Korea, the number of medical and public health facilities in the rural areas are still too small. This made it necessary to obtain the collaboration of laymen groups like school teachers, village chiefs etc., and their participation largely contributed to the success of the present programme. The degree of collaboration by the PCD units is higher in the more malarious areas. As no form of encouragement e.g., a reporting fee, has been given to these laymen during the past few years it becomes increasingly more difficult to maintain their active co-operation. It is felt that through passive case detection alone it will not be possible to collect adequate information to provide the proof for the complete interruption of transmission.
parasitology-protozoa ; Plasmodium vivax ; malaria ; diagnosis ; epidemiology

Parasitemia characteristics of Plasmodium vivax malaria in temperate regions may differ from those in tropical zones. However, most parasitological and clinical features of P. vivax malaria have been investigated in the latter. In this study, we investigated 383 malaria patients to clarify the parasitemia characteristics of a P. vivax strain in the Republic of Korea (ROK). The mean parasitemia (8,396/microL) was less than half of tropical P. vivax malaria, and multiple invasions of erythrocytes were not rare (53.5% of the patients, 2.4% of the total investigated RBCs), but less than the observations in tropical zones. The intervals between the first symptom onset and diagnosis were significantly longer in gametocyte (+) patients than in gametocyte (-) patients. Only half of the total patients had both genders of gametocytes (191 of 353), and the male gametocyte density (169/microL) was lower than that of P. vivax strains of a previous study. Multiple invasions of erythrocytes and gametocytemia were coincident factors of the degree of anemia in P. vivax malaria. The present findings demonstrate the P. vivax strain in ROK reveals relatively low parasitemia and low male to female gametocyte ratio. The low ratio may be related with low transmission efficacy.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Erythrocytes/parasitology ; Female ; Humans ; Malaria, Vivax/*diagnosis/epidemiology/parasitology ; Male ; Middle Aged ; Parasitemia/*diagnosis/epidemiology/parasitology ; Plasmodium vivax/isolation & purification ; Republic of Korea/epidemiology

Parasitemia characteristics of Plasmodium vivax malaria in temperate regions may differ from those in tropical zones. However, most parasitological and clinical features of P. vivax malaria have been investigated in the latter. In this study, we investigated 383 malaria patients to clarify the parasitemia characteristics of a P. vivax strain in the Republic of Korea (ROK). The mean parasitemia (8,396/microL) was less than half of tropical P. vivax malaria, and multiple invasions of erythrocytes were not rare (53.5% of the patients, 2.4% of the total investigated RBCs), but less than the observations in tropical zones. The intervals between the first symptom onset and diagnosis were significantly longer in gametocyte (+) patients than in gametocyte (-) patients. Only half of the total patients had both genders of gametocytes (191 of 353), and the male gametocyte density (169/microL) was lower than that of P. vivax strains of a previous study. Multiple invasions of erythrocytes and gametocytemia were coincident factors of the degree of anemia in P. vivax malaria. The present findings demonstrate the P. vivax strain in ROK reveals relatively low parasitemia and low male to female gametocyte ratio. The low ratio may be related with low transmission efficacy.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Erythrocytes/parasitology ; Female ; Humans ; Malaria, Vivax/*diagnosis/epidemiology/parasitology ; Male ; Middle Aged ; Parasitemia/*diagnosis/epidemiology/parasitology ; Plasmodium vivax/isolation & purification ; Republic of Korea/epidemiology

Prompt and accurate diagnosis of malaria is the key to prevent disease morbidity and mortality. This study was carried out to evaluate diagnostic performance of 3 commercial rapid detection tests (RDTs), i.e., Malaria Antigen Pf/Pantrade mark, Malaria Ag-Pftrade mark, and Malaria Ag-Pvtrade mark tests, in comparison with the microscopic and PCR methods. A total of 460 blood samples microscopically positive for Plasmodium falciparum (211 samples), P. vivax (218), mixed with P. falciparum and P. vivax (30), or P. ovale (1), and 124 samples of healthy subjects or patients with other fever-related infections, were collected. The sensitivities of Malaria Ag-Pftrade mark and Malaria Antigen Pf/Pantrade mark compared with the microscopic method for P. falciparum or P. vivax detection were 97.6% and 99.0%, or 98.6% and 99.0%, respectively. The specificities of Malaria Ag-Pftrade mark, Malaria Ag-Pvtrade mark, and Malaria Antigen Pf/Pantrade mark were 93.3%, 98.8%, and 94.4%, respectively. The sensitivities of Malaria Ag-Pftrade mark, Malaria Antigen Pf/Pantrade mark, and microscopic method, when PCR was used as a reference method for P. falciparum or P. vivax detection were 91.8%, 100%, and 96.7%, or 91.9%, 92.6%, and 97.3%, respectively. The specificities of Malaria Ag-Pftrade mark, Malaria Ag-Pvtrade mark, Malaria Antigen Pf/Pantrade mark, and microscopic method were 66.2%, 92.7%, 73.9%, and 78.2%, respectively. Results indicated that the diagnostic performances of all the commercial RDTs are satisfactory for application to malaria diagnosis.
Antigens, Protozoan/blood ; Cross-Sectional Studies ; *Diagnostic Techniques and Procedures/instrumentation ; Endemic Diseases/statistics & numerical data ; Humans ; Malaria/*diagnosis/epidemiology/parasitology ; Malaria, Vivax ; Plasmodium falciparum/genetics/immunology/*isolation & purification ; Reagent Kits, Diagnostic ; Thailand/epidemiology

An ELISA was developed for the diagnosis of vivax malaria using multiple stage-specific recombinant antigens of Plasmodium vivax. The DNA from the whole blood of a malaria patient was used as template to amplify the coding regions for the antigenic domains of circumsporozoite protein (CSP-1), merozoite surface protein (MSP-1), apical merozoite antigen (AMA-1), serine repeat antigen (SERA), and exported antigen (EXP-1). Each amplified DNA fragment was inserted into pQE30 plasmid to induce the expression of His-tagged protein in Escherichia coli (M15 strain) by IPTG. His-tagged proteins were purified by Ni-NTA metal-affinity chromatography and used as antigens for ELISA with patient sera that were confirmed previously by blood smear examinations. When applied to patient sera, 122 (80.3%) out of 152 vivax malaria cases reacted to at least one antigen, while no reactions were observed with 128 uninfected serum samples. We applied this ELISA to the screening of 3, 262 civilian residents in endemic regions near the DMZ, which resulted in 236 positively detected (7.2%) cases. This method can be applied to serological diagnosis and mass screening in endemic regions, or can be used as a safety test for transfusion blood in endemic areas.
Animals ; Antibodies, Protozoan/*blood ; Antigens, Protozoan/genetics/*immunology ; *Endemic Diseases ; Enzyme-Linked Immunosorbent Assay/methods ; Humans ; Life Cycle Stages ; Malaria, Vivax/*diagnosis/epidemiology/parasitology ; Mass Screening ; Plasmodium vivax/*growth & development/immunology ; Recombinant Proteins/*immunology ; Serologic Tests