최근 5년간(1993년~1997년) 국군장병에서 발생한 말라리아의 역학과 그 관리

Abstract

The author evaluated the cases of vivax malaria in Korean soldiers for the last 5 years (1993-1997). Vivax malaria have been rapidly increasing and spreading about 3-5 times each year in northern area of Kyunggi province in Korea. The incidence of vivax malaira occured in August, September, July in order, and was peaked from August to September in 1997. Especially the phenomenon that vivax malaria occurred all through in year 1997 was very interesting. The counties of high incidence were Yonchon (45%),Paju(33.2%) and Chorwon (13.1%). Incidence of ChorwonGun was increased 10 times extremely in 1996, but PajuGun was increased extremely in 1997. About 88% of malaria cases (n=343) were the army soldiers, who were residing in Demilitarized Zone areas (About 10 Km distance from southern demarcation line. of DMZ) from 1993 to q996. But about 73% of malaria cases (n=840) were related with DMZ in 1997. So relation between malaria incidence and DMZ slightly decreased and that aspects suggest spreading and becoming indigenous of vivax malaria. We administered chloroquine and primaquine for chemoprophylaxis of vivax malaria to soldiers who served in high incident region in 1997, so we could not find incident case who took medicine regularly and tolerant cases. But identified 126 malaria cases were due to inadequate, irregular taking medicine or stopped taking medicine for a time. All of the patient who affected with vivax malaria were hospitalized and treated with standardized regimen of chloroquine and primaquine (WHO, 1973), resistant cases were not seen. The duration of diagnosis that period between confirmed and symptom developed was 9.5 days in 1997. We concluded the necessity of an efficient and a systematic countermeasure for eradicating vivax malaria in northern areas of Kyunggi province in Korea.