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Imported Malaria in Korea: a 13-Year Experience in a Single Center

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The incidence of imported malaria has been increasing in Korea. We reviewed data retrospectively to evaluate the epidemiology, clinical features, and outcomes of imported malaria from 1995 to 2007 in a university hospital. All patients diagnosed with imported malaria were included. Imported malaria was defined as a positive smear for malaria that was acquired in a foreign country. A total of 49 patients (mean age, 35.7 year; M : F = 38 : 11) were enrolled. The predominant malarial species was Plasmodium falciparum (73.5%), and the most frequent area of acquisition was Africa (55.1%), followed by Southeast Asia (22.4%) and South Asia (18.4%). Fourteen-patients (30.6%) suffered from severe malaria caused by P. falciparum and 1 patient (2.0%) died of multiorgan failure. Most of the patients were treated with mefloquine (79.2%) or quinine (10.2%); other antimalarial agents had to be given in 13.2% treated with mefloquine and 44.4% with quinine due to adverse drug events (ADEs). P. falciparum was the most common cause of imported malaria, with the majority of cases acquired from Africa, and a significant number of patients had severe malaria. Alternative antimalarial agents with lower rates of ADEs might be considered for effective treatment instead of mefloquine and quinine.

Abstract

The incidence of imported malaria has been increasing in Korea. We reviewed data retrospectively to evaluate the epidemiology, clinical features, and outcomes of imported malaria from 1995 to 2007 in a university hospital. All patients diagnosed with imported malaria were included. Imported malaria was defined as a positive smear for malaria that was acquired in a foreign country. A total of 49 patients (mean age, 35.7 year; M : F = 38 : 11) were enrolled. The predominant malarial species was Plasmodium falciparum (73.5%), and the most frequent area of acquisition was Africa (55.1%), followed by Southeast Asia (22.4%) and South Asia (18.4%). Fourteen-patients (30.6%) suffered from severe malaria caused by P. falciparum and 1 patient (2.0%) died of multiorgan failure. Most of the patients were treated with mefloquine (79.2%) or quinine (10.2%); other antimalarial agents had to be given in 13.2% treated with mefloquine and 44.4% with quinine due to adverse drug events (ADEs). P. falciparum was the most common cause of imported malaria, with the majority of cases acquired from Africa, and a significant number of patients had severe malaria. Alternative antimalarial agents with lower rates of ADEs might be considered for effective treatment instead of mefloquine and quinine.

참고문헌 (9)

  1. "Center for Disease Control and Prevention"[URL]
  2. 한은택, "Reemerging vivax malaria: changing patterns of annual incidence and control programs in the Republic of Korea", The Korean Journal of Parasitology, 44(4), pp.285~294 (2006), 대한기생충학회
  3. Seo BS, "Parasitological studies of Korean forces in South Vietnam. I. Examination of blood films on malaria patients", Korean J Parasitol, 8, pp.25~29 (1970)
  4. "Center for Disease Control and Prevention"[URL]
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  6. World Health Organization, "Severe and complicated malaria, in Division of Control of Tropical Diseases", Trans R Soc Trop Med Hyg, 84(suppl. 2), pp.1~65 (1990)
  7. Greenwood BM, "Malaria", Lancet, 365, pp.1487~1498 (2005)
  8. Ki HK, "Incidence of mefloquine-related adverse reactions in Korean travelers", J Korean Soc Chemoth, 18, pp.299~306 (2000)
  9. Miura T, "Clinical characteristics of imported malaria in Japan: analysis at a referral hospital", Am J Trop Med Hyg, 73, pp.599~603 (2005)

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