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Jae-Won Park, M.D., Ph.D.*, 1, Jee-Young Hong, M.D.*, 2, Joon-Sup Yeom, M.D.3
, Sung-Rae Cho, M.D.1, Dae-Kyu Oh, M.D., Ph.D.4
, Sung-Rae Cho, M.D.1, Dae-Kyu Oh, M.D., Ph.D.4
Abstract
Background
Vivax malaria had spread rapidly in areas adjacent to the Demilitarized Zone to reach more than 4,000 cases in 2000 in the Republic of Korea (ROK). After year 2000, annual cases decreased rapidly to reach less than 1,000 cases in 2004. However, the number increased again since 2005. Epidemiological characteristics of vivax malaria in the ROK are different before and after 2000. This article was aimed to evaluate the current status of malaria elimination project in the ROK for providing suggestions for its improvement.
Materials and Methods
We analyzed the total reported malaria cases during 2005 to 2007 and reviewed the record on the malaria eradication project performed by the authorizations including the Korea Center for Disease Control and Prevention.
Results
During 2005 to 2007, 45% of all the vivax malaria occurred in patients living in the non-prevalent areas; the interval between first symptom onset and diagnosis was longer in the non-prevalent areas compared to that in the prevalent areas. Education and publicity on malaria has not been properly performed in the non-prevalent areas. The military didn't take part in the control of the malaria infected discharged soldiers, most of whom might have been infected with malaria during their military service.
Conclusion
For the efficient control of malaria and thus improving the effectiveness of the elimination project, education and publicity on malaria in the non-prevalent areas should be strengthened and cooperation between private and military sector regarding the ex-soldiers infected with malaria is essential. In addition, there should be bilateral communication among malaria-related teams within the Korea Centers for Disease Control and Prevention and also among all the malaria-related sectors. Furthermore, a common database on malaria patients and vector mosquitoes should be formed to grant access to all the malaria-related sectors. Improvement on report and surveillance system is also necessary.
Figures and Tables
Figure 1
Proportion of the patients in the malaria prevalent and non-prevalent areas during 2005-2007.
Figure 2
Proportion of the patients according to the type of medical institution, interval between first symptom onset and diagnosis according to the type of medical institution, and occupation of the patients during 2005-2007.
Figure 3
Current system of epidemiological investigation and surveillance on vector and patients with vivax malaria in the Republic of Korea.
Figure 4
Suggestion for improving the effectiveness of the current malaria elimination project in the Republic of Korea.
Table 1
Current Status of Surveillance, Education and Publicity for the Malaria Elimination Project in the Republic of Korea
*Malaria-monitoring network represents the cooperative surveillance system between private and public sectors, which consists of medical institution, pharmacy, nurse-teacher, representative of the residents, and regional bureaucrats.
†These activities have been performed in the public health center, not in the public health sub-center or community health post.
‡Adjacent areas represent the non-prevalent areas adjacent to the prevalent areas.
§This activity has been performed only in a few of the public health center in Seoul.
∥Non-adjacent areas represent the non-prevalent areas which are not adjacent to the prevalent areas.
Table 2
Current Status of Epidemiological Investigation on Vivax Malaria Patients in the Republic of Korea
Table 3
Current Status of Malaria Elimination Project in the Republic of Korea Army
*Health policy-planning group consists of the health policy division of the Ministry of National Defence and the Office of the Surgeon General of Army and Navy Headquarters
†In malaria elimination project, veteran patients are classified asinto civilians. Diagnosis, treatment, and report of the veteran patients have been performed by private medical institution of public health center. Surveillance system and evaluation of malaria control project on the veteran patients have been performed by the Korea Centers for Disease Control and Prevention, public health center of each county or district, and public health division of each city or province.
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