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High proportion of knowlesi malaria in recent malaria cases in Malaysia.

Yusof R, Lau YL, Mahmud R, Fong MY, Jelip J, Ngian HU, Mustakim S, Hussin HM, Marzuki N, Mohd Ali M - Malar. J. (2014)

Bottom Line: Notably, P. knowlesi (Included mixed infections involving P. knowlesi (P. knowlesi/P. vivax and P. knowlesi /P. falciparum)) showed the highest proportion in Sabah (84/115 cases, prevalence of 73.0%), Sarawak (83/120, 69.2%), Kelantan (42/56, 75.0%), Pahang (24/25, 96.0%), Johor (7/9, 77.8%), and Terengganu (4/5, 80.0%,).In contrast, the rates of P. knowlesi infection in Selangor and Negeri Sembilan were found to be 16.2% (18/111 cases) and 50.0% (5/10 cases), respectively.Sample of P. knowlesi was not obtained from Kuala Lumpur, Melaka, Perak, Pulau Pinang, and Perlis during the study period, while a microscopically-positive sample from Kedah was negative by PCR.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Parasitology, Faculty of Medicine, Tropical Infectious Disease Research and Education Center (TIDREC), University of Malaya, 50603 Kuala Lumpur, Malaysia. lauyeeling@um.edu.my.

ABSTRACT

Background: Plasmodium knowlesi is a simian parasite that has been recognized as the fifth species causing human malaria. Naturally-acquired P. knowlesi infection is widespread among human populations in Southeast Asia. The aim of this epidemiological study was to determine the incidence and distribution of malaria parasites, with a particular focus on human P. knowlesi infection in Malaysia.

Methods: A total of 457 microscopically confirmed, malaria-positive blood samples were collected from 22 state and main district hospitals in Malaysia between September 2012 and December 2013. Nested PCR assay targeting the 18S rRNA gene was used to determine the infecting Plasmodium species.

Results: A total of 453 samples were positive for Plasmodium species by using nested PCR assay. Plasmodium knowlesi was identified in 256 (56.5%) samples, followed by 133 (29.4%) cases of Plasmodium vivax, 49 (10.8%) cases of Plasmodium falciparum, two (0.4%) cases of Plasmodium ovale and one (0.2%) case of Plasmodium malariae. Twelve mixed infections were detected, including P. knowlesi/P. vivax (n = 10), P. knowlesi/P. falciparum (n = 1), and P. falciparum/P. vivax (n = 1). Notably, P. knowlesi (Included mixed infections involving P. knowlesi (P. knowlesi/P. vivax and P. knowlesi /P. falciparum)) showed the highest proportion in Sabah (84/115 cases, prevalence of 73.0%), Sarawak (83/120, 69.2%), Kelantan (42/56, 75.0%), Pahang (24/25, 96.0%), Johor (7/9, 77.8%), and Terengganu (4/5, 80.0%,). In contrast, the rates of P. knowlesi infection in Selangor and Negeri Sembilan were found to be 16.2% (18/111 cases) and 50.0% (5/10 cases), respectively. Sample of P. knowlesi was not obtained from Kuala Lumpur, Melaka, Perak, Pulau Pinang, and Perlis during the study period, while a microscopically-positive sample from Kedah was negative by PCR.

Conclusion: In addition to Sabah and Sarawak, which have been known for high prevalence of P. knowlesi infection, the findings from this study highlight the widespread distribution of P. knowlesi in many Peninsular Malaysia states.

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Map of Malaysia showing location of the study areas.
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Figure 1: Map of Malaysia showing location of the study areas.

Mentions: This study was approved by the Medical Research Ethic Committee (MREC) Ministry of Health Malaysia and Medical Ethics Committee of University Malaya Medical Centre. This study was conducted at 22 state and district government hospitals all over Malaysia: Raja Perempuan Zainab II Hospital, Kota Bharu; Sultanah Nur Zahirah Hospital, Kuala Terengganu, Terengganu; Tengku Ampuan Afzan Hospital, Kuantan, Pahang; Kuala Lipis Hospital, Kuala Lipis, Pahang; Jerantut Hospital Jerantut, Pahang; Sultanah Aminah Hospital, Johor Bahru, Johor; Sultanah Fatimah Specialist Hospital, Muar, Johor; Melaka Hospital, Melaka; Tuanku Jaafar Hospital, Seremban, Negeri Sembilan; Tengku Ampuan Rahimah Hospital, Klang, Selangor; Selayang Hospital, Selangor; Sungai Buloh Hospital, Selangor; Raja Permaisuri Bainun Hospital, Ipoh, Perak; Sultanah Bahiyah Hospital, Alor Setar, Kedah; Sultan Abdul Halim Hospital, Sungai Petani, Kedah; Pulau Pinang Hospital, Pulau Pinang; Tuanku Fauziah Hospital, Kangar, Perlis; Sarawak General Hospital, Kuching, Sarawak; Kapit Hospital, Kapit, Sarawak; Kota Bharu Public Health Laboratory, Kota Bharu, Kelantan and the Department of Vector Borne Disease Control Programme, Kota Kinabalu, Sabah (Figure 1).


High proportion of knowlesi malaria in recent malaria cases in Malaysia.

Yusof R, Lau YL, Mahmud R, Fong MY, Jelip J, Ngian HU, Mustakim S, Hussin HM, Marzuki N, Mohd Ali M - Malar. J. (2014)

Map of Malaysia showing location of the study areas.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4016780&req=5

Figure 1: Map of Malaysia showing location of the study areas.
Mentions: This study was approved by the Medical Research Ethic Committee (MREC) Ministry of Health Malaysia and Medical Ethics Committee of University Malaya Medical Centre. This study was conducted at 22 state and district government hospitals all over Malaysia: Raja Perempuan Zainab II Hospital, Kota Bharu; Sultanah Nur Zahirah Hospital, Kuala Terengganu, Terengganu; Tengku Ampuan Afzan Hospital, Kuantan, Pahang; Kuala Lipis Hospital, Kuala Lipis, Pahang; Jerantut Hospital Jerantut, Pahang; Sultanah Aminah Hospital, Johor Bahru, Johor; Sultanah Fatimah Specialist Hospital, Muar, Johor; Melaka Hospital, Melaka; Tuanku Jaafar Hospital, Seremban, Negeri Sembilan; Tengku Ampuan Rahimah Hospital, Klang, Selangor; Selayang Hospital, Selangor; Sungai Buloh Hospital, Selangor; Raja Permaisuri Bainun Hospital, Ipoh, Perak; Sultanah Bahiyah Hospital, Alor Setar, Kedah; Sultan Abdul Halim Hospital, Sungai Petani, Kedah; Pulau Pinang Hospital, Pulau Pinang; Tuanku Fauziah Hospital, Kangar, Perlis; Sarawak General Hospital, Kuching, Sarawak; Kapit Hospital, Kapit, Sarawak; Kota Bharu Public Health Laboratory, Kota Bharu, Kelantan and the Department of Vector Borne Disease Control Programme, Kota Kinabalu, Sabah (Figure 1).

Bottom Line: Notably, P. knowlesi (Included mixed infections involving P. knowlesi (P. knowlesi/P. vivax and P. knowlesi /P. falciparum)) showed the highest proportion in Sabah (84/115 cases, prevalence of 73.0%), Sarawak (83/120, 69.2%), Kelantan (42/56, 75.0%), Pahang (24/25, 96.0%), Johor (7/9, 77.8%), and Terengganu (4/5, 80.0%,).In contrast, the rates of P. knowlesi infection in Selangor and Negeri Sembilan were found to be 16.2% (18/111 cases) and 50.0% (5/10 cases), respectively.Sample of P. knowlesi was not obtained from Kuala Lumpur, Melaka, Perak, Pulau Pinang, and Perlis during the study period, while a microscopically-positive sample from Kedah was negative by PCR.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Parasitology, Faculty of Medicine, Tropical Infectious Disease Research and Education Center (TIDREC), University of Malaya, 50603 Kuala Lumpur, Malaysia. lauyeeling@um.edu.my.

ABSTRACT

Background: Plasmodium knowlesi is a simian parasite that has been recognized as the fifth species causing human malaria. Naturally-acquired P. knowlesi infection is widespread among human populations in Southeast Asia. The aim of this epidemiological study was to determine the incidence and distribution of malaria parasites, with a particular focus on human P. knowlesi infection in Malaysia.

Methods: A total of 457 microscopically confirmed, malaria-positive blood samples were collected from 22 state and main district hospitals in Malaysia between September 2012 and December 2013. Nested PCR assay targeting the 18S rRNA gene was used to determine the infecting Plasmodium species.

Results: A total of 453 samples were positive for Plasmodium species by using nested PCR assay. Plasmodium knowlesi was identified in 256 (56.5%) samples, followed by 133 (29.4%) cases of Plasmodium vivax, 49 (10.8%) cases of Plasmodium falciparum, two (0.4%) cases of Plasmodium ovale and one (0.2%) case of Plasmodium malariae. Twelve mixed infections were detected, including P. knowlesi/P. vivax (n = 10), P. knowlesi/P. falciparum (n = 1), and P. falciparum/P. vivax (n = 1). Notably, P. knowlesi (Included mixed infections involving P. knowlesi (P. knowlesi/P. vivax and P. knowlesi /P. falciparum)) showed the highest proportion in Sabah (84/115 cases, prevalence of 73.0%), Sarawak (83/120, 69.2%), Kelantan (42/56, 75.0%), Pahang (24/25, 96.0%), Johor (7/9, 77.8%), and Terengganu (4/5, 80.0%,). In contrast, the rates of P. knowlesi infection in Selangor and Negeri Sembilan were found to be 16.2% (18/111 cases) and 50.0% (5/10 cases), respectively. Sample of P. knowlesi was not obtained from Kuala Lumpur, Melaka, Perak, Pulau Pinang, and Perlis during the study period, while a microscopically-positive sample from Kedah was negative by PCR.

Conclusion: In addition to Sabah and Sarawak, which have been known for high prevalence of P. knowlesi infection, the findings from this study highlight the widespread distribution of P. knowlesi in many Peninsular Malaysia states.

Show MeSH
Related in: MedlinePlus