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RESEARCH ARTICLE

Plasmodium knowlesi: an update

Balbir Singh
+ Author Affiliations
- Author Affiliations

Malaria Research Centre
University Malaysia Sarawak
94300 Kota Samarahan
Sarawak, Malaysia
Tel: +6 082 581000
Fax: +6 082 665152
Email: bsingh@unimas.my

Microbiology Australia 37(1) 39-42 https://doi.org/10.1071/MA16014
Published: 12 February 2016

Abstract

There were only four species of Plasmodium that were thought to cause malaria in humans until a large number of human infections by Plasmodium knowlesi, a malaria parasite typically found in long-tailed and pig-tailed macaques, were reported in 2004 in Malaysian Borneo. Since then, cases of knowlesi malaria have been reported throughout South-east Asia and also in travellers returning from the region. This article describes the molecular, entomological and epidemiological data which indicate that P. knowlesi is an ancient parasite that is primarily zoonotic, and there are three highly divergent sub-populations. It also describes the detection methods for P. knowlesi, which is morphologicaly similar to P. malariae, and the clinical features and treatment of this malaria parasite that is potentially fatal.


References

[1]  Garnham, P.C.C. (1966) Malaria parasites and other haemosporidia. Blackwell Scientific Publications.

[2]  Singh, B. et al. (2004) A large focus of naturally acquired Plasmodium knowlesi infections in human beings. Lancet 363, 1017–1024.
A large focus of naturally acquired Plasmodium knowlesi infections in human beings.Crossref | GoogleScholarGoogle Scholar | 15051281PubMed |

[3]  Lee, K.S. et al. (2009) Morphological features and differential counts of Plasmodium knowlesi parasites in naturally acquired human infections. Malar. J. 8, 73.
Morphological features and differential counts of Plasmodium knowlesi parasites in naturally acquired human infections.Crossref | GoogleScholarGoogle Scholar | 19383118PubMed |

[4]  Singh, B. and Daneshvar, C. (2013) Human infections and detection of Plasmodium knowlesi. Clin. Microbiol. Rev. 26, 165–184.
Human infections and detection of Plasmodium knowlesi.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3sXnsVWrtbs%3D&md5=be64fd6b713090b0e7bd44187c259d50CAS | 23554413PubMed |

[5]  Tyagi, R.K. et al. (2013) Discordance in drug resistance-associated mutation patterns in marker genes of Plasmodium falciparum and Plasmodium knowlesi during coinfections. J. Antimicrob. Chemother. 68, 1081–1088.
Discordance in drug resistance-associated mutation patterns in marker genes of Plasmodium falciparum and Plasmodium knowlesi during coinfections.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3sXlvFWhtbw%3D&md5=6487afb1bf5af7809335f046efab942aCAS | 23292346PubMed |

[6]  William, T. et al. (2013) Increasing incidence of Plasmodium knowlesi malaria following control of P. falciparum and P. vivax Malaria in Sabah, Malaysia. PLoS Negl. Trop. Dis. 7, e2026.
Increasing incidence of Plasmodium knowlesi malaria following control of P. falciparum and P. vivax Malaria in Sabah, Malaysia.Crossref | GoogleScholarGoogle Scholar | 23359830PubMed |

[7]  Yusof, R. et al. (2014) High proportion of knowlesi malaria in recent malaria cases in Malaysia. Malar. J. 13, 168.
High proportion of knowlesi malaria in recent malaria cases in Malaysia.Crossref | GoogleScholarGoogle Scholar | 24886266PubMed |

[8]  Cox-Singh, J. and Singh, B. (2008) Knowlesi malaria: newly emergent and of public health importance? Trends Parasitol. 24, 406–410.
Knowlesi malaria: newly emergent and of public health importance?Crossref | GoogleScholarGoogle Scholar | 18678527PubMed |

[9]  Coatney, G.R. et al. (1971) The primate malarias. US Department of Health, Education and Welfare.

[10]  Collins, W.E. (2012) Plasmodium knowlesi: a malaria parasite of monkeys and humans. Annu. Rev. Entomol. 57, 107–121.
Plasmodium knowlesi: a malaria parasite of monkeys and humans.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC38XhsVOjtLg%3D&md5=957375e57cc46fb7848af710321904d0CAS | 22149265PubMed |

[11]  Vythilingam, I. et al. (2006) Natural transmission of Plasmodium knowlesi to humans by Anopheles latens in Sarawak, Malaysia. Trans. R. Soc. Trop. Med. Hyg. 100, 1087–1088.
Natural transmission of Plasmodium knowlesi to humans by Anopheles latens in Sarawak, Malaysia.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD28rjsFyguw%3D%3D&md5=1c83f998ea84361beb890dd5eea8432fCAS | 16725166PubMed |

[12]  Marchand, R.P. et al. (2011) Co-infections of Plasmodium knowlesi, P. falciparum, and P. vivax among humans and Anopheles dirus mosquitoes, Southern Vietnam. Emerg. Infect. Dis. 17, 1232–1239.
Co-infections of Plasmodium knowlesi, P. falciparum, and P. vivax among humans and Anopheles dirus mosquitoes, Southern Vietnam.Crossref | GoogleScholarGoogle Scholar | 21762577PubMed |

[13]  Vythilingam, I. et al. (2008) Plasmodium knowlesi in humans, macaques and mosquitoes in peninsular Malaysia. Parasit. Vectors 1, 26.
Plasmodium knowlesi in humans, macaques and mosquitoes in peninsular Malaysia.Crossref | GoogleScholarGoogle Scholar | 18710577PubMed |

[14]  Tan, C.H. et al. (2008) Bionomics of Anopheles latens in Kapit, Sarawak, Malaysian Borneo in relation to the transmission of zoonotic simian malaria parasite Plasmodium knowlesi. Malar. J. 7, 52.
Bionomics of Anopheles latens in Kapit, Sarawak, Malaysian Borneo in relation to the transmission of zoonotic simian malaria parasite Plasmodium knowlesi.Crossref | GoogleScholarGoogle Scholar | 18377652PubMed |

[15]  Vythilingam, I. (2012) Plasmodium knowlesi and Wuchereria bancrofti: their vectors and challenges for the future. Front. Physiol. 3, 115.
Plasmodium knowlesi and Wuchereria bancrofti: their vectors and challenges for the future.Crossref | GoogleScholarGoogle Scholar | 22557977PubMed |

[16]  Cramer, J.P. (2015) Plasmodium knowlesi malaria: overview focussing on travel-associated infections. Curr. Infect. Dis. Rep. 17, 8.
Plasmodium knowlesi malaria: overview focussing on travel-associated infections.Crossref | GoogleScholarGoogle Scholar |

[17]  Lee, K.S. et al. (2011) Plasmodium knowlesi: reservoir hosts and tracking the emergence in humans and macaques. PLoS Pathog. 7, e1002015.
Plasmodium knowlesi: reservoir hosts and tracking the emergence in humans and macaques.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3MXltVWlur8%3D&md5=248f553ebcb8c2963b7bbb04df5afcf1CAS | 21490952PubMed |

[18]  Ziegler, T. et al. (2007) Molecular phylogeny and evolutionary history of Southeast Asian macaques forming the M. silenus group. Mol. Phylogenet. Evol. 42, 807–816.
Molecular phylogeny and evolutionary history of Southeast Asian macaques forming the M. silenus group.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD2sXisVCnsLg%3D&md5=35e77f1356764b260b40f62fc1509b7aCAS | 17208017PubMed |

[19]  Divis, P.C. et al. (2015) Admixture in humans of two divergent Plasmodium knowlesi populations associated with different macaque host species. PLoS Pathog. 11, e1004888.
Admixture in humans of two divergent Plasmodium knowlesi populations associated with different macaque host species.Crossref | GoogleScholarGoogle Scholar | 26020959PubMed |

[20]  Assefa, S. et al. (2015) Population genomic structure and adaptation in the zoonotic malaria parasite Plasmodium knowlesi. Proc. Natl. Acad. Sci. USA 112, 13027–13032.
Population genomic structure and adaptation in the zoonotic malaria parasite Plasmodium knowlesi.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC2MXhs1Slu7nJ&md5=0a88844dd0e61124c8cbb2853da57002CAS | 26438871PubMed |

[21]  William, T. et al. (2014) Changing epidemiology of malaria in Sabah, Malaysia: increasing incidence of Plasmodium knowlesi. Malar. J. 13, 390.
Changing epidemiology of malaria in Sabah, Malaysia: increasing incidence of Plasmodium knowlesi.Crossref | GoogleScholarGoogle Scholar | 25272973PubMed |

[22]  Foster, D. et al. (2014) Evaluation of three rapid diagnostic tests for the detection of human infections with Plasmodium knowlesi. Malar. J. 13, 60.
Evaluation of three rapid diagnostic tests for the detection of human infections with Plasmodium knowlesi.Crossref | GoogleScholarGoogle Scholar | 24548805PubMed |

[23]  Barber, B.E. et al. (2013) Evaluation of the sensitivity of a pLDH-based and an aldolase-based rapid diagnostic test for diagnosis of uncomplicated and severe malaria caused by PCR-confirmed Plasmodium knowlesi, Plasmodium falciparum, and Plasmodium vivax. J. Clin. Microbiol. 51, 1118–1123.
Evaluation of the sensitivity of a pLDH-based and an aldolase-based rapid diagnostic test for diagnosis of uncomplicated and severe malaria caused by PCR-confirmed Plasmodium knowlesi, Plasmodium falciparum, and Plasmodium vivax.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3sXmtF2it7Y%3D&md5=1ffc85ebffc6bf6695f0cb7fb0f20ea5CAS | 23345297PubMed |

[24]  Grigg, M.J. et al. (2014) Combining parasite lactate dehydrogenase-based and histidine-rich protein 2-based rapid tests to improve specificity for diagnosis of malaria due to Plasmodium knowlesi and other Plasmodium species in Sabah, Malaysia. J. Clin. Microbiol. 52, 2053–2060.
Combining parasite lactate dehydrogenase-based and histidine-rich protein 2-based rapid tests to improve specificity for diagnosis of malaria due to Plasmodium knowlesi and other Plasmodium species in Sabah, Malaysia.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC2cXhs1Smtr7P&md5=404dfc872736e513da8cc62632041f5cCAS | 24696029PubMed |

[25]  Fornace, K.M. et al. (2015) Asymptomatic and submicroscopic carriage of Plasmodium knowlesi malaria in household and community members of clinical cases in Sabah, Malaysia. J. Infect. Dis. , .
Asymptomatic and submicroscopic carriage of Plasmodium knowlesi malaria in household and community members of clinical cases in Sabah, Malaysia.Crossref | GoogleScholarGoogle Scholar | 26433222PubMed |

[26]  Cox-Singh, J. et al. (2008) Plasmodium knowlesi malaria in humans is widely distributed and potentially life threatening. Clin. Infect. Dis. 46, 165–171.
Plasmodium knowlesi malaria in humans is widely distributed and potentially life threatening.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BD1cXhvVClsbo%3D&md5=d1cb7ee96755c11cec0080892d56bc66CAS | 18171245PubMed |

[27]  Daneshvar, C. et al. (2009) Clinical and laboratory features of human Plasmodium knowlesi infection. Clin. Infect. Dis. 49, 852–860.
Clinical and laboratory features of human Plasmodium knowlesi infection.Crossref | GoogleScholarGoogle Scholar | 19635025PubMed |

[28]  Rajahram, G.S. et al. (2012) Deaths due to Plasmodium knowlesi malaria in Sabah, Malaysia: association with reporting as Plasmodium malariae and delayed parenteral artesunate. Malar. J. 11, 284.
Deaths due to Plasmodium knowlesi malaria in Sabah, Malaysia: association with reporting as Plasmodium malariae and delayed parenteral artesunate.Crossref | GoogleScholarGoogle Scholar | 22905799PubMed |

[29]  Barber, B.E. et al. (2013) 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. Clin. Infect. Dis. 56, 383–397.
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.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3sXht1Oit7Y%3D&md5=85160eeae482c72836196433e1f91cbfCAS | 23087389PubMed |

[30]  Willmann, M. et al. (2012) Laboratory markers of disease severity in Plasmodium knowlesi infection: a case control study. Malar. J. 11, 363.
Laboratory markers of disease severity in Plasmodium knowlesi infection: a case control study.Crossref | GoogleScholarGoogle Scholar | 23110615PubMed |

[31]  William, T. et al. (2011) Severe Plasmodium knowlesi malaria in a tertiary care hospital, Sabah, Malaysia. Emerg. Infect. Dis. 17, 1248–1255.
Severe Plasmodium knowlesi malaria in a tertiary care hospital, Sabah, Malaysia.Crossref | GoogleScholarGoogle Scholar | 21762579PubMed |

[32]  Cox-Singh, J. et al. (2010) Severe malaria – a case of fatal Plasmodium knowlesi infection with post-mortem findings: a case report. Malar. J. 9, 10.
Severe malaria – a case of fatal Plasmodium knowlesi infection with post-mortem findings: a case report.Crossref | GoogleScholarGoogle Scholar | 20064229PubMed |

[33]  Barber, B.E. et al. (2011) Plasmodium knowlesi malaria in children. Emerg. Infect. Dis. 17, 814–820.
Plasmodium knowlesi malaria in children.Crossref | GoogleScholarGoogle Scholar | 21529389PubMed |

[34]  Daneshvar, C. et al. (2010) Clinical and parasitological response to oral chloroquine and primaquine in uncomplicated human Plasmodium knowlesi infections. Malar. J. 9, 238.
Clinical and parasitological response to oral chloroquine and primaquine in uncomplicated human Plasmodium knowlesi infections.Crossref | GoogleScholarGoogle Scholar | 20723228PubMed |

[35]  WHO (2011) Informal consultation on the public health importance of Plasmodium knowlesi. World Health Organization Regional Office for the Western Pacific Press.