Falling Plasmodium knowlesi Malaria Death Rate among Adults despite Rising Incidence, Sabah, Malaysia, 2010-2014

Giri Shan Rajahram, Bridget E. Barber, Timothy WILLIAM, Matthew J. Grigg, Jayaram Menon, Tsin W. Yeo, Nicholas M. Anstey

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    Abstract

    Deaths from Plasmodium knowlesi malaria have been linked to delayed parenteral treatment. In Malaysia, early intravenous artesunate is now recommended for all severe malaria cases. We describe P. knowlesi fatalities in Sabah, Malaysia, during 2012-2014 and report species-specific fatality rates based on 2010-2014 case notifications. Sixteen malaria-associated deaths (caused by PCR-confirmed P. knowlesi [7], P. falciparum [7], and P. vivax [1] and microscopy-diagnosed "P. malariae" [1]) were reported during 2012-2014. Six patients with severe P. knowlesi malaria received intravenous artesunate at hospital admission. For persons ≥15 years of age, overall fatality rates during 2010-2014 were 3.4, 4.2, and 1.0 deaths/1,000 P. knowlesi, P. falciparum, and P. vivax notifications, respectively; P. knowlesi-associated fatality rates fell from 9.2 to 1.6 deaths/1,000 notifications. No P. knowlesi-associated deaths occurred among children, despite 373 notified cases. Although P. knowlesi malaria incidence is rising, the notification-fatality rate has decreased, likely due to improved use of intravenous artesunate.

    Original languageEnglish
    Pages (from-to)41-48
    Number of pages8
    JournalEmerging Infectious Diseases
    Volume22
    Issue number1
    DOIs
    Publication statusPublished - Jan 2016

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    Accidental Falls
    Plasmodium knowlesi
    Plasmodium malariae
    Malaysia
    Mortality
    Incidence
    Malaria
    Microscopy
    Polymerase Chain Reaction

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    title = "Falling Plasmodium knowlesi Malaria Death Rate among Adults despite Rising Incidence, Sabah, Malaysia, 2010-2014",
    abstract = "Deaths from Plasmodium knowlesi malaria have been linked to delayed parenteral treatment. In Malaysia, early intravenous artesunate is now recommended for all severe malaria cases. We describe P. knowlesi fatalities in Sabah, Malaysia, during 2012-2014 and report species-specific fatality rates based on 2010-2014 case notifications. Sixteen malaria-associated deaths (caused by PCR-confirmed P. knowlesi [7], P. falciparum [7], and P. vivax [1] and microscopy-diagnosed {"}P. malariae{"} [1]) were reported during 2012-2014. Six patients with severe P. knowlesi malaria received intravenous artesunate at hospital admission. For persons ≥15 years of age, overall fatality rates during 2010-2014 were 3.4, 4.2, and 1.0 deaths/1,000 P. knowlesi, P. falciparum, and P. vivax notifications, respectively; P. knowlesi-associated fatality rates fell from 9.2 to 1.6 deaths/1,000 notifications. No P. knowlesi-associated deaths occurred among children, despite 373 notified cases. Although P. knowlesi malaria incidence is rising, the notification-fatality rate has decreased, likely due to improved use of intravenous artesunate.",
    keywords = "artesunate, death rate, deaths, fatal malaria, fatality rate, incidence, malaria, Malaysia, parasitemia, parasites, Plasmodium falciparum, Plasmodium vivax, severe malaria. Plasmodium knowlesi",
    author = "Rajahram, {Giri Shan} and Barber, {Bridget E.} and Timothy WILLIAM and Grigg, {Matthew J.} and Jayaram Menon and Yeo, {Tsin W.} and Anstey, {Nicholas M.}",
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    Falling Plasmodium knowlesi Malaria Death Rate among Adults despite Rising Incidence, Sabah, Malaysia, 2010-2014. / Rajahram, Giri Shan; Barber, Bridget E.; WILLIAM, Timothy; Grigg, Matthew J.; Menon, Jayaram; Yeo, Tsin W.; Anstey, Nicholas M.

    In: Emerging Infectious Diseases, Vol. 22, No. 1, 01.2016, p. 41-48.

    Research output: Contribution to journalArticleResearchpeer-review

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    AU - Rajahram, Giri Shan

    AU - Barber, Bridget E.

    AU - WILLIAM, Timothy

    AU - Grigg, Matthew J.

    AU - Menon, Jayaram

    AU - Yeo, Tsin W.

    AU - Anstey, Nicholas M.

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    Y1 - 2016/1

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    AB - Deaths from Plasmodium knowlesi malaria have been linked to delayed parenteral treatment. In Malaysia, early intravenous artesunate is now recommended for all severe malaria cases. We describe P. knowlesi fatalities in Sabah, Malaysia, during 2012-2014 and report species-specific fatality rates based on 2010-2014 case notifications. Sixteen malaria-associated deaths (caused by PCR-confirmed P. knowlesi [7], P. falciparum [7], and P. vivax [1] and microscopy-diagnosed "P. malariae" [1]) were reported during 2012-2014. Six patients with severe P. knowlesi malaria received intravenous artesunate at hospital admission. For persons ≥15 years of age, overall fatality rates during 2010-2014 were 3.4, 4.2, and 1.0 deaths/1,000 P. knowlesi, P. falciparum, and P. vivax notifications, respectively; P. knowlesi-associated fatality rates fell from 9.2 to 1.6 deaths/1,000 notifications. No P. knowlesi-associated deaths occurred among children, despite 373 notified cases. Although P. knowlesi malaria incidence is rising, the notification-fatality rate has decreased, likely due to improved use of intravenous artesunate.

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    KW - parasitemia

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