Details

Autor(en) / Beteiligte

• Cooper, Daniel J
• Rajahram, Giri S
• William, Timothy
• Jelip, Jenarun
• Mohammad, Rashidah
• Benedict, Joseph
• Alaza, Danshy A
• Malacova, Eva
• Yeo, Tsin W
• Grigg, Matthew J
• Anstey, Nicholas M
• Barber, Bridget E

Titel

Plasmodium knowlesi Malaria in Sabah, Malaysia, 2015–2017: Ongoing Increase in Incidence Despite Near-elimination of the Human-only Plasmodium Species

Ist Teil von

• Clinical infectious diseases, 2020-01, Vol.70 (3), p.361-367

Ort / Verlag

US: Oxford University Press

Erscheinungsjahr

2020

Link zum Volltext

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• Abstract Background Malaysia aims to eliminate malaria by 2020. However, while cases of Plasmodium falciparum and Plasmodium vivax have decreased substantially, the incidence of zoonotic malaria from Plasmodium knowlesi continues to increase, presenting a major challenge to regional malaria control efforts. Here we report incidence of all Plasmodium species in Sabah, including zoonotic P. knowlesi, during 2015–2017. Methods Microscopy-based malaria notification data and polymerase chain reaction (PCR) results were obtained from the Sabah Department of Health and State Public Health Laboratory, respectively, from January 2015 to December 2017. From January 2016 this was complemented by a statewide prospective hospital surveillance study. Databases were matched, and species was determined by PCR, or microscopy if PCR was not available. Results A total of 3867 malaria cases were recorded between 2015 and 2017, with PCR performed in 93%. Using PCR results, and microscopy if PCR was unavailable, P. knowlesi accounted for 817 (80%), 677 (88%), and 2030 (98%) malaria cases in 2015, 2016, and 2017, respectively. P. falciparum accounted for 110 (11%), 45 (6%), and 23 (1%) cases and P. vivax accounted for 61 (6%), 17 (2%), and 8 (0.4%) cases, respectively. Of those with P. knowlesi, the median age was 35 (interquartile range: 24–47) years, and 85% were male. Conclusions Malaysia is approaching elimination of the human-only Plasmodium species. However, the ongoing increase in P. knowlesi incidence presents a major challenge to malaria control and warrants increased focus on knowlesi-specific prevention activities. Wider molecular surveillance in surrounding countries is required. Despite near-elimination of Plasmodium falciparum and Plasmodium vivax malaria in Malaysia, more than 2000 cases of Plasmodium knowlesi occurred in the state of Sabah in 2017, accounting for 98% of malaria diagnoses and representing a major challenge to malaria control.