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Original Article

Recent Spatial and Temporal Trends of Malaria in Korea

Yeong Hoon Kim1, Hye-Jin Ahn2, Dongjae Kim3orcid, Sung-Jong Hong4orcid, Tong-Soo Kim4orcid, Ho-Woo Nam2,*orcid
The Korean Journal of Parasitology 2021;59(6):585-593.
Published online: December 22, 2021

1Department of Ophthalmology, College of Medicine, Catholic University of Korea, Seoul 06591, Korea

2Department of Parasitology, College of Medicine, Catholic University of Korea, Seoul 06591, Korea

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*Corresponding author (howoo@catholic.ac.kr)
• Received: November 28, 2021   • Revised: November 30, 2021   • Accepted: November 30, 2021

© 2021, Korean Society for Parasitology and Tropical Medicine

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Recent Spatial and Temporal Trends of Malaria in Korea
Korean J Parasitol. 2021;59(6):585-593.   Published online December 22, 2021
DOI: https://doi.org/10.3347/kjp.2021.59.6.585
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Recent Spatial and Temporal Trends of Malaria in Korea
Korean J Parasitol. 2021;59(6):585-593.   Published online December 22, 2021
DOI: https://doi.org/10.3347/kjp.2021.59.6.585
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Recent Spatial and Temporal Trends of Malaria in Korea
Image Image Image Image
Fig. 1 Clusters detected for all cases of malaria. Area codes represent administrative districts of the Korean government. Light to dark blue gradient indicates increasing order of log likelihood ratio. Dashed lines represent a joint cluster.
Fig. 2 Clusters detected for P. falciparum. Area codes represent administrative districts. Light to dark blue gradient indicates increasing order of log likelihood ratio.
Fig. 3 Clusters detected for P. vivax. Area codes represent administrative districts. Incheon was the most likely cluster.
Fig. 4 Spatiotemporal trends of malaria. Area codes represent administrative districts. Green represents clusters that showed decreased rate over the period of 2010–2019. Light to dark green gradient indicates increasing order of log likelihood ratio. Red represents clusters that showed increase over the same period.

Fig. 1

Fig. 2

Fig. 3

Fig. 4

Recent Spatial and Temporal Trends of Malaria in Korea

Population and malaria cases for 2010–2019 according to administrative district

Cluster (code) Cumulated Population Cases
P. falciparum P. vivax P. malariae P. ovale Clicially diagnosed All cases
Seoul (SE) 100,309,373 492 999 37 113 2,617 4,258
Busan (BU) 35,042,646 89 97 4 17 503 710
Daegu (DG) 24,866,860 56 67 1 10 352 486
Incheon (IN) 28,915,035 75 568 9 18 991 1,661
Gwangju (GW) 14,657,097 51 42 4 32 357 486
Daejeon (DJ) 15,108,648 57 53 2 6 217 335
Ulsan (UL) 11,546,517 23 30 0 6 89 148
Gyeonggi-do (GY) 124,839,896 414 2,126 80 141 3,561 6,322
Gangwon-do (GA) 15,426,610 84 114 37 15 425 675
Chungcheongbuk-do (CB) 15,798,992 45 46 9 9 323 432
Chungcheongnam-do (CN) 20,856,616 51 39 12 18 537 657
Jeollabuk-do (JB) 18,605,718 50 69 13 35 880 1,047
Jeollanam-do (JN) 19,016,443 271 43 5 14 608 941
Gyeongsangbuk-do (GB) 26,925,299 73 66 5 31 794 969
Gyeongsangnam-do (GN) 33,458,210 99 66 10 61 653 889
Jeju-do (JE) 6,193,531 4 11 4 4 195 218
Total 511,567,491 1,934 4,436 232 530 13,102 20,234
Adjusted cases*
Seoul (SE) 4.9 9.96 0.37 1.13 26.09 42.45
Busan (BU) 2.54 2.77 0.11 0.49 14.35 20.26
Daegu (DG) 2.25 2.69 0.04 0.40 14.16 19.54
Incheon (IN) 2.59 19.64 0.31 0.62 34.27 57.44
Gwangju (GW) 3.48 2.87 0.27 2.18 24.36 33.16
Daejeon (DJ) 3.77 3.51 0.13 0.4 14.36 22.17
Ulsan (UL) 1.99 2.60 0.00 0.52 7.71 12.82
Gyeonggi-do (GY) 3.32 17.03 0.64 1.13 28.52 50.64
Gangwon-do (GA) 5.45 7.39 2.40 0.97 27.55 43.76
Chungcheongbuk-do (CB) 2.85 2.91 0.57 0.57 20.44 27.34
Chungcheongnam-do (CN) 2.45 1.87 0.58 0.86 25.75 31.50
Jeollabuk-do (JB) 2.69 3.71 0.70 1.88 47.3 56.27
Jeollanam-do (JN) 14.25 2.26 0.26 0.74 31.97 49.48
Gyeongsangbuk-do (GB) 2.71 2.45 0.19 1.15 29.49 35.99
Gyeongsangnam-do (GN) 2.96 1.97 0.30 1.82 19.52 26.57
Jeju-do (JE) 0.65 1.78 0.65 0.65 31.48 35.20
Total 59 85 8 16 397 565

*Adjusted cumulated infection rate (cases/1,000,000).

Clusters detected malaria

District Cases Expected Relative Risk Log Likelihood Ratio P-value
All cases
 2010–2012 Incheon 694 471 1.52 49.274 <0.001
Jeollanam-do, Jeollabuk-do 733 636 1.17 7.674 0.00
Gangwon-do 314 258 1.23 5.914 0.01
 2013–2015 Incheon 497 322 1.60 43.556 <0.001
Gyeongsangbuk-do 406 300 1.38 17.984 <0.001
Gwangju 202 164 1.24 4.342 0.04
 2016–2019 Jeollanam-do, Jeollabuk-do 823 438 2.02 147.836 <0.001
Jeollabuk-do 438 216 2.11 91.604 <0.001
Jeollanam-do 385 221 1.79 51.661 <0.001
Incheon 470 346 1.39 21.285 <0.001
 Total period Incheon 1,661 1,144 1.49 109.579 <0.001
Jeollanam-do, Jeollabuk-do 1,988 1,488 1.37 82.628 <0.001
Jeollabuk-do 1,047 736 1.45 60.557 <0.001
Jeollanam-do 941 752 1.26 22.861 <0.001
P. falciparum
 2010–2012 Jeollanam-do 95 35 2.91 37.006 <0.001
Gangwon-do 47 28 1.71 5.52 0.01
 2013–2015 Jeollanam-do 65 19 3.81 36.544 <0.001
 2016–2019 Jeollanam-do 111 18 7.46 116.334 <0.001
 Total period Jeollanam-do 271 72 4.22 171.545 <0.001
Gangwon-do 84 58 1.46 5.146 0.02
P. vivax
 2010–2012 Incheon 264 117 2.42 72.733 <0.001
 2013–2015 Incheon 169 59 3.22 73.935 <0.001
 2016–2019 Incheon 135 73 1.96 22.949 <0.001
 Total period Incheon 568 251 2.45 159.54 <0.001
P. malariae
 Total period Gangwon-do 37 7 5.96 33.013 <0.001
P. ovale
 Total period Gyeongsangnam-do 61 35 1.86 8.853 <0.001
Gwangju 32 15 2.18 7.316 0.00
Jeollabuk-do 35 19 1.87 5.398 0.01
Clinically diagnosed malaria
 Total period Jeollabuk-do 880 477 1.91 142.846 <0.001
Incheon 991 741 1.37 40.797 <0.001
Jeju-do, Jeollanam-do 803 646 1.26 18.776 <0.001
Gyeongsangbuk-do 794 690 1.16 7.973 0.00

*Decreasing order of Log Likelihood Ratio.

Temporal trends of malaria

Malaria Districts Cases Trend inside cluster Trend outside cluster Log Likelihood Ratio P-value
All cases Gwangju 486 8.80 −10.47 73.128 <0.001
Jeju-do, Jeollanam-do, Jeollabuk-do 2,206 −2.57 −10.93 63.799 <0.001
Gyeongsangbuk-do 969 −19.70 −9.56 45.922 <0.001
Ulsan, Busan 858 −15.23 −9.83 11.593 <0.001
Gyeongsangnam-do 889 −6.58 −10.19 5.260 0.03
P. falciparum Jeollanam-do, Jeollabuk-do, Jeju-do, Daejeon 382 −4.70 −16.47 20.700 <0.001
Gyeongsangbuk-do, Daegu, Chungcheongbuk-do 193 −23.70 −13.15 9.456 0.00
P. vivax Jeollabuk-do, Daejeon, Chungcheongbuk-do 168 −22.86 −12.80 7.965 0.00
Ulsan, Busan 127 −23.66 −12.89 6.925 0.01
Gwangju 42 6.03 −13.33 6.866 0.01
P. malariae Jeollanam-do, Jeollabuk-do, Jeju-do, Daejeon 24 22.14 −6.27 5.741 0.02
P. ovale Jeollabuk-do 35 0.80 −19.81 6.714 0.01
Clinically diagnosed Gwangju 357 17.25 −8.78 85.97 <0.001
Jeju-do, Jeollanam-do, Jeollabuk-do 1,683 −0.50 −9.25 50.545 <0.001
Gyeongsangbuk-do 794 −18.45 −7.49 42.941 <0.001
Daejeon 217 −21.79 −7.93 19.403 <0.001
Ulsan, Busan 592 −13.11 −7.94 7.191 0.00
Chungcheongbuk-do 323 −1.81 −8.31 6.027 0.01

*Trend inside/outside cluster denotes % increase/decrease over the period of 2010–2019.

**Decreasing order of Log Likelihood Ratio.

Table 1 Population and malaria cases for 2010–2019 according to administrative district

Adjusted cumulated infection rate (cases/1,000,000).

Table 2 Clusters detected malaria

Decreasing order of Log Likelihood Ratio.

Table 3 Temporal trends of malaria

Trend inside/outside cluster denotes % increase/decrease over the period of 2010–2019.

Decreasing order of Log Likelihood Ratio.

Table 1

Table 2

Table 3

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