Status of Plasmodium vivax malaria in the Republic of Korea, 2008–2009: decrease followed by resurgence

The number of Plasmodium vivax malaria cases in the Republic of Korea (ROK) in 2008 was 1009, a 54.2% decrease on the previous year. It then resurged to 1317 cases in 2009 (30.5% increase on 2008). One possible cause for the sharp decrease in 2008 might be the large-scale presumptive anti-relapse therapy with primaquine that was undertaken in the Democratic People's Republic of Korea in 2007. Of the 2326 cases of P. vivax malaria diagnosed in the ROK during 2008–2009, 599 cases (25.8%) were military personnel, 535 cases (23.0%) were veterans, and 1192 cases (51.2%) were civilians. Local transmission within the ROK appeared to increase gradually, and the length of the transmission period of P. vivax malaria extended during this period. Parasite clearance time after chloroquine treatment has increased in the late 2000s, which requires the introduction of countermeasures against the decreasing chloroquine susceptibility, including reduction of mass chemoprophylaxis with chloroquine in the ROK Army.