Increasing Incidence of Plasmodium knowlesi Malaria following Control of P. falciparum and P. vivax Malaria in Sabah, Malaysia

Timothy William, Hasan Rahman, Jenarun Jelip, Mohammad Ibrahim, Jayaram Menon, Matthew Grigg, Tsin Yeo, Nicholas Anstey, Bridget Barber

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Abstract

Background: The simian parasite Plasmodium knowlesi is a common cause of human malaria in Malaysian Borneo and threatens the prospect of malaria elimination. However, little is known about the emergence of P. knowlesi, particularly in Sabah. We reviewed Sabah Department of Health records to investigate the trend of each malaria species over time.

Methods

Reporting of microscopy-diagnosed malaria cases in Sabah is mandatory. We reviewed all available Department of Health malaria notification records from 1992–2011. Notifications of P. malariae and P. knowlesi were considered as a single group due to microscopic near-identity.

Results: 
From 1992–2011 total malaria notifications decreased dramatically, with P. falciparum peaking at 33,153 in 1994 and decreasing 55-fold to 605 in 2011, and P. vivax peaking at 15,857 in 1995 and decreasing 25-fold to 628 in 2011. Notifications of P. malariae/P. knowlesi also demonstrated a peak in the mid-1990s (614 in 1994) before decreasing to ≈100/year in the late 1990s/early 2000s. However, P. malariae/P. knowlesi notifications increased >10-fold between 2004 (n = 59) and 2011 (n = 703). In 1992 P. falciparum, P. vivax and P. malariae/P. knowlesi monoinfections accounted for 70%, 24% and 1% respectively of malaria notifications, compared to 30%, 31% and 35% in 2011. The increase in P. malariae/P. knowlesi notifications occurred state-wide, appearing to have begun in the southwest and progressed north-easterly.

Conclusions: 
A significant recent increase has occurred in P. knowlesi notifications following reduced transmission of the human Plasmodium species, and this trend threatens malaria elimination. Determination of transmission dynamics and risk factors for knowlesi malaria is required to guide measures to control this rising incidence.
Original languageEnglish
Article numbere2026
Pages (from-to)1-9
Number of pages9
JournalPLoS Neglected Tropical Diseases
Volume7
Issue number1
DOIs
Publication statusPublished - 2013

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Plasmodium knowlesi
Plasmodium malariae
Vivax Malaria
Malaysia
Malaria
Incidence
Borneo
Plasmodium
Health

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@article{31636895557d48ce98e4fb8e9584f801,
title = "Increasing Incidence of Plasmodium knowlesi Malaria following Control of P. falciparum and P. vivax Malaria in Sabah, Malaysia",
abstract = "Background: The simian parasite Plasmodium knowlesi is a common cause of human malaria in Malaysian Borneo and threatens the prospect of malaria elimination. However, little is known about the emergence of P. knowlesi, particularly in Sabah. We reviewed Sabah Department of Health records to investigate the trend of each malaria species over time.MethodsReporting of microscopy-diagnosed malaria cases in Sabah is mandatory. We reviewed all available Department of Health malaria notification records from 1992–2011. Notifications of P. malariae and P. knowlesi were considered as a single group due to microscopic near-identity.Results: From 1992–2011 total malaria notifications decreased dramatically, with P. falciparum peaking at 33,153 in 1994 and decreasing 55-fold to 605 in 2011, and P. vivax peaking at 15,857 in 1995 and decreasing 25-fold to 628 in 2011. Notifications of P. malariae/P. knowlesi also demonstrated a peak in the mid-1990s (614 in 1994) before decreasing to ≈100/year in the late 1990s/early 2000s. However, P. malariae/P. knowlesi notifications increased >10-fold between 2004 (n = 59) and 2011 (n = 703). In 1992 P. falciparum, P. vivax and P. malariae/P. knowlesi monoinfections accounted for 70{\%}, 24{\%} and 1{\%} respectively of malaria notifications, compared to 30{\%}, 31{\%} and 35{\%} in 2011. The increase in P. malariae/P. knowlesi notifications occurred state-wide, appearing to have begun in the southwest and progressed north-easterly.Conclusions: A significant recent increase has occurred in P. knowlesi notifications following reduced transmission of the human Plasmodium species, and this trend threatens malaria elimination. Determination of transmission dynamics and risk factors for knowlesi malaria is required to guide measures to control this rising incidence.",
keywords = "adolescent, adult, age distribution, article, child, data analysis, female, human, incidence, infection control, malaria falciparum, Malaysia, male, medical record, microscopy, Plasmodium knowlesi malaria, Plasmodium vivax malaria, school child, seasonal variation, sex ratio, Adolescent, Adult, Aged, Aged, 80 and over, Animals, Child, Child, Preschool, Female, Humans, Incidence, Infant, Infant, Newborn, Malaria, Male, Middle Aged, Plasmodium falciparum, Plasmodium knowlesi, Plasmodium vivax, Young Adult",
author = "Timothy William and Hasan Rahman and Jenarun Jelip and Mohammad Ibrahim and Jayaram Menon and Matthew Grigg and Tsin Yeo and Nicholas Anstey and Bridget Barber",
year = "2013",
doi = "10.1371/journal.pntd.0002026",
language = "English",
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journal = "PLoS Neglected Tropical Diseases",
issn = "1935-2727",
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Increasing Incidence of Plasmodium knowlesi Malaria following Control of P. falciparum and P. vivax Malaria in Sabah, Malaysia. / William, Timothy; Rahman, Hasan; Jelip, Jenarun; Ibrahim, Mohammad; Menon, Jayaram; Grigg, Matthew; Yeo, Tsin; Anstey, Nicholas; Barber, Bridget.

In: PLoS Neglected Tropical Diseases, Vol. 7, No. 1, e2026, 2013, p. 1-9.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Increasing Incidence of Plasmodium knowlesi Malaria following Control of P. falciparum and P. vivax Malaria in Sabah, Malaysia

AU - William, Timothy

AU - Rahman, Hasan

AU - Jelip, Jenarun

AU - Ibrahim, Mohammad

AU - Menon, Jayaram

AU - Grigg, Matthew

AU - Yeo, Tsin

AU - Anstey, Nicholas

AU - Barber, Bridget

PY - 2013

Y1 - 2013

N2 - Background: The simian parasite Plasmodium knowlesi is a common cause of human malaria in Malaysian Borneo and threatens the prospect of malaria elimination. However, little is known about the emergence of P. knowlesi, particularly in Sabah. We reviewed Sabah Department of Health records to investigate the trend of each malaria species over time.MethodsReporting of microscopy-diagnosed malaria cases in Sabah is mandatory. We reviewed all available Department of Health malaria notification records from 1992–2011. Notifications of P. malariae and P. knowlesi were considered as a single group due to microscopic near-identity.Results: From 1992–2011 total malaria notifications decreased dramatically, with P. falciparum peaking at 33,153 in 1994 and decreasing 55-fold to 605 in 2011, and P. vivax peaking at 15,857 in 1995 and decreasing 25-fold to 628 in 2011. Notifications of P. malariae/P. knowlesi also demonstrated a peak in the mid-1990s (614 in 1994) before decreasing to ≈100/year in the late 1990s/early 2000s. However, P. malariae/P. knowlesi notifications increased >10-fold between 2004 (n = 59) and 2011 (n = 703). In 1992 P. falciparum, P. vivax and P. malariae/P. knowlesi monoinfections accounted for 70%, 24% and 1% respectively of malaria notifications, compared to 30%, 31% and 35% in 2011. The increase in P. malariae/P. knowlesi notifications occurred state-wide, appearing to have begun in the southwest and progressed north-easterly.Conclusions: A significant recent increase has occurred in P. knowlesi notifications following reduced transmission of the human Plasmodium species, and this trend threatens malaria elimination. Determination of transmission dynamics and risk factors for knowlesi malaria is required to guide measures to control this rising incidence.

AB - Background: The simian parasite Plasmodium knowlesi is a common cause of human malaria in Malaysian Borneo and threatens the prospect of malaria elimination. However, little is known about the emergence of P. knowlesi, particularly in Sabah. We reviewed Sabah Department of Health records to investigate the trend of each malaria species over time.MethodsReporting of microscopy-diagnosed malaria cases in Sabah is mandatory. We reviewed all available Department of Health malaria notification records from 1992–2011. Notifications of P. malariae and P. knowlesi were considered as a single group due to microscopic near-identity.Results: From 1992–2011 total malaria notifications decreased dramatically, with P. falciparum peaking at 33,153 in 1994 and decreasing 55-fold to 605 in 2011, and P. vivax peaking at 15,857 in 1995 and decreasing 25-fold to 628 in 2011. Notifications of P. malariae/P. knowlesi also demonstrated a peak in the mid-1990s (614 in 1994) before decreasing to ≈100/year in the late 1990s/early 2000s. However, P. malariae/P. knowlesi notifications increased >10-fold between 2004 (n = 59) and 2011 (n = 703). In 1992 P. falciparum, P. vivax and P. malariae/P. knowlesi monoinfections accounted for 70%, 24% and 1% respectively of malaria notifications, compared to 30%, 31% and 35% in 2011. The increase in P. malariae/P. knowlesi notifications occurred state-wide, appearing to have begun in the southwest and progressed north-easterly.Conclusions: A significant recent increase has occurred in P. knowlesi notifications following reduced transmission of the human Plasmodium species, and this trend threatens malaria elimination. Determination of transmission dynamics and risk factors for knowlesi malaria is required to guide measures to control this rising incidence.

KW - adolescent

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KW - age distribution

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KW - female

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KW - incidence

KW - infection control

KW - malaria falciparum

KW - Malaysia

KW - male

KW - medical record

KW - microscopy

KW - Plasmodium knowlesi malaria

KW - Plasmodium vivax malaria

KW - school child

KW - seasonal variation

KW - sex ratio

KW - Adolescent

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Animals

KW - Child

KW - Child, Preschool

KW - Female

KW - Humans

KW - Incidence

KW - Infant

KW - Infant, Newborn

KW - Malaria

KW - Male

KW - Middle Aged

KW - Plasmodium falciparum

KW - Plasmodium knowlesi

KW - Plasmodium vivax

KW - Young Adult

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DO - 10.1371/journal.pntd.0002026

M3 - Article

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