Plasmodium knowlesi malaria in Phang-Nga Province, 2021–2022
Keywords:
malaria, Plasmodium knowlesi, epidemiology, entomology, diagnosis and treatment, Phang-Nga ProvinceAbstract
Introduction: Plasmodium knowlesi (P. knowlesi) malaria is a zoonotic disease that is classified as type 5 of human malaria. Commonly found in macaques (Macaca fascicularis) and (Macaca nemestrina), P. knowlesi is capable of resulting in both uncomplicated and severe malaria in humans. Situation of P. knowlesi malaria in Phang-Nga province from fiscal year (FY) 2020–2022 revealed no case report in FY 2020, however, a total of 14 cases had been reported in FY 2021–2022. This research aimed to 1) study the epidemiology of P. knowlesi, 2) examine the clinical manifestations of P. knowlesi patients, 3) analyze the ecology and entomology of P. knowlesi, and 4) analyze the diagnosis and treatment of P. knowlesi.
Method: This research was a retrospective descriptive study/case report. The study was conducted in 14 patients with P. knowlesi malaria between FY 2021 and 2022 in 4 districts of Phang-Nga Province including Thapput, Kapong, Takuapa and Khuraburi.
Results: The study subjects of P. knowlesi malaria were all males. Most of them were working age groups as farmers and worked in forest or plantation areas. All had no history of blood transfusions. Most of the patients did not use mosquito nets and had a history of camping in the forest prior to the onset of fever. The main symptoms brought to the hospital were fever, chills, headache, body aches. Laboratory findings on the first day of diagnosis were as follows: The white blood cell count was found within the normal range. In the proportion of white blood cells, eosinophils were found to be slightly higher than normal. Slight anemia was found on early examination. The platelet count was found to be below normal in all cases. Severely low platelet count (2,000 cells/mm3) was found in severe cases with multiple complications. No patient was found dead but 85.7% of complications were found, with acute renal failure being the most common.
Conclusion and Recommendation: P. knowlesi malaria is an emerging infectious disease transmitted from animals to humans. There are challenges in epidemiology, entomology, ecology for effective surveillance, prevention and control. Early diagnosis and treatment would reduce complications and prevent death.
References
Knowles R, Das Gupta BM. A study of monkey-malaria and its experimental transmission to man. Ind Med Gaz. 1932; 67: 301–20.
White NJ. Plasmodium knowlesi: the fifth human malaria parasite. Clin Infect Dis. 2008; 46: 172–3.
Chin W, Contacos PG, Coatney GR, Kimball HR. A naturally acquired quotidian-type malaria in man transferable to monkeys. Science. 1965; 149(3686): 865.
Coatney GR, Collins WE, Warren M, Contacos PG. The primate malarias [original book published 1971] [CD-ROM]. Version 1.0. Atlanta: Centers for Disease Control and Prevention; 2003.
Fooden J. Malaria in macaques. Int J Primatol. 1994; 15: 573–96.
Jongwutiwes S, Putaporntip C, Iwasaki T, Sata T, Kanbara H. Naturally acquired Plasmodium knowlesi malaria in human, Thailand. Emerging Infectious Diseases. 2004; 10 (12): 2211–3.
มรกต แก้วธรรมสอน. พลาสโมเดียม โนว์ลซาย : โรครับจากสัตว์ ภัยร้ายที่คนไม่นึกถึง. เชียงใหม่สัตวแพทยสาร. 2556; 11(3): 289–300.
Luchavez J, Espino F, Curameng P, Espina R, Bell D, Chiodini P, et al. Human infections with Plasmodium knowlesi, the Philippines. Emerging Infectious Diseases. 2008; 14: 811–3.
Ng OT, Eng EO, Cheng CL, Piao JL, Lee CN, Pei SW, et al. Naturally acquired human Plasmodium knowlesi infection, Singapore. Emerging Infectious Diseases. 2008; 14(5): 814–6.
Lee CE, Adeeba K, Freigang G. Human Plasmodium knowlesi infections in Klang valley, Peninsula Malaysia: a case series. Medical Journal of Malaysia. 2010; 65(1): 63–5.
Antinori S, Galimberti L, Milazzo L, Cabellino M. Plasmodium knowlesi: the emerging zoonotic malaria parasite. Acta Tropica. 2013; 125: 191–201.
Cox-Singh J, Singh B. Knowlesi malaria: newly emergent and of public health importance? Trends Parasitol. 2008; 24: 406–10.
Lee KS, Divis PCS, Zakaria SK, Matusop A, Julin RA, Conway DJ, et al. Plasmodium knowlesi: Reservoir hosts and tracking the emergence in humans and macaques. PLoS Pathogens. 2011; 7(4): 1–11.
Sabbatani S, Fiorino S, Manfredi R. Plasmodium knowlesi: from Malaysia, a novel health care threat. Infez Med. 2012; n 1: 5–11.
Fan L, Lee SY, Koay E, Harkensee C. Plasmodium knowlesi infection: a diagnostic challenge. BMJ Case Report. 2013. doi: 10.1136/bcr-2013-009558; 1–3.
Takaya S, Kutsuna S, Suzuki T, Komaki-Yasuda K, Kano S, Ohmagari N. Case report: Plasmodium knowlesi infection with Rhabdomyolysis in a Japanese traveler to Palawan, the Philippines. Am J Trop Med Hyg. 2018; 99(4): 967–9.
Putaporntip C, Hongsrimuang T, Sethamchai S, Kobasa T, Limkittikul K, Cui L, et al. Differential prevalence of Plasmodium infections and cryptic P. knowlesi malaria in humans, Thailand. J Infect Dis. 2009; 199 (8): 1143–50.
Jongwutiwes S, Buppan P, Kosuvin R, Sethamchai S, Pattanawong U, Sirichaisinthop J, et al. Plasmodium knowlesi malaria in humans and macaques, Thailand. Emerging Infectious Diseases. 2011; 17 (10): 1799–806.
Sermwittayawong N, Singh B, Nishibuchi M, Sawangjaroen N, Vuddhakul V. Human Plasmodium knowlesi infection in Ranong province, southwestern border of Thailand. Malaria journal. 2012; 11(36): 1–6.
Ngernna S, Rachaphaew N, Thammapalo S, Prikchoo P, Kaewnah O, Manopwisedjaroen K, et al. Case report: Case series of human Plasmodium knowlesi infection on southern border of Thailand. Am J Trop Med Hyg. 2019; 101(6): 1397–401.
Yek C, Lay S, Bohi JA, Man S, Chea S, Lon C, et al. Case report: Cambodian national malaria surveillance program detection of Plasmodium knowlesi. Am J Trop Med Hyg. 2022; 107(1): 151–3.
จิตติ จันทรมงคล, สมพาส แดงมณีกุล. รายงานสอบสวนผู้ป่วยเสียชีวิตจาก Plasmodium knowlesi รุนแรงในอำเภอเบตง จังหวัดยะลา รายงานผู้ป่วย 1 ราย. นนทบุรี: สำนักระบาดวิทยา กรมควบคุมโรค กระทรวงสาธารณสุข; 2559. หน้า 1–18.
กองโรคติดต่อนำโดยแมลง กรมควบคุมโรค กระทรวงสาธารณสุข. โครงการกำจัดโรคไข้มาลาเรียประเทศไทย (Thailand Malaria Elimination Program). นนทบุรี; 31 พฤษภาคม 2565 [เข้าถึงเมื่อ 1 ธันวาคม 2565]. เข้าถึงได้จาก: http://malaria.ddc.moph.go.th/malariaR10/index_newversion.php
Koh GJN, Ismail PK, Koh D. Occupationally acquired Plasmodium knowlesi malaria in Brunei Darussalam. Saf Health Work. 2019; 10: 122–4.
Barber BE, William T, Grigg MJ, Menon J, Auburn S, Marfurt J, et al. A prospective comparative study of knowlesi, falciparum, and vivax malaria in Sabah, Malaysia: high proportion with severe disease from Plasmodium knowlesi and Plasmodium vivax but no mortality with early referral and artesunate therapy. CID. 2013; 56(3): 383–97.
Daneshvar C, Davis TME, Cox-Singh J, Rafa’ee MZ, Zakaria SK. Divis PCS, et al. Clinical and laboratory features of human Plasmodium knowlesi infection. CID. 2009; 49: 854–60.
Rajahram JS, Cooper DJ, William T, Grigg MJ, Anstey NM. Barber BE. Deaths from Plasmodium knowlesi Malaria: case series and systematic review. Clinical Infectious Diseases. 2019; 69(10): 1703–11.
Cheo SW, Khoo TT, Lee KS, Tan YA, Yeoh WC, Low QJ. A case of severe Plasmodium knowlesi malaria in a post–splenectomy patient. Med J Malaysis. 2020; 75(4): 447–9.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Weekly Epidemiological Surveillance Report
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Responsibility and Copyright
1. Author Responsibility and Editorial Disagreement
The content and data in all articles published in WESR are the direct opinions and responsibility of the article authors, and the Journal's Editorial Board is not necessarily in agreement with, or jointly responsible for, them.
2. Copyright and Referencing
All articles, data, content, figures, etc., published in WESR are considered the copyright of the academic journal. If any individual or entity wishes to disseminate all or any part of the published material, appropriate citation of the article is required.
