Malaria Diagnosis Status in Republic of Korea, 2021-2025

This study aims to identify the characteristics of domestic malaria by examining the status of malaria diagnoses referred to the Korea Disease Control and Prevention Agency (KDCA) between 2021 and 2025.

Malaria diagnostic samples referred to the KDCA were classified into private sector submissions from medical institutions and public sector submissions from public health centers and military hospitals. Malaria infection was confirmed by microscopic examination or molecular detection. Patient characteristics, such as parasitemia levels, were estimated using a formula based on real-time polymerase chain reaction (PCR) cycle threshold (C_t) values.

The KDCA collected a total of 2,508 malaria-positive samples between 2021 and 2025. Domestic Plasmodium vivax accounted for 96.2% of malaria cases, whereas imported malaria cases were caused by Plasmodium falciparum (75.8%), Plasmodium ovale (16.8%), P. vivax (5.3%), and P. falciparum-P. ovale coinfection (2.1%). The proportion of diagnostic referrals from public health centers was peaked at 58.9% in 2023 and subsequently decreased, whereas the proportion from secondary hospitals gradually increased, reaching 43.8% in 2025. In contrast, the proportion from military hospitals markedly declined from 26.8% in 2024 to 9.9% in 2025. Based on parasitemia estimates calculated from real-time PCR C_t values, most patients in 2024-2025 showed parasitemia levels of 8,000/µl or higher.

Accurate malaria diagnosis is essential for effective disease prevention and control. This study is expected to facilitate patient management and contribute to national malaria elimination by providing basic information through an analysis of the status of malaria diagnosis over five years.