Characteristics of imported and domestic malaria cases in Gyeonggi Province, Korea
Article information
To the Editor:
The authors regret that there were errors in the text.
Content of correction:
Imported cases’ major malaria species is P. falciparum (62.3%), not P. malariae.
So, P. malariae in the graphical abstract key message, keywords in the abstract, results, and discussion is changed to P. falciparum.
Plasmodium vivax was the predominant species in domestic cases (94.9%), whereas P. malariae was more common in imported cases (62.3%).
Plasmodium vivax was the predominant species in domestic cases (94.9%), whereas P. falciparum was more common in imported cases (62.3%). (Revised)
KEY WORDS: Malaria, Plasmodium vivax, Plasmodium malariae
KEY WORDS: Malaria, Plasmodium vivax, Plasmodium falciparum (Revised)
Notably, West Africa was responsible for over half of the P. malariae infections.
Notably, West Africa was responsible for over half of the P. falciparum infections. (Revised)
P. vivax was the most common malarial species in domestic cases, accounting for 94.9%, while P. malariae was more prevalent among imported cases, at 62.3%.
P. vivax was the most common malarial species in domestic cases, accounting for 94.9%, while P. falciparum was more prevalent among imported cases, at 62.3%. (Revised)
However, P. malariae accounted for 62.3% of imported malaria. cases, followed by P. vivax at 29%, indicating a stark However, P. malariae accounted for 62.3% of imported malaria cases, followed by P. vivax at 29%, indicating a stark difference between domestic and imported infections. P. malariae is a less-studied species, and malaria caused by this species is referred to as “benign malaria” because of its low prevalence and mild clinical symptoms. P. malariae is prevalent in sub-Saharan Africa [21].
In this study, among 114 cases of P. malariae, 112 contracted the infection in Africa, reflecting its global distribution. P. malariae has become common in the areas where the incidence of P. falciparum has decreased because of successful interventions [21]; therefore, successful interventions with other malarial species may increase the incidence of other rare malarial species. Despite the lower pathogenicity of P. malariae, which accounted for the majority of imported cases, 67.2% of individuals infected overseas were hospitalized, and 80% received treatment—rates significantly higher than those observed in domestic cases. This discrepancy may be attributed to the older age of patients with imported malaria compared to those with domestic malaria.
Additionally, given that P. malariae is the most frequent coinfection in populations endemic for P. falciparum and P. vivax, the high proportion of P. malariae among imported cases, combined with the predominance of P. vivax in domestic cases, could pose a public health challenge in Korea.
However, P. falciparum accounted for 62.3% of imported malaria cases, followed by P. vivax at 29%, indicating a stark difference between domestic and imported infections. Additionally, P. malariae is a less-studied species due to its low parasite density and frequent co-infections with P. falciparum, making its detection challenging with routine diagnostic methods. Although P. malariae is often considered to cause mild disease, it can persist as a chronic infection and has been associated with nephropathy. This species is prevalent in sub-Saharan Africa, with reported prevalence ranging from 0% to 32% depending on diagnostic methods, and seroprevalence reaching up to 56% in some countries [21].
In this study, among 114 cases of P. falciparum, 112 were acquired in Africa, reflecting its global distribution. Meanwhile, although P. malariae remains relatively rare, its prevalence may have increased in regions where P. falciparum has declined due to successful interventions [21]. Therefore, successful interventions with other malarial species may increase the incidence of other rare malarial species.
Given the high proportion of P. falciparum among imported cases, which accounted for 62.3% of infections, 67.2% of individuals infected overseas were hospitalized, and 80% received treatment—rates significantly higher than those observed in domestic cases. This discrepancy may be attributed to the severe nature of P. falciparum infections and the older age of patients with imported malaria compared to those with domestic malaria.
Additionally, P. malariae is commonly detected as a coinfection in populations endemic for P. falciparum and P. vivax. The high proportion of P. falciparum among imported cases, combined with the predominance of P. vivax in domestic cases, could pose a public health challenge in Korea. (Revised)
DOI of original article https://doi.org/10.4178/epih.e2024087