• Parasites, Hosts and Diseases
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• 제47권3호
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• pp.227-233
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• 2009

Local malaria transmission in the United Arab Emirates (UAE) came to an end in 1997. Nevertheless, UAE has been subjected to substantial importation of malaria cases from abroad, concerning both UAE nationals and immigrants from malarious countries with a total number of 2,119 cases in 2007. To evaluate a new DNA extraction technique using nested PCR, blood samples were collected from 132 individuals who presented to Infectious Diseases Department in Rashid Hospital, Dubai, and Central Department of Malaria Control with fever and persistent headache. Giemsa-stained blood films and ELISA test for malaria antibodies were carried out for detection of Plasmodium infection. Plasmodium infections were identified with the genus-specific primer set and species differentiation using nested PCR. A rapid procedure for diagnosis of malaria infections directly from dried blood spots using for the first time DNA extract from FTA Elute cards was evaluated in contrast to extraction techniques using FTA classic cards and rapid boiling technique. Our new simple technique for DNA extraction using FTA Elute cards was very sensitive giving a sensitivity of 100% compared to 94% using FTA classic cards and 62% in the rapid boiling technique. No complex preparation of blood samples was required prior to the amplification. The production cost of DNA isolation in our PCR assay was much less incomparable to that of other DNA extraction protocols. The nested PCR detected plasmodial infection and could differentiate P. falciparum from P. vivax, and also detected the mixed infection.

• Parasites, Hosts and Diseases
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• 제51권5호
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• pp.557-562
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• 2013

In contrast to the gradual reduction in the number of locally transmitted malaria cases in China, the number of imported malaria cases has been increasing since 2008. Here, we report a case of a 39-year-old Chinese man who acquired Plasmodium ovale wallikeri infection while staying in Ghana, West Africa for 6 months in 2012. Microscopic examinations of Giemsa-stained thin and thick blood smears indicated Plasmodium vivax infection. However, the results of rapid diagnostic tests, which were conducted 3 times, were not in agreement with P. vivax. To further check the diagnosis, standard PCR analysis of the small-subunit rRNA gene was conducted, based on which a phylogeny tree was constructed. The results of gene sequencing indicated that this malaria is a variant of P. ovale (P. ovale wallikeri). The infection in this patient was not a new infection, but a relapse of the infection from the one that he had contracted in West Africa.

• Pediatric Infection and Vaccine
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• 제4권2호
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• pp.288-292
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• 1997

Malaria is a febrile disease caused by protozoan parasites, genus Plasmodium. In Korea., indigenous malaria has been believed to be eradicated by 1984, and, thereafter, all of the reported cases were imported malaria. But since the first case report of re-emerging indigenous malaria in 1993, increasing number of cases were reported reaching more than 350 cases in 1996. However, indigenous malaria in children has not been reported yet. We experienced two cases of indigenous malaria in sisters who were 7 and 5 years old, respectively. Elder sister was presented with periodic fever, splenomegaly and mild headache. She had been to Guam before 4 months of the onset of symptoms. Younger sister was suffered from fever and splenomegaly and has not been abroad. They were diagnosed by examination of peripheral blood smear to be infected with Plasmodium vivax and were treated with hydroxychloroquine and primaquine successfully. These cases are believed to be first re-emerging cases of indigenous malaria in children, and malaria should be included in the differential diagnosis of unexplained febrile children.

• Parasites, Hosts and Diseases
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• 제52권6호
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• pp.667-672
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• 2014

While imported falciparum malaria has been increasingly reported in recent years in Korea, clinicians have difficulties in making a clinical diagnosis as well as in having accessibility to effective anti-malarial agents. Here we describe an unusual case of imported falciparum malaria with severe hemolytic anemia lasting over 2 weeks, clinically mimicking a coinfection with babesiosis. A 48-year old Korean man was diagnosed with severe falciparum malaria in France after traveling to the Republic of Benin, West Africa. He received a 1-day course of intravenous artesunate and a 7-day course of Malarone (atovaquone/proguanil) with supportive hemodialysis. Coming back to Korea 5 days after discharge, he was readmitted due to recurrent fever, and further treated with Malarone for 3 days. Both the peripheral blood smears and PCR test were positive for Plasmodium falciparum. However, he had prolonged severe hemolytic anemia (Hb 5.6 g/dl). Therefore, 10 days after the hospitalization, Babesia was considered to be potentially coinfected. A 7-day course of Malarone and azithromycin was empirically started. He became afebrile within 3 days of this babesiosis treatment, and hemolytic anemia profiles began to improve at the completion of the treatment. He has remained stable since his discharge. Unexpectedly, the PCR assays failed to detect DNA of Babesia spp. from blood. In addition, during the retrospective review of the case, the artesunate-induced delayed hemolytic anemia was considered as an alternative cause of the unexplained hemolytic anemia.

• Parasites, Hosts and Diseases
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• 제36권2호
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• pp.143-146
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• 1998

최근 primaquine으로 완치 (radicalcure)된 후에도 재발하는 삼일열 말라리아 보고가 많아지면 서 primaquine에 대한 내성 가능성이 언급되고 있다. 저자들은 해외여행 중에 감염된 삼일열 말라리아를 hydroxychloroquine과 primaquine으로 치료한 후 재발한 예를 경험하였기에 문헌고찰과 함께 보고한다. 35세 남자 환자가 내원 34일 전부터 15일간 인도 뭄바이와 중국 쉬천에 출장 다녀왔고 귀국 3일 후부터 고열이 발생하여 발열 17일째 본원에 입원하였다. 말초혈액 도말검사에 서 분열체 내의 분열소체의 수가 14개 이상 되고 세포질 형태가 불규칙적인 영양형이 보여 삼일열 말라리아로 진단한 후 hydrouychloroquine를 투여하고 열이 떨어진 후 primaquine (15 mg/일, 14일간)을 투여하였다. 치료 후 55일째까지 말라리아 재발의 증상이 없었고 말초혈액 도말에서도 말라리아 원충이 없음을 확인하였다. 6개월 후 다시 발열이 생기고 말초혈액 도말검사에서 분열소 체와 영양형이 보여 재발로 진단하였다 처음 입원 때와 같은 방법으로 치료하였고 현재까지 10개월간 경과 관찰 중이며 증상의 재발은 없었다.

• Parasites, Hosts and Diseases
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• 제22권1호
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• pp.72-77
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• 1984

A case of congenital malaria infection has been studied in a 46-day old female Korean infant. Her mother suffered from malaria infection during pregnancy in Uppervolta, Africa, and returned to Korea at the 9th month of gestation for delivery. At 39 days of age, the clinical features characterized by fever, irritability, pallor, jaundice and hepatosplenomegaly were developed. The laboratory data revealed a hemolytic anemia with thronbocytopenia, hyperbilirubinemia and increased hepatic enzyme values. A peripheral blood smear demonstrated intraerythrocytic malarial parasites and gametocytes of Plasmodium falciparum. She was successfully treated with quinine solfate (25mg/kg/day in three doses for 5 days) and trimethoprimejsulfamethoxazole (8mg/kg/day in two doses for 5 days) orally, and repeated blood smear had been negative for malaria. This report also signifies the first description of congenital malaria in Korea imported from Uppervolta in Africa. A brief review of related literature was made.

• 항공우주의학회지
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• 제29권3호
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• pp.96-100
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• 2019

본 연구는 2015년부터 2017년까지 한국과 일본에서 보고된 해외유입 말라리아(Exotic Malaria) 사례를 분석하여 말라리아 발병 국가를 방문한 여행자들의 위험 요인과 한국과 일본의 발병 유형에 차이점이 있는지를 확인하고자 하였다. 2015년 부터 2017년까지 한국의 질병통제예방센터(KCDC)와 일본의 국립전염병연구소(NIID) 웹사이트에서 얻은 해외유입 말라리아에 대한 자료를 분석하였다. 한국 전역에서 162건의 해외유입 말라리아가 발생하여 10만명당 누적 발생률(CIR)이 0.105이며, 해외여행자 10만명당 CIR은 0.238이었다. 같은 기간 일본 전역에서 152건의 해외유입 말라리아가 발생하여 10만명당 CIR이 0.041, 해외여행자 10만명당 CIR이 0.297이었다. 양국을 비교했을 때 전국적으로 해외유입 말라리아의 CIR은 일본에 비해 훨씬 높았지만(P0.01), 한국 해외여행자의 CIR은 일본보다 낮았다(P0.01). 두 나라 모두 여성보다 남성의 경우 해외유입 말라리아 감염이 더 많았다(한국에서는 4.06배, 일본에서는 3.22배). 한국에서는 4050세 연령층에서 감염 발생률이 가장 높았고(전체 사례의 51.9%), 일본에서는 20-39세 연령층에서 감염발생률이 가장 높았다(전체 사례의 50.0%) (P0.01).

• Parasites, Hosts and Diseases
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• 제56권6호
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• pp.609-613
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• 2018

Babesiosis, caused by Babesia microti and B. divergens, is transmitted by Ixodid ticks. Symptoms of babesiosis vary from a mild flu-like illness to acute, severe, and sometimes fatal and fulminant disease. In Korea, 7 imported babesiosis cases and 1 endemic case have been reported. We report 2 cases of severe babesiosis initially mistaken as malaria. The first patient was complicated by shock and splenic infarction, the other co-infected with Lyme disease. As the population traveling abroad increases every year, physicians should be aware of babesiosis which mimics malaria, co-infection with other diseases, and its complications.

• Pediatric Infection and Vaccine
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• 제24권2호
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• pp.117-122
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• 2017

흑수열은 급성 혈관 내 용혈, 발열과 검붉은색 소변 등의 증상을 보이는 증후군으로, 말라리아 및 불규칙적인 키닌의 투약과 관련 있는 것으로 알려져 있다. 국내에서는 삼일열 말라리아만 발생하고 있으나, 최근 말라리아 유행지역을 여행한 해외여행객들로부터 열대열 말라리아의 해외 유입 보고가 증가하고 있다. 따라서 의료진들은 열대열 말라리아와 그 합병증에 대해 알 필요가 있다. 본 증례는 쇼크를 동반한 중증 열대열 말라리아 이후에 흑수열이 합병한 14세 여자에 대해 보고하는 바이다.

• Parasites, Hosts and Diseases
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• 제22권2호
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• pp.267-272
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• 1984

1983년 6월에 일본으로부터 자연농권 동물권에 수입된 3세령의 반umboldt젠귄 4수가 입사한지 일주만에 갑자기 식욕절폐, 원기소침하여 4∼6일만에 3수가 폐 사하였다. 환조의 혈액도말표본에서 성숙적혈구내에 발육단계가 다른 기생체가 확인되었다. 폐사한 동물은 폐장과 심장에서 심한 수종성 변화가 인정되었고 간장과 비장이 종창해 있었다. 각 장기의 조직학적 결사에서 간회, 등장 및 폐장등에서 광범위하게 현저한 세강훈 피계세계의 증식과 활성화가 관찰되었고 이들 세포에서 여러 발육단계의 schizont가 확인되었다. 이상의 관찰보고는 국내에서 조류의 말라리아 유행을 처음으로 기록한 것이다.