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Epidemiological Characteristics of Re-emerging Vivax Malaria in the Republic of Korea (1993-2017)

Young Yil Bahk1, Hyeong-Woo Lee2, Byoung-Kuk Na3, Jeonga Kim4, Kyoung Jin5, Yeong Seon Hong5, Tong-Soo Kim6,*
The Korean Journal of Parasitology 2018;56(6):531-543.
Published online: December 31, 2018

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*Corresponding author (tongsookim@inha.ac.kr)
• Received: April 12, 2018   • Revised: October 29, 2018   • Accepted: November 2, 2018

Copyright © 2018 by The Korean Society for Parasitology and Tropical Medicine

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Epidemiological Characteristics of Re-emerging Vivax Malaria in the Republic of Korea (1993-2017)
Korean J Parasitol. 2018;56(6):531-543.   Published online December 31, 2018
DOI: https://doi.org/10.3347/kjp.2018.56.6.531
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DOI: https://doi.org/10.3347/kjp.2018.56.6.531
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Epidemiological Characteristics of Re-emerging Vivax Malaria in the Republic of Korea (1993-2017)
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Fig. 1 Map of the Korean Peninsula. The DMZ divides Korea and North Korea. Malaria in Korea occurs mainly in the northern area close to the DMZ of Incheon-si, Gyeonggi-do, and Gangwon-do, and malaria in North Korea occurs in Gaeseong City, North and South Hwanghae provinces, and Gangwon province.
Fig. 2 Indigenous malaria cases in Korea before re-emergence. Indigenous vivax malaria was highly prevalent in Korea, but it was successfully eradicated from the region in the early 1970s [13–16]. The asterisk indicates the number of imported cases of malaria.
Fig. 3 Indigenous malaria cases in Korea after re-emergence. Since its re-emerging in 1993, the highest patient outbreak occurred in 2000. Since 2000, there has been a mixed pattern of repeated increases and decreases in the incidence of malaria, but the overall trend shows a plateau.

Fig. 1

Fig. 2

Fig. 3

Epidemiological Characteristics of Re-emerging Vivax Malaria in the Republic of Korea (1993-2017)

Number and percentage of vivax malaria cases confirmed in Korea from 1993 through 2017, and the distribution of the confirmed cases according to the month

Year No. Jan. Feb. Mar Apr. May Jun. Jul. Aug. Sep. Oct. Nov. Dec.
1993 3 1 1 1
1994 25 1 1 2 1 20
1995 107 1 13 22 44 22 5
1996 356 2 10 20 57 138 102 24 3
1997 1,724 3 1 4 12 35 163 337 465 519 144 36 5
1998 3,932 6 8 9 40 164 509 1,182 1,199 553 219 34 9
1999 3,621 13 12 22 80 257 516 798 978 602 273 59 11
2000 4,142 16 14 30 62 285 516 842 1,076 862 272 115 52
2001 2,556 14 19 34 45 176 369 681 624 378 173 30 12
2002 1,799 11 4 5 34 102 192 407 561 297 145 36 5
2003 1,171 10 8 9 25 73 176 275 295 186 85 22 7
2004 864 6 7 4 19 42 141 211 214 126 76 13 5
2005 1,369 6 5 12 21 49 133 295 398 256 154 34 6
2006 2,051 9 3 19 29 109 301 432 516 384 193 40 16
2007 2,227 15 8 10 20 110 239 605 639 329 173 65 14
2008 1,052 22 8 8 37 85 148 235 228 172 85 14 10
2009 1,345 3 3 9 48 121 213 313 269 211 99 45 11
2010 1,772 1 8 8 36 171 358 454 401 211 93 21 10
2011 838 8 10 12 25 82 171 209 166 95 44 12 4
2012 555 3 3 6 10 45 89 147 116 81 36 10 9
2013 445 4 6 8 15 53 77 95 69 58 49 10 1
2014 638 4 10 5 15 28 107 163 142 92 47 10 15
2015 699 8 5 8 37 84 129 151 146 79 36 7 9
2016 681 9 4 6 30 75 149 166 113 91 35 3 0
2017 515 7 7 2 9 37 86 133 112 76 35 4 7
Total (%) 34,487 (100) 178 (0.52) 154 (0.45) 233 (0.68) 651 (1.89) 2,194 (6.36) 4,818 (13.97) 8,211 (23.81) 8,909 (25.83) 5,782 (16.77) 2,515 (7.29) 623 (1.81) 218 (0.63)

Number and percentage of vivax malaria cases confirmed in Korea from 1993 through 2017 according to the Province

Total Seoul Busan Daegu Incheon Gwangju Daejeon Ulsan Gyeonggi Gangwon Chungbuk Chungam Jeonbuk Jeonnam Gyeongbuk Gyeongnam Jeju Sejong Unkonwn Imported case Men Women
1993 3 1 1 1 2
1994 25 1 1 2 20 1 N.D.
1995 107 5 1 1 1 93 4 1 1 N.D.
1996 356 9 1 1 5 1 290 40 1 2 4 2 N.D.
1997 1,724 99 17 14 52 6 8 1,277 177 5 14 8 14 11 20 2 N.D.
1998 3,932 449 108 55 212 29 24 13 2,197 519 32 63 25 59 42 99 6 N.D.
1999 3,621 487 81 41 328 25 40 36 1,760 514 26 40 43 59 72 60 9 N.D.
2000 4,142 494 92 82 461 47 43 37 1,649 825 41 60 58 73 78 71 18 13 N.D.
2001 2,556 346 65 30 271 30 31 32 898 544 23 34 39 36 42 61 6 12 67 2,190 366
2002 1,799 285 49 25 267 17 18 10 756 216 22 22 27 19 29 32 2 3 36 1,487 312
2003 1,171 170 27 13 166 17 9 18 518 132 9 16 12 20 24 13 2 5 64 948 223
2004 864 136 16 13 107 16 12 13 399 65 12 17 17 11 16 12 1 1 38 709 155
2005 1,369 213 28 16 222 8 12 13 660 78 10 11 25 20 26 22 4 1 45 1,126 243
2006 2,051 272 62 25 465 15 14 23 869 123 25 23 30 29 32 40 4 30 1,671 380
2007 2,227 314 41 36 484 7 23 16 1,007 125 30 23 23 20 35 41 2 35 1,834 393
2008 1,052 126 27 15 164 8 10 7 490 109 11 21 14 11 17 17 5 29 901 151
2009 1,345 178 33 25 164 10 21 16 611 154 18 27 18 11 32 26 1 26 1,183 162
2010 1,772 290 43 19 256 9 15 8 818 184 23 14 22 21 19 24 7 51 1,476 296
2011 838 94 24 16 124 6 9 7 389 94 11 12 12 11 12 13 4 64 744 94
2012 555 67 7 4 143 1 4 3 263 13 8 7 5 4 8 16 2 53 446 109
2013 445 45 8 8 84 3 4 1 228 27 7 3 2 4 11 8 2 60 369 76
2014 638 96 17 8 131 3 2 4 311 16 4 12 10 1 9 12 2 80 514 124
2015 699 91 6 5 108 1 6 4 417 20 8 8 7 4 6 5 2 1 71 600 99
2016 681 94 9 12 84 2 7 7 393 26 8 5 3 8 9 10 3 1 71 558 123
2017 515 68 3 4 80 9 1 3 295 12 2 10 3 3 13 4 4 1 0 79 400 115
Total (%) 34,487 (100) 4,430 (12.85) 766 (2.22) 468 (1.36) 4,382 (12.71) 270 (0.78) 313 (0.91) 271 (0.79) 16,609 (48.16) 4,017 (11.65) 336 (0.98) 443 (1.28) 403 (1.17) 440 (1.28) 547 (1.59) 610 (1.77) 88 (0.26) 3 (0.01) 35 (0.1) 901 (2.61)

Incidence rate (per 100,000 population) of vivax malaria from 1993 through 2017 according to the Province

Total Seoul Busan Daegu Incheon Gwangju Daejeon Ulsan Gyeonggi Gangwon Chungbuk Chungnam Jeonbuk Jeonnam Gyeongbuk Gyeongnam Jeju Sejong Unkonwn
1993 0.01 0.01 0.04 0.01
1994 0.06 0.01 0.03 0.09 0.26 0.03
1995 0.24 0.05 0.03 0.04 0.04 1.22 0.27 0.07 0.03
1996 0.77 0.09 0.03 0.04 0.20 0.07 3.22 2.69 0.05 0.10 0.15 0.07
1997 3.74 1.00 0.46 0.56 2.10 0.44 0.58 14.20 11.90 0.34 0.76 0.42 0.70 0.40 0.67 0.39
1998 8.52 4.54 2.94 2.22 8.57 2.14 1.75 1.28 24.45 34.90 2.18 3.41 1.32 2.96 1.54 3.32 1.17
1999 7.89 4.92 2.21 1.65 13.25 1.85 2.92 3.55 19.59 34.57 1.77 2.17 2.27 2.96 2.64 2.01 1.75
2000 8.98 4.99 2.51 3.31 18.63 3.47 2.92 3.65 18.35 55.48 2.80 3.25 3.07 3.66 2.86 2.38 3.51
2001 5.34 3.40 1.79 1.20 10.37 2.14 2.12 2.94 8.31 36.04 1.54 1.73 1.92 1.99 1.56 1.93 1.08 0 0
2002 3.74 2.80 1.35 1.00 10.22 1.21 1.23 0.92 7.00 14.31 1.47 1.12 1.01 1.38 1.08 1.01 0.36 0 0
2003 2.42 1.67 0.74 0.52 6.35 1.21 0.62 1.65 4.80 8.75 0.60 0.81 1.07 0.61 0.89 0.41 0.36 0 0
2004 1.78 1.34 0.44 0.52 4.10 1.14 0.82 1.19 3.69 4.31 0.80 0.86 0.59 0.87 0.60 0.38 0.18 0 0
2005 2.81 2.09 0.77 0.64 8.50 0.57 0.82 1.19 6.11 5.17 0.67 0.56 1.07 1.28 0.97 0.69 0.72 0 0
2006 4.20 2.67 1.71 1.00 17.80 1.07 0.96 2.11 8.05 8.15 1.68 1.17 1.60 1.48 1.19 1.26 0.72 0 0
2007 4.53 3.08 1.14 1.44 18.30 0.50 1.56 1.46 9.15 8.31 2.00 1.16 1.23 1.03 1.30 1.19 0.36 0 0
2008 2.13 1.24 0.76 0.60 6.12 0.56 0.68 0.63 4.38 7.24 0.73 1.05 0.75 0.57 0.63 0.53 0.89 0 0
2009 2.71 1.74 0.93 1.00 6.07 0.70 1.42 1.44 5.37 10.19 1.18 1.33 0.97 0.57 1.20 0.80 0.18 0 0
2010 3.53 2.83 1.21 0.76 9.36 0.62 1.00 0.71 7.04 12.09 1.49 0.68 1.18 1.10 0.71 0.73 1.23 0 0
2011 1.63 0.91 0.67 0.64 4.46 0.41 0.60 0.62 3.28 6.13 0.71 0.57 0.64 0.57 0.45 0.39 0.70 0 0
2012 1.07 0.66 0.20 0.16 5.07 0.07 0.26 0.26 2.19 0.85 0.51 0.34 0.27 0.21 0.30 0.48 0.34 0 0
2013 0.87 0.44 0.23 0.32 2.94 0.20 0.26 0.09 1.87 1.75 0.45 0.15 0.11 0.21 0.41 0.24 0.34 0 0
2014 1.25 0.95 0.48 0.32 4.53 0.20 0.13 0.34 2.53 1.04 0.25 0.58 0.53 0.05 0.33 0.36 0.33 0 0
2015 1.37 0.92 0.17 0.20 3.74 0.07 0.39 0.34 3.34 1.32 0.50 0.38 0.38 0.22 0.22 0.15 0.30 0.49 0
2016 1.33 0.95 0.26 0.49 2.91 0.13 0.46 0.60 3.15 1.71 0.50 0.24 0.16 0.44 0.34 0.30 0.46 0.49 0
2017 1.01 0.67 0.09 0.16 2.71 0.61 0.07 0.26 2.29 0.78 0.13 0.47 0.16 0.16 0.48 0.12 0.61 0.35 0

Number and percentage of vivax malaria cases confirmed in Korea from 2001 through 2017 according to the age groups and gender. Because of unavailability of number of vivax malaria according to age groups, this table presents the vivax malaria cases in Korea from 2001 through 2017

0–9 10–19 20–29 30–39 40–49 50–59 60–69 70- Total
Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total Male Female Total
2001 13 7 20 66 35 101 1,530 36 1,566 190 56 246 222 76 298 86 50 136 58 67 125 25 39 64 2,556
2002 15 7 22 38 18 56 969 41 1,010 166 52 218 145 74 219 82 48 130 53 47 100 19 25 44 1,799
2003 9 9 18 28 17 45 602 28 630 119 35 154 116 51 167 38 29 67 22 32 54 14 22 36 1,171
2004 3 3 6 30 17 47 444 18 462 64 29 93 81 29 110 45 23 68 28 19 47 14 17 31 864
2005 9 3 12 32 14 46 590 26 616 156 34 190 184 60 244 80 41 121 55 41 96 20 24 44 1,369
2006 17 11 28 68 28 96 843 45 888 257 47 304 241 87 328 130 65 195 80 55 135 35 42 77 2,015
2007 10 9 19 60 33 93 989 43 1,032 217 46 263 282 80 362 161 80 241 73 60 133 42 42 84 2,227
2008 1 2 3 34 8 42 498 22 520 87 26 113 146 35 181 74 27 101 37 17 54 24 14 38 1,052
2009 5 3 8 43 13 56 738 27 765 86 14 100 156 39 195 104 31 135 35 17 52 16 18 34 1,345
2010 7 5 12 55 23 78 813 36 849 145 52 197 223 67 290 147 48 195 62 37 99 24 28 52 1,772
2011 2 1 3 29 7 36 484 14 498 53 6 59 64 24 88 67 17 84 26 12 38 9 11 20 826
2012 3 1 4 17 8 25 197 14 211 47 15 62 77 20 97 58 18 76 19 12 31 16 20 36 542
2013 3 1 4 16 8 24 181 8 189 49 12 61 51 13 64 45 13 58 15 12 27 9 9 18 445
2014 1 1 2 20 9 29 195 10 205 77 22 99 100 24 124 85 29 114 27 13 40 9 16 25 638
2015 4 6 10 24 6 30 309 13 322 80 12 92 85 20 105 66 22 88 23 9 32 9 11 20 699
2016 3 1 4 12 4 16 326 21 347 69 7 76 71 23 94 52 28 80 22 12 34 9 13 22 673
2017 0 5 5 15 5 20 188 19 207 47 11 58 57 28 85 64 19 83 24 19 43 5 9 14 515
Total (%) 105 (0.51) 75 (0.37) 180 (0.88) 587 (2.86) 253 (1.23) 840 (4.09) 9,896 (48.17) 421 (2.05) 10,317 (50.22) 1,909 (9.29) 476 (2.32) 2,385 (11.61) 2,301 (11.20) 750 (3.65) 3,051 (14.85) 1,384 (6.74) 588 (2.86) 1,972 (9.60) 659 (3.21) 481 (2.34) 1,140 (5.55) 299 (1.46) 360 (1.75) 659 (3.21) 20,544 (100)
Table 1 Number and percentage of vivax malaria cases confirmed in Korea from 1993 through 2017, and the distribution of the confirmed cases according to the month
Table 2 Number and percentage of vivax malaria cases confirmed in Korea from 1993 through 2017 according to the Province
Table 3 Incidence rate (per 100,000 population) of vivax malaria from 1993 through 2017 according to the Province
Table 4 Number and percentage of vivax malaria cases confirmed in Korea from 2001 through 2017 according to the age groups and gender. Because of unavailability of number of vivax malaria according to age groups, this table presents the vivax malaria cases in Korea from 2001 through 2017

Table 1

Table 2

Table 3

Table 4

PHD : Parasites, Hosts and Diseases

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