Journal List > J Korean Med Assoc > v.50(1) > 1041954

Yeom and Park: Treatment of Korean Vivax Malaria in Korea

Abstract

Although it is not certain when malaria began to appear in the Korean peninsula, it is believed to have had been an endemic disease until 1984. Vivax malaria reemerged in the Republic of Korea (ROK) in 1993. In the early period most of the cases occurred among soldiers stationed in the DMZ and the adjacent region. In order to cope with malaria, the soldiers at risk received chemoprophylaxis with chloroquine and primaquine. The regimen for the treatment of vivax malaria in Korea was established in 1950's. Primaquine was introduced in 1951, and the field testing during the Korean War demonstrated that the combination of three days of chloroquine administration with fourteen days of primaquine reliably prevented the recurrence of vivax malaria. The regimen has been used since then, but there were some controversies as to whether or not to start chloroquine and primaquine on the same day. Most of the current treatment guidelines recommend the use of primaquine for fourteen days to overlap with blood schizonticide agents such as chloroquine and routine tests for G-6-PD deficiency before use. Previous data showed that the G-6-PD deficiency rate has been found very low among Koreans. Thus, it is not always necessarily mandatory to test for G-6-PD deficiency among Korean patients.

Figures and Tables

Table 1
Anti-malarial therapy for vivax malaria in Korea (for Adult)
jkma-50-88-i001

*: 24 hours after first chloroquine given on Day 0

: 48 hours after first chloroquine given on Day 0

: In regimen A and B, chloroquine can be given in different way: 5mg/kg of chloroquine can be given for 3 times on 12 hours interval after first dose (10mg/kg).

§: 1 tablet of chloroquine phosphate (250mg salt) = 156mg chloroquine base

1 tablet of hydroxychloroquine (200mg salt) = 155mg chloroquine base

: 1 tablet of primaquine phosphate (26.3mg) = 15mg primaquine base

References

1. WHO. Synopsis of the world malaria situation in 1979. Wkly Epidemiol Rec. 1981. 56:145–149.
2. Park JW, Klein TA, Lee HC, Pacha LA, Ryu SH, Yeom JS, Moon SH, Kim TS, Chai JY, Oh MD, Choe KW. Vivax malaria: A continuing health threat to the Republic of Korea. Am J Trop Med Hyg. 2003. 69:159–167.
crossref
3. Yeom JS, Ryu SH, Oh S, Lee WJ, Kim TS, Kim KH, Kim YA, Ahn SY, Cha JE, Park JW. Status of plasmodium vivax malaria in the Republic of Korea during 2001 ~ 2003. Am J Trop Med Hyg. 2005. 73:604–608.
crossref
4. Alving AS. Mass therapy of subclinical vivax malaria with primaquine. JAMA. 1952. 149:1558–1562.
5. Coatney GR, Getz ME. Primaquine and quinocide as curative agents against sporozoite-induced Chesson strain vivax malaria. Bulletin of WHO. 1962. 27:290–293.
6. Hale TR, Halpenny GW. Malaria in Korean veterans. CanadMAJ. 1953. 68:444–448.
7. Paik YH, Song JH, Lee SW. The study on the radical treatment of vivax malaria with primaquire. Korean J Parasito. 1964. 2:110.
8. Byun KS, Baek YS, Lee KS, Chang WI, Park Y. Clincal observation on 1,000 cases of malaria from Nha-Trang area in Vietnam.
12. WHO. Advances in malaria chemotherapy. WHO Technical Reports Series. 1984. 63:711.
13. WHO. WHO Model Prescribing Information - Drugs used in Parasitic Diseases. 1995. 2nd ed. 43–45.
15. CDC. Treatment of Malaria (Guidelines for Clinicians). 2004. 5.
16. Gustafsson LL, Beermann B, Abdi YA. Handbooks of Drugs for Tropical Parasitic Infections. 1987.
17. Pukrittayakamee S, Vanijanonta S, Chantra A, Clemens R, White NJ. Blood stage antimalarial efficacy of primaquine in Plasmodium vivax malaria. J Infect Dis. 1994. 169:932–935.
crossref
18. WHO. The Use of Antimalarial Drugs. 2001.
19. WHO. Malaria Epidemics. 2004.
20. WHO. Intercountry Workshop on Monitoring Therapeutic Efficacy of Antimalarial Drugs. 2002.
21. WHO. Control of Malaria in East Asia. 2005.
22. WHO. Guidelines for the Treatment of Malaria. 2006.
23. Hill DR, Baird JK, Parise ME, Lewis LS, Ryan ET, Magrill AJ. Primaquine: report from CDC expert meeting on malria chemoprophylaxis I. Am J Trop Med Hy. 2006. 75:402–415.
24. Schmidt LH, Fradkin R, Vaughan D, Rasco J. Radical cure of infections with Plasmodium cynomolgi: a function of total 8-aminoquinoline dose. Am J Trop Med Hyg. 1977. 26:1116–1128.
crossref
25. Blackwell RQ, Ro IH, Yen L. Low incidence of erythrocyte G6PD deficiency in Koreans. Vox Sang. 1968. 14:299–303.
crossref
26. Kim MK, Yang CH, Kang SH, Lyu CJ, Kim KY. Glucose-6-phosphate dehydrogenase deficiency. J Korean Med Sci. 1992. 7:71–75.
27. Chung YJ, Kang SJ, Joo EJ. A study of erythrocyte G6PD gene frequency in Korean Population. Journal of Korean Research Institute for Better Living. 1989. 43:55–63.
TOOLS
ORCID iDs

Joon-Sup Yeom
https://orcid.org/http://orcid.org/0000-0001-8940-7170

Similar articles