Plasmodium knowlesi detection methods for human infections: Diagnosis and surveillance

Matthew J. Grigg, Inke N. Lubis, Kevin K.A. Tetteh, Bridget E. Barber, Timothy William, Giri S. Rajahram, Angelica F. Tan, Colin J. Sutherland, Rintis Noviyanti, Chris J. Drakeley, Sumudu Britton, Nicholas M. Anstey

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review

10 Citations (Scopus)

Abstract

Within the overlapping geographical ranges of P. knowlesi monkey hosts and vectors in Southeast Asia, an estimated 1.5 billion people are considered at risk of infection. P. knowlesi can cause severe disease and death, the latter associated with delayed treatment occurring from misdiagnosis. Although microscopy is a sufficiently sensitive first-line tool for P. knowlesi detection for most low-level symptomatic infections, misdiagnosis as other Plasmodium species is common, and the majority of asymptomatic infections remain undetected. Current point-of-care rapid diagnostic tests demonstrate insufficient sensitivity and poor specificity for differentiating P. knowlesi from other Plasmodium species. Molecular tools including nested, real-time, and single-step PCR, and loop-mediated isothermal amplification (LAMP), are sensitive for P. knowlesi detection. However, higher cost and inability to provide the timely point-of-care diagnosis needed to guide appropriate clinical management has limited their routine use in most endemic clinical settings. P. knowlesi is likely underdiagnosed across the region, and improved diagnostic and surveillance tools are required. Reference laboratory molecular testing of malaria cases for both zoonotic and non-zoonotic Plasmodium species needs to be more widely implemented by National Malaria Control Programs across Southeast Asia to accurately identify the burden of zoonotic malaria and more precisely monitor the success of human-only malaria elimination programs. The implementation of specific serological tools for P. knowlesi would assist in determining the prevalence and distribution of asymptomatic and submicroscopic infections, the absence of transmission in certain areas, and associations with underlying land use change for future spatially targeted interventions.

Original languageEnglish
Title of host publicationAdvances in Parasitology
EditorsChris Drakeley
Place of PublicationLondon, UK
PublisherAcademic Press
Chapter3
Pages77-130
Volume113
Edition1
ISBN (Electronic)9780323907286
ISBN (Print)9780323907279
DOIs
Publication statusPublished - 2021

Publication series

NameAdvances in Parasitology
ISSN (Print)0065-308X

Bibliographical note

Funding Information:
M.J.G., I.N.L., and R.N. are supported by the ZOOMAL project (‘Evaluating zoonotic malaria and agricultural land use in Indonesia’; #LS-2019-116), Australian Centre for International Agricultural Research and Department of Foreign Affairs, Australian Government. K.K.A.T. was supported by a Bloomsbury SET Innovation Fellowship (‘Development of a suspension bead assay targeting the zoonotic malaria parasite Plasmodium knowlesi’; BSA14). This work was also supported by the Australian National Health and Medical Research Council (grant numbers 1037304 and 1045156; fellowships to N.M.A. [1042072], B.E.B. [1088738]; M.J.G. [1138860] and ‘Improving Health Outcomes in the Tropical North: A multidisciplinary collaboration “Hot North”’, [grant 1131932]). The Sabah Malaria Research Program is supported by the US NIH IRIDA program. We thank Sitti Saimah binti Sakam from the IDSKKS-Menzies Clinical Research Unit, Sabah, Malaysia for input into the microscopic diagnosis section.

Fingerprint

Dive into the research topics of 'Plasmodium knowlesi detection methods for human infections: Diagnosis and surveillance'. Together they form a unique fingerprint.

Cite this