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Johnson E, Sunil Kumar Sharma R, Ruiz Cuenca P, Byrne I, Salgado-Lynn M, Suraya Shahar Z, Col Lin L, Zulkifli N, Dilaila Mohd Saidi N, Drakeley C, Matthiopoulos J, Nelli L, Fornace K. Landscape drives zoonotic malaria prevalence in non-human primates. eLife 2024; 12:RP88616. [PMID: 38753426 PMCID: PMC11098556 DOI: 10.7554/elife.88616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2024] Open
Abstract
Zoonotic disease dynamics in wildlife hosts are rarely quantified at macroecological scales due to the lack of systematic surveys. Non-human primates (NHPs) host Plasmodium knowlesi, a zoonotic malaria of public health concern and the main barrier to malaria elimination in Southeast Asia. Understanding of regional P. knowlesi infection dynamics in wildlife is limited. Here, we systematically assemble reports of NHP P. knowlesi and investigate geographic determinants of prevalence in reservoir species. Meta-analysis of 6322 NHPs from 148 sites reveals that prevalence is heterogeneous across Southeast Asia, with low overall prevalence and high estimates for Malaysian Borneo. We find that regions exhibiting higher prevalence in NHPs overlap with human infection hotspots. In wildlife and humans, parasite transmission is linked to land conversion and fragmentation. By assembling remote sensing data and fitting statistical models to prevalence at multiple spatial scales, we identify novel relationships between P. knowlesi in NHPs and forest fragmentation. This suggests that higher prevalence may be contingent on habitat complexity, which would begin to explain observed geographic variation in parasite burden. These findings address critical gaps in understanding regional P. knowlesi epidemiology and indicate that prevalence in simian reservoirs may be a key spatial driver of human spillover risk.
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Affiliation(s)
- Emilia Johnson
- School of Biodiversity, One Health and Veterinary Medicine, University of GlasgowGlasgowUnited Kingdom
- Department of Disease Control, London School of Hygiene & Tropical MedicineLondonUnited Kingdom
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical MedicineLondonUnited Kingdom
| | | | - Pablo Ruiz Cuenca
- Department of Disease Control, London School of Hygiene & Tropical MedicineLondonUnited Kingdom
- Lancaster University, BailriggLancasterUnited Kingdom
- Liverpool School of Tropical Medicine, Pembroke Place LiverpoolLiverpoolUnited Kingdom
| | - Isabel Byrne
- Department of Disease Control, London School of Hygiene & Tropical MedicineLondonUnited Kingdom
| | - Milena Salgado-Lynn
- School of Biosciences, Cardiff UniversityCardiffUnited Kingdom
- Wildlife Health, Genetic and Forensic Laboratory, Sabah Wildlife Department, Wisma MuisKota KinabaluMalaysia
- Danau Girang Field Centre, Sabah Wildlife DepartmentKinabalu SabahMalaysia
| | | | - Lee Col Lin
- Faculty of Veterinary Medicine, Universiti Putra MalaysiaSelangorMalaysia
| | - Norhadila Zulkifli
- Faculty of Veterinary Medicine, Universiti Putra MalaysiaSelangorMalaysia
| | | | - Chris Drakeley
- Department of Infection Biology, London School of Hygiene & Tropical MedicineLondonUnited Kingdom
| | - Jason Matthiopoulos
- School of Biodiversity, One Health and Veterinary Medicine, University of GlasgowGlasgowUnited Kingdom
| | - Luca Nelli
- School of Biodiversity, One Health and Veterinary Medicine, University of GlasgowGlasgowUnited Kingdom
| | - Kimberly Fornace
- School of Biodiversity, One Health and Veterinary Medicine, University of GlasgowGlasgowUnited Kingdom
- Department of Disease Control, London School of Hygiene & Tropical MedicineLondonUnited Kingdom
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical MedicineLondonUnited Kingdom
- Saw Swee Hock School of Public Health, National University of SingaporeSingaporeSingapore
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Davidson G, Speldewinde P, Manin BO, Cook A, Weinstein P, Chua TH. Forest Restoration and the Zoonotic Vector Anopheles balabacensis in Sabah, Malaysia. ECOHEALTH 2024; 21:21-37. [PMID: 38411846 DOI: 10.1007/s10393-024-01675-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 01/16/2024] [Indexed: 02/28/2024]
Abstract
Anthropogenic changes to forest cover have been linked to an increase in zoonotic diseases. In many areas, natural forests are being replaced with monoculture plantations, such as oil palm, which reduce biodiversity and create a mosaic of landscapes with increased forest edge habitat and an altered micro-climate. These altered conditions may be facilitating the spread of the zoonotic malaria parasite Plasmodium knowlesi in Sabah, on the island of Borneo, through changes to mosquito vector habitat. We conducted a study on mosquito abundance and diversity in four different land uses comprising restored native forest, degraded native forest, an oil palm estate and a eucalyptus plantation, these land uses varying in their vegetation types and structure. The main mosquito vector, Anopheles balabacensis, has adapted its habitat preference from closed canopy rainforest to more open logged forest and plantations. The eucalyptus plantations (Eucalyptus pellita) assessed in this study contained significantly higher abundance of many mosquito species compared with the other land uses, whereas the restored dipterocarp forest had a low abundance of all mosquitos, in particular, An. balabacensis. No P. knowlesi was detected by PCR assay in any of the vectors collected during the study; however, P. inui, P. fieldi and P. vivax were detected in An. balabacensis. These findings indicate that restoring degraded natural forests with native species to closed canopy conditions reduces abundance of this zoonotic malarial mosquito vector and therefore should be incorporated into future restoration research and potentially contribute to the control strategies against simian malaria.
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Affiliation(s)
- Gael Davidson
- School of Agriculture and Environment, University of Western Australia, Albany, Australia
- School of Population and Global Health, University of Western Australia, Perth, Australia
| | - Peter Speldewinde
- School of Agriculture and Environment, University of Western Australia, Albany, Australia
| | - Benny Obrain Manin
- Borneo Medical and Health Research Centre (BMHRC), Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Angus Cook
- School of Population and Global Health, University of Western Australia, Perth, Australia
| | - Philip Weinstein
- School of Biological Sciences, University of Adelaide, Adelaide, Australia
| | - Tock H Chua
- Edulife Berhad, Kota Kinabalu, Sabah, Malaysia.
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Naserrudin NA, Lin PYP, Monroe A, Baumann SE, Adhikari B, Miller AC, Sato S, Fornace KM, Culleton R, Cheah PY, Hod R, Jeffree MS, Ahmed K, Hassan MR. Disentangling the intersection of inequities with health and malaria exposure: key lessons from rural communities in Northern Borneo. Malar J 2023; 22:343. [PMID: 37946259 PMCID: PMC10636872 DOI: 10.1186/s12936-023-04750-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 10/11/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND The increasing incidence of Plasmodium knowlesi malaria poses a significant challenge to efforts to eliminate malaria from Malaysia. Macaque reservoirs, outdoors-biting mosquitoes, human activities, and agricultural work are key factors associated with the transmission of this zoonotic pathogen. However, gaps in knowledge regarding reasons that drive malaria persistence in rural Kudat, Sabah, Northern Borneo remain. This study was conducted to address this knowledge gap, to better understand the complexities of these entangled problems, and to initiate discussion regarding new countermeasures to address them. This study aims to highlight rural community members' perspectives regarding inequities to health relating to P. knowlesi malaria exposure. METHODS From January to October 2022, a study using qualitative methods was conducted in four rural villages in Kudat district of Sabah, Malaysia. A total of nine in-depth interviews were conducted with community and faith leaders, after the completion of twelve focus group discussions with 26 photovoice participants. The interviews were conducted using the Sabah Malay dialect, audio-recorded, transcribed, and translated into English. The research team led the discussion and analysis, which was approved by participants through member checking at the community level. RESULTS Participants identified disparity in health as a key issue affecting their health and livelihoods. Injustice in the social environment was also identified as a significant challenge, including the importance of listening to the voices of affected communities in disentangling the social and economic phenomena that can impact malaria control. Specific concerns included inadequate access to health-related resources and degradation of the environment. Participants recommended improving access to water and other necessities, increasing the availability of malaria control commodities in healthcare facilities, and developing sustainable programs to reduce socioeconomic disparities. CONCLUSION Inequities to health emerged as a key concern for malaria control in rural Kudat, Sabah. A locally targeted malaria programme cantered on improving the social and economic disparities associated with health outcomes, could be a potential strategy for malaria prevention in such areas. Community-level perspectives gathered from this study can be used as a foundation for future discussions and dialogues among policymakers and community members for achieving greater transparency, improving social equity, and interoperability in addressing P. knowlesi malaria control.
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Affiliation(s)
- Nurul Athirah Naserrudin
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000, Kuala Lumpur, Malaysia
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Sabah, Malaysia
- Sabah State Health Department, Ministry of Health, 88590, Kota Kinabalu, Malaysia
| | - Pauline Yong Pau Lin
- Faculty of Social Sciences and Humanities, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Malaysia
| | - April Monroe
- Johns Hopkins Center for Communication Programs, Baltimore, MD, USA
| | - Sara Elizabeth Baumann
- Department of Behavioral and Community Health Sciences, University of Pittsburgh School of Public Health, Pittsburgh, PA, 15261, USA
| | - Bipin Adhikari
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | | | - Shigeharu Sato
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Sabah, Malaysia
- Department of Pathology and Microbiology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Malaysia
| | - Kimberly M Fornace
- School of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, Glasgow, UK
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Richard Culleton
- Division of Molecular Parasitology, Proteo-Science Center, Ehime University, Toon, Ehime, 791-0295, Japan
| | - Phaik Yeong Cheah
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- The Ethox Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Rozita Hod
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000, Kuala Lumpur, Malaysia
| | - Mohammad Saffree Jeffree
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Sabah, Malaysia
- Department of Public Health Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Malaysia
| | - Kamruddin Ahmed
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Sabah, Malaysia
- Department of Pathology and Microbiology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Malaysia
| | - Mohd Rohaizat Hassan
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000, Kuala Lumpur, Malaysia.
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Sabah, Malaysia.
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Pramasivan S, Ngui R, Jeyaprakasam NK, Low VL, Liew JWK, Vythilingam I. Spatial analyses of Plasmodium knowlesi vectors with reference to control interventions in Malaysia. Parasit Vectors 2023; 16:355. [PMID: 37814287 PMCID: PMC10563288 DOI: 10.1186/s13071-023-05984-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 09/25/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND Malaria parasites such as Plasmodium knowlesi, P. inui, and P. cynomolgi are spread from macaques to humans through the Leucosphyrus Group of Anopheles mosquitoes. It is crucial to know the distribution of these vectors to implement effective control measures for malaria elimination. Plasmodium knowlesi is the most predominant zoonotic malaria parasite infecting humans in Malaysia. METHODS Vector data from various sources were used to create distribution maps from 1957 to 2021. A predictive statistical model utilizing logistic regression was developed using significant environmental factors. Interpolation maps were created using the inverse distance weighted (IDW) method and overlaid with the corresponding environmental variables. RESULTS Based on the IDW analysis, high vector abundances were found in the southwestern part of Sarawak, the northern region of Pahang and the northwestern part of Sabah. However, most parts of Johor, Sabah, Perlis, Penang, Kelantan and Terengganu had low vector abundance. The accuracy test indicated that the model predicted sampling and non-sampling areas with 75.3% overall accuracy. The selected environmental variables were entered into the regression model based on their significant values. In addition to the presence of water bodies, elevation, temperature, forest loss and forest cover were included in the final model since these were significantly correlated. Anopheles mosquitoes were mainly distributed in Peninsular Malaysia (Titiwangsa range, central and northern parts), Sabah (Kudat, West Coast, Interior and Tawau division) and Sarawak (Kapit, Miri, and Limbang). The predicted Anopheles mosquito density was lower in the southern part of Peninsular Malaysia, the Sandakan Division of Sabah and the western region of Sarawak. CONCLUSION The study offers insight into the distribution of the Leucosphyrus Group of Anopheles mosquitoes in Malaysia. Additionally, the accompanying predictive vector map correlates well with cases of P. knowlesi malaria. This research is crucial in informing and supporting future efforts by healthcare professionals to develop effective malaria control interventions.
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Affiliation(s)
- Sandthya Pramasivan
- Department of Parasitology, Faculty of Medicine, Universiti Malaya (UM), Kuala Lumpur, Malaysia
| | - Romano Ngui
- Department of ParaClinical Sciences, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak (UNIMAS), Sarawak, Malaysia.
| | - Nantha Kumar Jeyaprakasam
- Biomedical Science Program, Center for Toxicology and Health Risk Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Van Lun Low
- Tropical Infectious Diseases Research & Education Centre (TIDREC), Universiti Malaya (UM), Kuala Lumpur, Malaysia
| | | | - Indra Vythilingam
- Department of Parasitology, Faculty of Medicine, Universiti Malaya (UM), Kuala Lumpur, Malaysia.
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Naserrudin NA, Jiee SF, Habil B, Jantim A, Mohamed AFB, Dony JJF, Ibrahim SSA, Fornace KM, Hassan MR, Jeffree MS, Hod R, Culleton R, Ahmed K. The public health response to a Plasmodium malariae outbreak in Penampang district, Sabah during a COVID-19 movement control order. Malar J 2023; 22:292. [PMID: 37789320 PMCID: PMC10546630 DOI: 10.1186/s12936-023-04693-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 08/29/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND Since 2018, no indigenous human malaria cases has been reported in Malaysia. However, during the recent COVID-19 pandemic the World Health Organization is concerned that the pandemic might erode the success of malaria control as there are reports of increase malaria cases in resource limited countries. Little is known how the COVID-19 pandemic has impacted malaria in middle-income countries like Malaysia. Here the public health response to a Plasmodium malariae outbreak occurred in a village in Sabah state, Malaysia, during a COVID-19 movement control order is reported. METHODS An outbreak was declared following the detection of P. malariae in July 2020 and active case detection for malaria was performed by collecting blood samples from residents residing within 2 km radius of Moyog village. Vector prevalence and the efficacy of residual insecticides were determined. Health awareness programmes were implemented to prevent future outbreaks. A survey was conducted among villagers to understand risk behaviour and beliefs concerning malaria. RESULTS A total of 5254 blood samples collected from 19 villages. Among them, 19 P. malariae cases were identified, including the index case, which originated from a man who returned from Indonesia. His return from Indonesia and healthcare facilities visit coincided with the movement control order during COVID-19 pandemic when the healthcare facilities stretched its capacity and only serious cases were given priority. Despite the index case being a returnee from a malaria endemic area presenting with mild fever, no malaria test was performed at local healthcare facilities. All cases were symptomatic and uncomplicated except for a pregnant woman with severe malaria. There were no deaths; all patients recovered following treatment with artemether-lumefantrine combination therapy. Anopheles balabacensis and Anopheles barbirostris were detected in ponds, puddles and riverbeds. The survey revealed that fishing and hunting during night, and self-treatment for mild symptoms contributed to the outbreak. Despite the index case being a returnee from a malaria-endemic area presenting with mild fever, no malaria test was performed at local healthcare facilities. CONCLUSION The outbreak occurred during a COVID-19 movement control order, which strained healthcare facilities, prioritizing only serious cases. Healthcare workers need to be more aware of the risk of malaria from individuals who return from malaria endemic areas. To achieve malaria elimination and prevention of disease reintroduction, new strategies that include multisectoral agencies and active community participation are essential for a more sustainable malaria control programme.
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Affiliation(s)
- Nurul Athirah Naserrudin
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bangi, Malaysia
- Sabah State Health Department, Ministry of Health, Kota Kinabalu, Malaysia
| | - Sam Froze Jiee
- Department of Community Medicine and Public Health, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Kota Samarahan, Malaysia
| | - Bobby Habil
- Penampang District Health Office, Ministry of Health, Kota Kinabalu, Malaysia
| | - Anisah Jantim
- Penampang District Health Office, Ministry of Health, Kota Kinabalu, Malaysia
| | | | | | | | - Kimberly M Fornace
- School of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, Glasgow, UK
- Faculty of Infectious and Tropical Diseases and Centre for Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, UK
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Mohd Rohaizat Hassan
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bangi, Malaysia
| | - Mohammad Saffree Jeffree
- Department of Public Health Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Rozita Hod
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bangi, Malaysia
| | | | - Kamruddin Ahmed
- Borneo Medical Health and Research Centre,, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia.
- Department of Pathology and Microbiology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia.
- Research Center for Global and Local Infectious Diseases, Oita University, Oita, Japan.
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Naserrudin NA, Yong PPL, Monroe A, Culleton R, Baumann SE, Sato S, Hod R, Jeffree MS, Ahmed K, Hassan MR. Seeing malaria through the eyes of affected communities: using photovoice to document local knowledge on zoonotic malaria causation and prevention practices among rural communities exposed to Plasmodium knowlesi malaria in Northern Borneo Island. Malar J 2023; 22:166. [PMID: 37237418 DOI: 10.1186/s12936-023-04603-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 05/22/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Many rural communities in Malaysian Borneo and Southeast Asia are at risk of Plasmodium knowlesi malaria. Multiple factors contribute to infection, however, a deep understanding of illness causation and prevention practices among at-risk communities remains limited. This study aims to document local knowledge on malaria causation and preventive practices of rural communities in Sabah, Malaysia, using photovoice-a participatory research method. METHODS From January to June 2022, a photovoice study was conducted with rural communities in Matunggong subdistrict, Malaysia, to explore their experiences with and local knowledge of non-human primate malaria and prevention practices. The study included (1) an introductory phase in which participants were introduced to the photovoice method; (2) a documentation phase in which participants captured and narrated photos from their communities; (3) a discussion phase in which participants discussed photos and relevant topics through a series of three focus group discussions (FGDs) per village; and (4) a dissemination phase where selected photos were shared with key stakeholders through a photo exhibition. A purposively selected sample of 26 participants (adults > 18 years old, male, and female) from four villages participated in all phases of the study. The study activities were conducted in Sabah Malay dialect. Participants and the research team contributed to data review and analyses. RESULTS Rural communities in Sabah, Malaysia possess local knowledge that attributes non-human primate malaria to natural factors related to the presence of mosquitoes that bite humans and which carry "kuman-malaria" or malaria parasite. Participants revealed various preventive practises ranging from traditional practises, including burning dried leaves and using plants that produce foul odours, to non-traditional approaches such as aerosols and mosquito repellents. By engaging with researchers and policymakers, the participants or termed as co-researchers in this study, showcased their ability to learn and appreciate new knowledge and perspectives and valued the opportunity to share their voices with policymakers. The study successfully fostered a balance of power dynamics between the co-researchers, research team members and policymakers. CONCLUSION There were no misconceptions about malaria causation among study participants. The insights from study participants are relevant because of their living experience with the non-human malaria. It is critical to incorporate rural community perspectives in designing locally effective and feasible malaria interventions in rural Sabah, Malaysia. Future research can consider adapting the photovoice methodology for further research with the community toward building locally tailored-malaria strategies.
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Affiliation(s)
- Nurul Athirah Naserrudin
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000, Kuala Lumpur, Malaysia
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia, Sabah, 88400, Kota Kinabalu, Malaysia
- Sabah State Health Department, Ministry of Health, 88590, Kota Kinabalu, Malaysia
| | - Pauline Pau Lin Yong
- Faculty of Social Sciences and Humanities, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Malaysia
| | - April Monroe
- Johns Hopkins Center for Communication Programs, Baltimore, MD, USA
| | - Richard Culleton
- Division of Molecular Parasitology, Proteo-Science Center, Ehime University, Toon, Ehime, 791-0295, Japan
| | - Sara Elizabeth Baumann
- Department of Behavioral and Community Health Sciences, University of Pittsburgh School of Public Health, Pittsburgh, PA, 15261, USA
| | - Shigeharu Sato
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia, Sabah, 88400, Kota Kinabalu, Malaysia
- Department of Public Health Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Malaysia
- Department of Pathology and Microbiology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Malaysia
| | - Rozita Hod
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000, Kuala Lumpur, Malaysia
| | - Mohammad Saffree Jeffree
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia, Sabah, 88400, Kota Kinabalu, Malaysia
- Department of Public Health Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Malaysia
| | - Kamruddin Ahmed
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia, Sabah, 88400, Kota Kinabalu, Malaysia
- Department of Public Health Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Malaysia
- Department of Pathology and Microbiology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Malaysia
| | - Mohd Rohaizat Hassan
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000, Kuala Lumpur, Malaysia.
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia, Sabah, 88400, Kota Kinabalu, Malaysia.
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Naserrudin NA, Hod R, Saffree Jeffree M, Ahmed K, Hassan MR. International modified Delphi study on malaria preventive behaviour: new themes, contexts and framework for future research on Plasmodium knowlesi malaria. BMJ Open 2023; 13:e067451. [PMID: 36898744 PMCID: PMC10008207 DOI: 10.1136/bmjopen-2022-067451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/12/2023] Open
Abstract
INTRODUCTION Plasmodium knowlesi malaria is a non-human simian malaria that threatens Southeast Asian rural communities. Studies indicate that non-compliant bednet usage, travelling into the forest and working as farmers and rubber tappers put communities at risk for infection. Despite guidelines, malaria incidence increases yearly and has become a public health concern. In addition to research gaps addressing factors that influence malaria prevention behaviour in these communities, there are no specific guidelines to facilitate strategies against the threat of P. knowlesi malaria. METHOD To examine potential factors that influence malaria-prevention behaviour in communities exposed to P. knowlesi malaria, 12 malaria experts participated in a modified Delphi study; every participant maintained their anonymity throughout the study. Three Delphi rounds were conducted via different online platforms between 15 November 2021 and 26 February 2022, and consensus was achieved when 70% of the participants agreed on a particular point with a 4-5 median. The results from the open-ended questions were then subjected to thematic analysis, and the dataset generated by this study was analysed using a deductive and inductive approach. RESULTS After a systematic, iterative process, knowledge and belief, social support, cognitive and environmental factors, past experience as a malaria patient, and the affordability and feasibility of a given intervention were critical contributors to malaria-prevention behaviour. CONCLUSION Future research on P. knowlesi malaria could adapt this study's findings for a more nuanced understanding of factors that influence malaria-prevention behaviour and improve P. knowlesi malaria programmes based on the expert consensus.
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Affiliation(s)
- Nurul Athirah Naserrudin
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
- Sabah State Health Department, Ministry of Health, Kota Kinabalu, Sabah, Malaysia
| | - Rozita Hod
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Mohammad Saffree Jeffree
- Department of Public Health Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Kamruddin Ahmed
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
- Department of Pathobiology and Medical Diagnostics, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Mohd Rohaizat Hassan
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
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Naserrudin NA, Hassan MR, Jeffree MS, Culleton R, Hod R, Ahmed K. A systematic review of asymptomatic Plasmodium knowlesi infection: an emerging challenge involving an emerging infectious disease. Malar J 2022; 21:373. [PMID: 36474243 PMCID: PMC9724390 DOI: 10.1186/s12936-022-04339-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 10/18/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND In the last decade Plasmodium knowlesi has been detected in humans throughout South East Asia. The highest risk groups for this infection are males, adults and those performing forest-related work. Furthermore, asymptomatic cases of P. knowlesi malaria have been reported including among women and children. METHODS Pubmed, Scopus and the Web of Science databases for literature describing asymptomatic P. knowlesi malaria published between 2010 and 2020 were searched. A systematic literature review was conducted to identify studies reporting the prevalence and incidence of laboratory confirmed asymptomatic P. knowlesi cases in humans, their clinical and demographic characteristics, and methods used to diagnose these cases. RESULTS By analysing over 102 papers, thirteen were eligible for this review. Asymptomatic P. knowlesi infections have been detected in 0.03%-4.0% of the population depending on region, and infections have been described in children as young as 2 years old. Various different diagnostic methods were used to detect P. knowlesi cases and there were differing definitions of asymptomatic cases in these studies. The literature indicates that regionally-differing immune-related mechanisms may play a part on the prevalence of asymptomatic P. knowlesi. CONCLUSION Differing epidemiological characteristics of asymptomatic P. knowlesi malaria in different regions reinforces the need to further investigate disease transmission mechanics. Effective public health responses to changes in P. knowlesi epidemiology require proactive intervention and multisectoral collaboration.
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Affiliation(s)
- Nurul Athirah Naserrudin
- grid.412113.40000 0004 1937 1557Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia ,grid.265727.30000 0001 0417 0814Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia, Sabah, Kota Kinabalu, Malaysia ,grid.415759.b0000 0001 0690 5255Sabah State Health Department, Ministry of Health, Kota Kinabalu, Malaysia
| | - Mohd Rohaizat Hassan
- grid.412113.40000 0004 1937 1557Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia ,grid.265727.30000 0001 0417 0814Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia, Sabah, Kota Kinabalu, Malaysia
| | - Mohammad Saffree Jeffree
- grid.265727.30000 0001 0417 0814Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia, Sabah, Kota Kinabalu, Malaysia ,grid.265727.30000 0001 0417 0814Department of Community and Family Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Richard Culleton
- grid.255464.40000 0001 1011 3808Division of Molecular Parasitology, Proteo-Science Center, Ehime University, Toon, Japan
| | - Rozita Hod
- grid.412113.40000 0004 1937 1557Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Kamruddin Ahmed
- grid.265727.30000 0001 0417 0814Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia, Sabah, Kota Kinabalu, Malaysia ,grid.265727.30000 0001 0417 0814Department of Pathology and Microbiology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
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9
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Naserrudin NA, Culleton R, Pau Lin PY, Baumann SE, Hod R, Jeffree MS, Ahmed K, Hassan MR. Generating Trust in Participatory Research on Plasmodium knowlesi Malaria: A Study with Rural Community Gatekeepers during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192315764. [PMID: 36497837 PMCID: PMC9737837 DOI: 10.3390/ijerph192315764] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/15/2022] [Accepted: 11/23/2022] [Indexed: 06/01/2023]
Abstract
BACKGROUND Plasmodium knowlesi malaria is a zoonotic infection that affects rural communities in South East Asia. Although the epidemiology of the disease has been extensively researched, the voices of individuals within affected communities often go unheard. Here, we describe a study that explores the importance of gatekeepers in conducting research among rural communities, their perspectives on the challenges encountered when attempting to avoid malaria infection, and their views on participatory research. METHODS Between 1 November 2021 and 28 February 2022, we conducted a study in Kudat district, Sabah, using a multi-method design. All participants consented to the study, which included health care workers (HCWs) (n = 5), community leaders (n = 8), and faith leaders (n = 1). We conducted interviews, transect walks, and observations with gatekeepers to ensure data trustworthiness. All interviews were conducted in the Sabah Malay dialect. The sessions were audio- and video-recorded, transcribed into English and analyzed using thematic analysis. RESULTS Between 2017 and 2021, the number of cases of P. knowlesi malaria detected in humans ranged from 35 to 87 in villages under the care of the Lotong primary health care clinic. The challenges in controlling malaria include social norms, lifestyles, socioeconomic factors, environmental factors, and limitations of basic resources. Critical discussions regarding participation with the gatekeepers identified that face-to-face interviews were preferable to online discussions, and influenced willingness to participate in future research. CONCLUSION This study was conducted among village gatekeepers during the COVID-19 pandemic and generated information to drive methodological changes, opening up new ideas by sharing perspectives on challenges in P. knowlesi malaria control among vulnerable communities. The study generated trust in the community and expanded knowledge regarding participation that is critical for future community-based studies.
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Affiliation(s)
- Nurul Athirah Naserrudin
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu 88400, Malaysia
- Sabah State Health Department, Ministry of Health, Kota Kinabalu 88590, Malaysia
| | - Richard Culleton
- Division of Molecular Parasitology, Proteo-Science Center, Ehime University, Toon, Ehime, Matsuyama 791-0295, Japan
| | - Pauline Yong Pau Lin
- Faculty of Social Sciences and Humanities, Universiti Malaysia Sabah, Kota Kinabalu 88400, Malaysia
| | - Sara Elizabeth Baumann
- Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Rozita Hod
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
| | - Mohammad Saffree Jeffree
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu 88400, Malaysia
- Department of Public Health Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu 88400, Malaysia
| | - Kamruddin Ahmed
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu 88400, Malaysia
- Department of Public Health Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu 88400, Malaysia
- Department of Pathobiology and Medical Diagnostics, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu 88400, Malaysia
| | - Mohd Rohaizat Hassan
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu 88400, Malaysia
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10
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Chua TH, Manin BO, Fornace K. Life table analysis of Anopheles balabacensis, the primary vector of Plasmodium knowlesi in Sabah, Malaysia. Parasit Vectors 2022; 15:442. [PMID: 36434625 PMCID: PMC9701013 DOI: 10.1186/s13071-022-05552-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 10/07/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Plasmodium knowlesi has become a major public health concern in Sabah, Malaysian Borneo, where it is now the only cause of indigenous malaria. The importance of P. knowlesi has spurred on a series of studies on this parasite, as well as on the biology and ecology of its principal vector, Anopheles balabacensis. However, there remain critical knowledge gaps on the biology of An. balabacensis, such as life history data and life table parameters. To fill these gaps, we conducted a life table study of An. balabacensis in the laboratory. Characterising vector life cycles and survival rates can inform more accurate estimations of the serial interval, the time between two linked cases, which is crucial to understanding and monitoring potentially changing transmission patterns. METHODS Individuals of An. balabacensis were collected in the field in Ranau district, Sabah to establish a laboratory colony. Induced mating was used, and the life history parameters of the progeny were recorded. The age-stage, two-sex life table approach was used in the analysis. The culture conditions in the laboratory were 9 h light:15 h dark, mean temperature 25.7 °C ± 0.05 and relative humidity 75.8% ± 0.31. RESULTS The eggs hatched within 2 days, and the larval stage lasted for 10.5 days in total, with duration of instar stages I, II, III and IV of 2.3, 3.7, 2.3, 2.2 days, respectively. The maximum total fecundity was 729 for one particular female, while the maximum female age-specific mean fecundity (mx) was 142 at age 59 days. The gross reproductive rate or number of offspring per individual was about 102. On average, each female laid 1.81 ± 0.19 (range 1-7) batches of eggs, with 63% of the females producing only one batch; only one female laid six batches, while one other laid seven. Each batch comprised 159 ± 17.1 eggs (range 5-224) and the female ratio of offspring was 0.28 ± 0.06. The intrinsic rate of increase, finite rate of increase, net reproductive rate, mean generation time and doubling time were, respectively, 0.12 ± 0.01 day-1, 1.12 ± 0.01 day-1, 46.2 ± 14.97, 33.02 ± 1.85 and 5.97 days. CONCLUSIONS Both the net reproductive rate and intrinsic rate of increase of An. balabacensis are lower than those of other species in published studies. Our results can be used to improve models of P. knowlesi transmission and to set a baseline for assessing the impacts of environmental change on malaria dynamics. Furthermore, incorporating these population parameters of An. balabacensis into spatial and temporal models on the transmission of P. knowlesi would provide better insight and increase the accuracy of epidemiological forecasting.
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Affiliation(s)
- Tock H. Chua
- grid.265727.30000 0001 0417 0814Department of Pathology and Microbiology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Sabah, Malaysia
| | - Benny Obrain Manin
- grid.265727.30000 0001 0417 0814Department of Pathology and Microbiology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Sabah, Malaysia
| | - Kimberly Fornace
- grid.8756.c0000 0001 2193 314XSchool of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, Glasgow, UK ,grid.4280.e0000 0001 2180 6431Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
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11
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Narrative Review of the Control and Prevention of Knowlesi Malaria. Trop Med Infect Dis 2022; 7:tropicalmed7080178. [PMID: 36006270 PMCID: PMC9414718 DOI: 10.3390/tropicalmed7080178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 07/28/2022] [Accepted: 08/01/2022] [Indexed: 11/17/2022] Open
Abstract
Despite the reduction in the number of cases of human malaria throughout the world, the incidence rate of knowlesi malaria is continuing to rise, especially in Southeast Asia. The conventional strategies for the prevention and control of human malaria can provide some protection against knowlesi malaria. Despite the numerous studies on the risk factors and the innovative methods that may be used to prevent and control the vectors of Plasmodium knowlesi, the incidence rate remains high. An integrated approach that includes environmental intervention should be adopted in order to ensure the successful control of zoonotic malaria. A combination of personal-level protection, vector control and environmental control may mitigate the risk of Plasmodium knowlesi transmission from macaques to humans and, ultimately, reduce the incidence rate of knowlesi malaria.
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12
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Naserrudin NA, Culleton R, Hod R, Saffree Jeffree M, Ahmed K, Hassan MR. Exploring the key anthropological drivers of and barriers to zoonotic malaria preventative behaviour in a community exposed to Plasmodium knowlesi infection in Malaysia: protocol for a qualitative study with a participatory research design. BMJ Open 2022; 12:e060866. [PMID: 35772825 PMCID: PMC9247694 DOI: 10.1136/bmjopen-2022-060866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Plasmodium knowlesi malaria is a zoonotic mosquito-borne disease with complex epidemiology. According to the WHO, the prevention and control of vector-borne diseases require community participation to increase coherence between malaria interventions and sustainable public health programmes. We describe a participatory research (PR) design for a study aimed at exploring the key anthropological drivers of and barriers to zoonotic malaria preventive behaviour among communities exposed to P. knowlesi infection in Malaysia. Participatory approaches can facilitate policymakers in designing future zoonotic malaria control programmes by investigating community perspectives and concerns about zoonotic malaria in a local context. METHODS AND ANALYSIS The PR will be conducted over a period of 12 months, from March 2022 to March 2023, among adults (>18 years old) who are permanent residents in a rural village exposed to P. knowlesi malaria in Sabah, Malaysia. We will select patients who were diagnosed with P. knowlesi infection from January to December 2021 for focus group discussions (FGDs), as they can provide perspectives on the disease from the point of view of those previously diagnosed with infection. In-depth interviews (IDIs) with people of importance in the community, such as village heads, will also be conducted. Both FGDs and IDIs will be conducted from March 2022 until June 2022. Concurrently, a photovoice with adults over 18 years old who reside in the community will be conducted. The target sample sizes for FGDs, IDIs and photovoice are 6-8, 12 and 10-15 participants, respectively. We will use a study framework as a theoretical lens to guide the exploration of the beliefs, social contexts, barriers and drivers surrounding zoonotic malaria preventive behaviour. ETHICS AND DISSEMINATION This study has been approved by the Medical Research and Ethics Committee Ministry of Health Malaysia (NMRR ID-21-01980-JEH) and the Research and Innovation Secretariat, Faculty of Medicine, Universiti Kebangsaan Malaysia (FF-2021-462). All participants will provide consent prior to participation. The results will be reported in international peer-reviewed journals and presented at conferences and on other platforms.
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Affiliation(s)
- Nurul Athirah Naserrudin
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bangi, Kuala Lumpur, Malaysia
| | - Richard Culleton
- Division of Molecular Parasitology, Proteo-Science Center, Ehime University, Matsuyama, Ehime, Japan
| | - Rozita Hod
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bangi, Kuala Lumpur, Malaysia
| | - Mohammad Saffree Jeffree
- Public Health Medicine Department, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Kamruddin Ahmed
- Department of Pathology and Microbiology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Mohd Rohaizat Hassan
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bangi, Kuala Lumpur, Malaysia
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13
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Yusuf NM, Zulkefli J, Jiram AI, Vythilingam I, Hisam S, Devi R, Salehhuddin A, Ali NM, Isa M, Alias N, Ogu salim N, Aziz AA, Sulaiman LH. Plasmodium spp. in macaques, Macaca fascicularis, in Malaysia, and their potential role in zoonotic malaria transmission. Parasite 2022; 29:32. [PMID: 35674419 PMCID: PMC9175634 DOI: 10.1051/parasite/2022032] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 05/22/2022] [Indexed: 11/14/2022] Open
Abstract
Macaques, Macaca fascicularis, are a known reservoir of Plasmodium knowlesi, the agent of simian malaria which is the predominant zoonotic species affecting humans in Malaysia and other Southeast Asian countries. Recently, a naturally acquired human infection of another simian malaria parasite, P. cynomolgi has been reported. Thus, it is crucial to study the distribution of simian Plasmodium infections with particular attention to the macaques. Four hundred and nineteen (419) long-tailed macaques (Macaca fascicularis) were trapped in selected areas where human cases of P. knowlesi and P. cynomolgi have been reported. Nested polymerase chain reaction (PCR) was conducted to identify the Plasmodium spp., and circumsporozoite protein (CSP) genes of P. knowlesi samples were sequenced. Plasmodium cynomolgi infection was shown to be the most prevalent among the macaque population (68.4%). Although 50.6% of analyzed samples contained single infections either with P. knowlesi, P. cynomolgi, P. inui, P. coatneyi, or P. fieldi, mixed infections with double, triple, quadruple, and all 5 species were also detected. Infection with P. cynomolgi and P. knowlesi were the highest among Malaysian macaques in areas where humans and macaques are in close contact. The risk of zoonotic infection in these areas needs to be addressed since the number of zoonotic malaria cases is on the rise. With the elimination of human malaria, the risk of humans being infected with simian malaria is very high and steps should be taken to mitigate this issue.
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Affiliation(s)
- Noorazian Md Yusuf
- Parasitology Unit, Infectious Disease Research Centre, Institute for Medical Research, Block C3 & C7, Level 2, National Institutes of Health (NIH), Ministry of Health Malaysia No. 1 Jalan Setia Murni U13/52, Seksyen U13, Bandar Setia Alam 40170 Shah Alam Selangor Malaysia
- Corresponding author: ,
| | - Jannah Zulkefli
- Parasitology Unit, Infectious Disease Research Centre, Institute for Medical Research, Block C3 & C7, Level 2, National Institutes of Health (NIH), Ministry of Health Malaysia No. 1 Jalan Setia Murni U13/52, Seksyen U13, Bandar Setia Alam 40170 Shah Alam Selangor Malaysia
| | - Adela Ida Jiram
- Parasitology Unit, Infectious Disease Research Centre, Institute for Medical Research, Block C3 & C7, Level 2, National Institutes of Health (NIH), Ministry of Health Malaysia No. 1 Jalan Setia Murni U13/52, Seksyen U13, Bandar Setia Alam 40170 Shah Alam Selangor Malaysia
| | - Indra Vythilingam
- Parasitology Unit, Infectious Disease Research Centre, Institute for Medical Research, Block C3 & C7, Level 2, National Institutes of Health (NIH), Ministry of Health Malaysia No. 1 Jalan Setia Murni U13/52, Seksyen U13, Bandar Setia Alam 40170 Shah Alam Selangor Malaysia
- Department of Parasitology, Faculty of Medicine, University of Malaya 50603 Kuala Lumpur Malaysia
| | - Shamilah Hisam
- Parasitology Unit, Infectious Disease Research Centre, Institute for Medical Research, Block C3 & C7, Level 2, National Institutes of Health (NIH), Ministry of Health Malaysia No. 1 Jalan Setia Murni U13/52, Seksyen U13, Bandar Setia Alam 40170 Shah Alam Selangor Malaysia
| | - Renuka Devi
- Parasitology Unit, Infectious Disease Research Centre, Institute for Medical Research, Block C3 & C7, Level 2, National Institutes of Health (NIH), Ministry of Health Malaysia No. 1 Jalan Setia Murni U13/52, Seksyen U13, Bandar Setia Alam 40170 Shah Alam Selangor Malaysia
| | - Afiqah Salehhuddin
- Parasitology Unit, Infectious Disease Research Centre, Institute for Medical Research, Block C3 & C7, Level 2, National Institutes of Health (NIH), Ministry of Health Malaysia No. 1 Jalan Setia Murni U13/52, Seksyen U13, Bandar Setia Alam 40170 Shah Alam Selangor Malaysia
| | - Nurulshuhada Md Ali
- Parasitology Unit, Infectious Disease Research Centre, Institute for Medical Research, Block C3 & C7, Level 2, National Institutes of Health (NIH), Ministry of Health Malaysia No. 1 Jalan Setia Murni U13/52, Seksyen U13, Bandar Setia Alam 40170 Shah Alam Selangor Malaysia
| | - Maccallyster Isa
- Parasitology Unit, Infectious Disease Research Centre, Institute for Medical Research, Block C3 & C7, Level 2, National Institutes of Health (NIH), Ministry of Health Malaysia No. 1 Jalan Setia Murni U13/52, Seksyen U13, Bandar Setia Alam 40170 Shah Alam Selangor Malaysia
| | - Norwahida Alias
- Parasitology Unit, Infectious Disease Research Centre, Institute for Medical Research, Block C3 & C7, Level 2, National Institutes of Health (NIH), Ministry of Health Malaysia No. 1 Jalan Setia Murni U13/52, Seksyen U13, Bandar Setia Alam 40170 Shah Alam Selangor Malaysia
| | - Nurhainis Ogu salim
- Parasitology Unit, Infectious Disease Research Centre, Institute for Medical Research, Block C3 & C7, Level 2, National Institutes of Health (NIH), Ministry of Health Malaysia No. 1 Jalan Setia Murni U13/52, Seksyen U13, Bandar Setia Alam 40170 Shah Alam Selangor Malaysia
| | - Adli Abd Aziz
- Parasitology Unit, Infectious Disease Research Centre, Institute for Medical Research, Block C3 & C7, Level 2, National Institutes of Health (NIH), Ministry of Health Malaysia No. 1 Jalan Setia Murni U13/52, Seksyen U13, Bandar Setia Alam 40170 Shah Alam Selangor Malaysia
- School of Biology, Faculty of Applied Sciences, Universiti Teknologi MARA Cawangan Negeri Sembilan Kampus Kuala Pilah, Pekan Parit Tinggi 72000 Kuala Pilah Negeri Sembilan Malaysia
| | - Lokman Hakim Sulaiman
- Parasitology Unit, Infectious Disease Research Centre, Institute for Medical Research, Block C3 & C7, Level 2, National Institutes of Health (NIH), Ministry of Health Malaysia No. 1 Jalan Setia Murni U13/52, Seksyen U13, Bandar Setia Alam 40170 Shah Alam Selangor Malaysia
- Centre for Environmental and Population Health, Institute for Research, Development, and Innovation, and Department of Community Medicine, School of Medicine, International Medical University No. 126, Jalan Jalil Perkasa 19, Bukit Jalil 57000 Kuala Lumpur Malaysia
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14
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Lee WC, Cheong FW, Amir A, Lai MY, Tan JH, Phang WK, Shahari S, Lau YL. Plasmodium knowlesi: the game changer for malaria eradication. Malar J 2022; 21:140. [PMID: 35505339 PMCID: PMC9066973 DOI: 10.1186/s12936-022-04131-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 03/18/2022] [Indexed: 11/12/2022] Open
Abstract
Plasmodium knowlesi is a zoonotic malaria parasite that has gained increasing medical interest over the past two decades. This zoonotic parasitic infection is prevalent in Southeast Asia and causes many cases with fulminant pathology. Despite several biogeographical restrictions that limit its distribution, knowlesi malaria cases have been reported in different parts of the world due to travelling and tourism activities. Here, breakthroughs and key information generated from recent (over the past five years, but not limited to) studies conducted on P. knowlesi were reviewed, and the knowledge gap in various research aspects that need to be filled was discussed. Besides, challenges and strategies required to control and eradicate human malaria with this emerging and potentially fatal zoonosis were described.
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Affiliation(s)
- Wenn-Chyau Lee
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Fei Wen Cheong
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Amirah Amir
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Meng Yee Lai
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Jia Hui Tan
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Wei Kit Phang
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Shahhaziq Shahari
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Yee-Ling Lau
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.
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15
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Naserrudin NA, Monroe A, Culleton R, Hod R, Jeffree MS, Ahmed K, Hassan MR. Reimagining zoonotic malaria control in communities exposed to Plasmodium knowlesi infection. J Physiol Anthropol 2022; 41:14. [PMID: 35413881 PMCID: PMC9004057 DOI: 10.1186/s40101-022-00288-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 03/31/2022] [Indexed: 12/21/2022] Open
Abstract
Plasmodium knowlesi malaria infection in humans has been reported throughout southeast Asia. The communities at risk are those living in areas where Macaque monkeys and Anopheles mosquito are present. Zoonotic malaria control is challenging due to the presence of the reservoir host and the possibility of human-vector-human transmission. Current control measures, including insecticide-treated nets (ITNs) and indoor residual spraying (IRS), are insufficient to address this threat due to gaps in protection associated with outdoor and early evening vector biting and social and economic activities, such as agricultural and forest work. Understanding the challenges faced by affected communities in preventing mosquito bites is important for reducing disease transmission. This opinion paper discusses opportunities to improve P. knowlesi malaria control through understanding the challenges faced by communities at risk and increasing community engagement and ownership of control measures. The paper highlights this issue by describing how the concept of reimagining malaria can be adapted to zoonotic malaria control measures including identifying current gaps in vector control, understanding interactions between environmental, economic, and human behavioral factors, and increasing community participation in and ownership of control measures.
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Affiliation(s)
- Nurul Athirah Naserrudin
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia.,Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia, Kota Kinabalu, Sabah, Malaysia.,Sabah State Health Department, Ministry of Health, Kota Kinabalu, Malaysia
| | - April Monroe
- Johns Hopkins Center for Communication Programs, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Richard Culleton
- Department of Molecular Parasitology, Proteo-Science Centre, Ehime University, Matsuyama, Japan
| | - Rozita Hod
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Muhammad Saffree Jeffree
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia, Kota Kinabalu, Sabah, Malaysia.,Department of Public Health, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Kamruddin Ahmed
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia, Kota Kinabalu, Sabah, Malaysia.,Department of Public Health, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Mohd Rohaizat Hassan
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia.
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Naserrudin NA, Hod R, Jeffree MS, Ahmed K, Hassan MR. The Emerging Threat of Plasmodium knowlesi Malaria Infection: A Concept Paper on the Vulnerable Factors in Human. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074419. [PMID: 35410098 PMCID: PMC8998343 DOI: 10.3390/ijerph19074419] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 03/28/2022] [Accepted: 04/03/2022] [Indexed: 02/01/2023]
Abstract
In South-East Asia (SEA), there has been an increase in the trend of detected and reported cases of Plasmodium knowlesi malaria in the last few decades. This higher transmission rate within SEA countries is attributed to the distribution of the Macaque, banded leaf monkeys, and Anopheles mosquito in this region. This study aims to propose a concept that highlights the integration of vulnerability factors to P. knowlesi malaria infection. The relevant literature on the vulnerability factors of P. knowlesi was reviewed. Any theories and models that could be integrated to support the factors were also explored throughout this study. Exposure to P. knowlesi malaria was found to be influenced by sociodemographic, socioeconomic, environmental, social context, belief, and human behaviour factors. However, these factors were commonly discussed separately in existing studies. For better disease prevention and control, all these factors should be explored collectively, to facilitate research aimed at generating a deeper understanding of the vulnerability factors to P. knowlesi malaria from various perspectives, including the genetic, sociodemographic, socioeconomic, environmental, sociocultural beliefs, and human behaviour of the population.
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Affiliation(s)
- Nurul Athirah Naserrudin
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (N.A.N.); (R.H.)
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu 88400, Malaysia; (M.S.J.); (K.A.)
- Sabah State Health Department, Ministry of Health, Putrajaya 62590, Malaysia
| | - Rozita Hod
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (N.A.N.); (R.H.)
| | - Mohammad Saffree Jeffree
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu 88400, Malaysia; (M.S.J.); (K.A.)
- Department of Public Health, Universiti Malaysia Sabah, Kota Kinabalu 88400, Malaysia
| | - Kamruddin Ahmed
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu 88400, Malaysia; (M.S.J.); (K.A.)
- Department of Pathobiology and Medical Diagnostics, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu 88400, Malaysia
| | - Mohd Rohaizat Hassan
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (N.A.N.); (R.H.)
- Correspondence:
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The Role of Human Behavior in Plasmodium knowlesi Malaria Infection: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063675. [PMID: 35329359 PMCID: PMC8953169 DOI: 10.3390/ijerph19063675] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/15/2022] [Accepted: 03/17/2022] [Indexed: 12/22/2022]
Abstract
Objectives: Plasmodium knowlesi is a non-human parasite that causes zoonotic disease in humans. This systematic review aims to highlight and summarize studies describing human behaviors and activities that expose humans to mosquito bites. Design: English entries in PubMed, Web of Science, and Science Direct from 2010 to 2020 were systematically perused, and the results were synthesized. Methodological quality was assessed using the Joanna Briggs Institute quality appraisal checklists. Setting: Studies that described malaria preventive measures were included. Laboratory, in vivo, in vitro, and animal studies were excluded. Primary and secondary outcome measures: The main outcome of the review was findings from studies describing the behavior that exposed a person or a group to P. knowlesi infection. Results: Twelve eligible studies were of good or medium quality. Attitude, disease misconceptions, perceived threat of disease, lack of motivation, and supernatural or traditional beliefs causing individuals to seek treatment from traditional healers influenced the exposure of individuals or communities to P. knowlesi malaria. Other factors were forestry activities (2.48, 1.45–4.23,95% CI, p = 0.0010) and sleeping outdoors (3.611, 1.48–8.85, 95% CI, p = 0.0049). Conclusions: Future studies must consider the importance of human behavior and community perspective on the infection to provide novel information to improve the current zoonotic malaria programs. Policymakers should concentrate on understanding human behavior and activities that expose individuals or communities to mosquito bites, in order to better design socially feasible interventions.
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Vythilingam I, Chua TH, Liew JWK, Manin BO, Ferguson HM. The vectors of Plasmodium knowlesi and other simian malarias Southeast Asia: challenges in malaria elimination. ADVANCES IN PARASITOLOGY 2021; 113:131-189. [PMID: 34620382 DOI: 10.1016/bs.apar.2021.08.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Plasmodium knowlesi, a simian malaria parasite of great public health concern has been reported from most countries in Southeast Asia and exported to various countries around the world. Currently P. knowlesi is the predominant species infecting humans in Malaysia. Besides this species, other simian malaria parasites such as P. cynomolgi and P. inui are also infecting humans in the region. The vectors of P. knowlesi and other Asian simian malarias belong to the Leucosphyrus Group of Anopheles mosquitoes which are generally forest dwelling species. Continual deforestation has resulted in these species moving into forest fringes, farms, plantations and human settlements along with their macaque hosts. Limited studies have shown that mosquito vectors are attracted to both humans and macaque hosts, preferring to bite outdoors and in the early part of the night. We here review the current status of simian malaria vectors and their parasites, knowledge of vector competence from experimental infections and discuss possible vector control measures. The challenges encountered in simian malaria elimination are also discussed. We highlight key knowledge gaps on vector distribution and ecology that may impede effective control strategies.
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Affiliation(s)
- Indra Vythilingam
- Department of Parasitology, University of Malaya, Kuala Lumpur, Malaysia.
| | - Tock Hing Chua
- Department of Pathobiology and Microbiology, Faculty of Medicine and Health Sciences, Universiti Sabah Malaysia, Kota Kinabalu, Sabah, Malaysia.
| | - Jonathan Wee Kent Liew
- Department of Parasitology, University of Malaya, Kuala Lumpur, Malaysia; Environmental Health Institute, National Environment Agency, Singapore, Singapore
| | - Benny O Manin
- Department of Pathobiology and Microbiology, Faculty of Medicine and Health Sciences, Universiti Sabah Malaysia, Kota Kinabalu, Sabah, Malaysia
| | - Heather M Ferguson
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, Scotland, United Kingdom
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19
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Chin AZ, Avoi R, Atil A, Awang Lukman K, Syed Abdul Rahim SS, Ibrahim MY, Ahmed K, Jeffree MS. Risk factor of plasmodium knowlesi infection in Sabah Borneo Malaysia, 2020: A population-based case-control study. PLoS One 2021; 16:e0257104. [PMID: 34506556 PMCID: PMC8432820 DOI: 10.1371/journal.pone.0257104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 08/23/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND In the Malaysian state of Sabah, P. knowlesi notifications increased from 2% (59/2,741) of total malaria notifications in 2004 to 98% (2030/2,078) in 2017. There was a gap regarding P. knowlesi acquisition risk factors related to practice specifically in working age group. The main objective of this study was to identify the risk factors for acquiring P. knowlesi infection in Sabah among the working age group. METHODS AND METHODS This retrospective population-based case-control study was conducted in Ranau district to assess sociodemographic, behavioural and medical history risk factors using a pretested questionnaire. The data were entered and analyzed using IBM SPSS version 23. Bivariate analysis was conducted using binary logistic regression whereas multivariate analysis was conducted using multivariable logistic regression. We set a statistical significance at p-value less than or equal to 0.05. RESULTS A total of 266 cases and 532 controls were included in the study. Male gender (AOR = 2.71; 95% CI: 1.63-4.50), spending overnight in forest (AOR = 1.92; 95% CI: 1.20-3.06), not using mosquito repellent (AOR = 2.49; 95% CI: 1.36-4.56) and history of previous malaria infection (AOR = 49.34; 95% CI: 39.09-78.32) were found to be independent predictors of P. knowlesi infection. CONCLUSIONS This study showed the need to strengthen the strategies in preventing and controlling P. knowlesi infection specifically in changing the practice of spending overnight in forest and increasing the usage of personal mosquito repellent.
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Affiliation(s)
- Abraham Zefong Chin
- Faculty of Medicine and Health Sciences, Department of Public Health Medicine, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Richard Avoi
- Faculty of Medicine and Health Sciences, Department of Public Health Medicine, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Azman Atil
- Faculty of Medicine and Health Sciences, Department of Public Health Medicine, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
- Faculty of Medicine, Department of Community Health, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latiff, Bandar Tun Razak, Cheras, Kuala Lumpur, Malaysia
| | - Khamisah Awang Lukman
- Faculty of Medicine and Health Sciences, Department of Public Health Medicine, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Syed Sharizman Syed Abdul Rahim
- Faculty of Medicine and Health Sciences, Department of Public Health Medicine, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Mohd Yusof Ibrahim
- Faculty of Medicine and Health Sciences, Department of Public Health Medicine, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Kamruddin Ahmed
- Borneo Medical and Health Research Centre, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
- Faculty of Medicine and Health Sciences, Department of Pathology and Microbiology, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Mohammad Saffree Jeffree
- Faculty of Medicine and Health Sciences, Department of Public Health Medicine, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
- Borneo Medical and Health Research Centre, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
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20
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Malijan RPB, Mechan F, Braganza JC, Valle KMR, Salazar FV, Torno MM, Aure WE, Bacay BA, Espino FE, Torr SJ, Fornace KM, Drakeley C, Ferguson HM. The seasonal dynamics and biting behavior of potential Anopheles vectors of Plasmodium knowlesi in Palawan, Philippines. Parasit Vectors 2021; 14:357. [PMID: 34233742 PMCID: PMC8261946 DOI: 10.1186/s13071-021-04853-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 06/17/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A small number of human cases of the zoonotic malaria Plasmodium knowlesi have been reported in Palawan Island, the Philippines. Identification of potential vector species and their bionomics is crucial for understanding human exposure risk in this setting. Here, we combined longitudinal surveillance with a trap-evaluation study to address knowledge gaps about the ecology and potential for zoonotic spillover of this macaque malaria in Palawan Island. METHODS The abundance, diversity and biting behavior of human-biting Anopheles mosquitoes were assessed through monthly outdoor human landing catches (HLC) in three ecotypes representing different land use (forest edge, forest and agricultural area) across 8 months. Additionally, the host preference and biting activity of potential Anopheles vectors were assessed through comparison of their abundance and capture time in traps baited with humans (HLC, human-baited electrocuting net-HEN) or macaques (monkey-baited trap-MBT, monkey-baited electrocuting net-MEN). All female Anopheles mosquitoes were tested for the presence of Plasmodium parasites by PCR. RESULTS Previously incriminated vectors Anopheles balabacensis and An. flavirostris accounted for > 95% of anophelines caught in longitudinal surveillance. However, human biting densities were relatively low (An. balabacensis: 0.34-1.20 per night, An. flavirostris: 0-2 bites per night). Biting densities of An. balabacensis were highest in the forest edge, while An. flavirostris was most abundant in the agricultural area. The abundance of An. balabacensis and An. flavirostris was significantly higher in HLC than in MBT. None of the 357 female Anopheles mosquitoes tested for Plasmodium infection were positive. CONCLUSIONS The relatively low density and lack of malaria infection in Anopheles mosquitoes sampled here indicates that exposure to P. knowlesi in this setting is considerably lower than in neighboring countries (i.e. Malaysia), where it is now the primary cause of malaria in humans. Although anophelines had lower abundance in MBTs than in HLCs, An. balabacensis and An. flavirostris were caught by both methods, suggesting they could act as bridge vectors between humans and macaques. These species bite primarily outdoors during the early evening, confirming that insecticide-treated nets are unlikely to provide protection against P. knowlesi vectors.
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Affiliation(s)
- Richard Paul B Malijan
- Department of Medical Entomology, Research Institute for Tropical Medicine, Alabang, 1781, Muntinlupa City, Metro Manila, Philippines
| | - Frank Mechan
- Department of Vector Biology, Liverpool School of Tropical Medicine, Liverpool, L3 5Q4, UK
| | - Jessie C Braganza
- Department of Medical Entomology, Research Institute for Tropical Medicine, Alabang, 1781, Muntinlupa City, Metro Manila, Philippines
| | - Kristelle Mae R Valle
- Department of Medical Entomology, Research Institute for Tropical Medicine, Alabang, 1781, Muntinlupa City, Metro Manila, Philippines
| | - Ferdinand V Salazar
- Department of Medical Entomology, Research Institute for Tropical Medicine, Alabang, 1781, Muntinlupa City, Metro Manila, Philippines
| | - Majhalia M Torno
- Department of Medical Entomology, Research Institute for Tropical Medicine, Alabang, 1781, Muntinlupa City, Metro Manila, Philippines.,Taxonomy & Pesticide Efficacy Branch, Vector Biology & Control Division, Environment Health Institute, National Environment Agency, Ministry of Sustainability and the Environment, 11 Biopolis Way, Singapore, 138667, Singapore
| | - Wilfredo E Aure
- Department of Medical Entomology, Research Institute for Tropical Medicine, Alabang, 1781, Muntinlupa City, Metro Manila, Philippines
| | - Brian A Bacay
- Department of Medical Entomology, Research Institute for Tropical Medicine, Alabang, 1781, Muntinlupa City, Metro Manila, Philippines
| | - Fe Esperanza Espino
- Department of Parasitology, Research Institute for Tropical Medicine, Alabang, 1781, Muntinlupa City, Ma, Metro Manila, Philippines
| | - Stephen J Torr
- Department of Vector Biology, Liverpool School of Tropical Medicine, Liverpool, L3 5Q4, UK
| | - Kimberly M Fornace
- Faculty of Infectious and Tropical Diseases, London School of Tropical Medicine and Hygiene, London, WC1E 7HT, UK
| | - Chris Drakeley
- Faculty of Infectious and Tropical Diseases, London School of Tropical Medicine and Hygiene, London, WC1E 7HT, UK
| | - Heather M Ferguson
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, G12 8QQ, UK.
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21
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Byrne I, Aure W, Manin BO, Vythilingam I, Ferguson HM, Drakeley CJ, Chua TH, Fornace KM. Environmental and spatial risk factors for the larval habitats of Plasmodium knowlesi vectors in Sabah, Malaysian Borneo. Sci Rep 2021; 11:11810. [PMID: 34083582 PMCID: PMC8175559 DOI: 10.1038/s41598-021-90893-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 05/18/2021] [Indexed: 12/22/2022] Open
Abstract
Land-use changes, such as deforestation and agriculture, can influence mosquito vector populations and malaria transmission. These land-use changes have been linked to increased incidence in human cases of the zoonotic malaria Plasmodium knowlesi in Sabah, Malaysian Borneo. This study investigates whether these associations are partially driven by fine-scale land-use changes creating more favourable aquatic breeding habitats for P. knowlesi anopheline vectors. Using aerial remote sensing data, we developed a sampling frame representative of all land use types within a major focus of P. knowlesi transmission. From 2015 to 2016 monthly longitudinal surveys of larval habitats were collected in randomly selected areas stratified by land use type. Additional remote sensing data on environmental variables, land cover and landscape configuration were assembled for the study site. Risk factor analyses were performed over multiple spatial scales to determine associations between environmental and spatial variables and anopheline larval presence. Habitat fragmentation (300 m), aspect (350 m), distance to rubber plantations (100 m) and Culex larval presence were identified as risk factors for Anopheles breeding. Additionally, models were fit to determine the presence of potential larval habitats within the areas surveyed and used to generate a time-series of monthly predictive maps. These results indicate that land-use change and topography influence the suitability of larval habitats, and may partially explain the link between P. knowlesi incidence and deforestation. The predictive maps, and identification of the spatial scales at which risk factors are most influential may aid spatio-temporally targeted vector control interventions.
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Affiliation(s)
- Isabel Byrne
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, Bloomsbury, London, WCIE 7HT, UK.
| | - Wilfredo Aure
- Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
- Research Institute for Tropical Medicine, Manila, Philippines
| | - Benny O Manin
- Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Indra Vythilingam
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Heather M Ferguson
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, UK
| | - Chris J Drakeley
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, Bloomsbury, London, WCIE 7HT, UK
| | - Tock H Chua
- Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Kimberly M Fornace
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, Keppel Street, Bloomsbury, London, WCIE 7HT, UK
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22
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Hii J, Hustedt J, Bangs MJ. Residual Malaria Transmission in Select Countries of Asia-Pacific Region: Old Wine in a New Barrel. J Infect Dis 2021; 223:S111-S142. [PMID: 33906222 PMCID: PMC8079134 DOI: 10.1093/infdis/jiab004] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Background Despite substantial reductions in malaria burden and improvement in case management, malaria remains a major public health challenge in the Asia-Pacific region. Residual malaria transmission (RMT) is the fraction of total transmission that persists after achievement of full operational coverage with effective insecticide-treated bed nets (ITNs)/long-lasting insecticidal nets (LLINs) and/or indoor residual spray interventions. There is a critical need to standardize and share best practices for entomological, anthropological, and product development investigative protocols to meet the challenges of RMT and elimination goals. Methods A systematic review was conducted to describe when and where RMT is occurring, while specifically targeting ownership and usage of ITN/LLINs, indoor residual spray application, insecticide susceptibility of vectors, and human and vector biting behavior, with a focus on nighttime activities. Results Sixty-six publications from 1995 to present met the inclusion criteria for closer review. Associations between local vector control coverage and use with behaviors of human and mosquito vectors varied by locality and circumstance. Consequently, the magnitude of RMT is insufficiently studied and analyzed with sparse estimates of individual exposure in communities, insufficient or incomplete observations of ITN/LLIN use, and the local human population movement into and from high-risk areas. Conclusions This review identified significant gaps or deficiencies that require urgent attention, namely, developing standardized procedures and methods to estimate risk exposure beyond the peridomestic setting, analytical approaches to measure key human-vector interactions, and seasonal location-specific agricultural or forest use calendars, and establishing the collection of longitudinal human and vector data close in time and location.
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Affiliation(s)
- Jeffrey Hii
- Malaria Consortium Asia, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | | | - Michael J Bangs
- Public Health and Malaria Control Department, PT Freeport Indonesia, International SOS, Jl. Kertajasa, Kuala Kencana, Papua, Indonesia.,Department of Entomology, Faculty of Agriculture, Kasertart University, Bangkok, Thailand
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23
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Abstract
Plasmodium knowlesi, a simian malaria parasite, has been in the limelight since a large focus of human P. knowlesi infection was reported from Sarawak (Malaysian Borneo) in 2004. Although this infection is transmitted across Southeast Asia, the largest number of cases has been reported from Malaysia. The increasing number of knowlesi malaria cases has been attributed to the use of molecular tools for detection, but environmental changes including deforestation likely play a major role by increasing human exposure to vector mosquitoes, which coexist with the macaque host. In addition, with the reduction in human malaria transmission in Southeast Asia, it is possible that human populations are at a greater risk of P. knowlesi infection due to diminishing cross-species immunity. Furthermore, the possibility of increasing exposure of humans to other simian Plasmodium parasites such as Plasmodium cynomolgi and Plasmodium inui should not be ignored. We here review the current status of these parasites in humans, macaques, and mosquitoes to support necessary reorientation of malaria control and elimination in the affected areas.
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24
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Scott J. Proposed Integrated Control of Zoonotic Plasmodium knowlesi in Southeast Asia Using Themes of One Health. Trop Med Infect Dis 2020; 5:E175. [PMID: 33233871 PMCID: PMC7709578 DOI: 10.3390/tropicalmed5040175] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 11/15/2020] [Accepted: 11/18/2020] [Indexed: 01/28/2023] Open
Abstract
Zoonotic malaria, Plasmodium knowlesi, threatens the global progression of malaria elimination. Southeast Asian regions are fronting increased zoonotic malaria rates despite the control measures currently implemented-conventional measures to control human-malaria neglect P. knowlesi's residual transmission between the natural macaque host and vector. Initiatives to control P. knowlesi should adopt themes of the One Health approach, which details that the management of an infectious disease agent should be scrutinized at the human-animal-ecosystem interface. This review describes factors that have conceivably permitted the emergence and increased transmission rates of P. knowlesi to humans, from the understanding of genetic exchange events between subpopulations of P. knowlesi to the downstream effects of environmental disruption and simian and vector behavioral adaptations. These factors are considered to advise an integrative control strategy that aligns with the One Health approach. It is proposed that surveillance systems address the geographical distribution and transmission clusters of P. knowlesi and enforce ecological regulations that limit forest conversion and promote ecosystem regeneration. Furthermore, combining individual protective measures, mosquito-based feeding trapping tools and biocontrol strategies in synergy with current control methods may reduce mosquito population density or transmission capacity.
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Affiliation(s)
- Jessica Scott
- College of Public Health and Medical and Veterinary Sciences, Australian Institute of Tropical Health and Medicine, James Cook University, Townsville 4811, Australia
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25
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Brown R, Chua TH, Fornace K, Drakeley C, Vythilingam I, Ferguson HM. Human exposure to zoonotic malaria vectors in village, farm and forest habitats in Sabah, Malaysian Borneo. PLoS Negl Trop Dis 2020; 14:e0008617. [PMID: 32886679 PMCID: PMC7497982 DOI: 10.1371/journal.pntd.0008617] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 09/17/2020] [Accepted: 07/20/2020] [Indexed: 12/27/2022] Open
Abstract
The zoonotic malaria parasite, Plasmodium knowlesi, is now a substantial public health problem in Malaysian Borneo. Current understanding of P. knowlesi vector bionomics and ecology in Sabah comes from a few studies near the epicentre of human cases in one district, Kudat. These have incriminated Anopheles balabacensis as the primary vector, and suggest that human exposure to vector biting is peri-domestic as well as in forest environments. To address the limited understanding of vector ecology and human exposure risk outside of Kudat, we performed wider scale surveillance across four districts in Sabah with confirmed transmission to investigate spatial heterogeneity in vector abundance, diversity and infection rate. Entomological surveillance was carried out six months after a cross-sectional survey of P. knowlesi prevalence in humans throughout the study area; providing an opportunity to investigate associations between entomological indicators and infection. Human-landing catches were performed in peri-domestic, farm and forest sites in 11 villages (3-4 per district) and paired with estimates of human P. knowlesi exposure based on sero-prevalence. Anopheles balabacensis was present in all districts but only 6/11 villages. The mean density of An. balabacensis was relatively low, but significantly higher in farm (0.094/night) and forest (0.082/night) than peri-domestic areas (0.007/night). Only one An. balabacensis (n = 32) was infected with P. knowlesi. Plasmodium knowlesi sero-positivity in people was not associated with An. balabacensis density at the village-level however post hoc analyses indicated the study had limited power to detect a statistical association due low vector density. Wider scale sampling revealed substantial heterogeneity in vector density and distribution between villages and districts. Vector-habitat associations predicted from this larger-scale surveillance differed from those inferred from smaller-scale studies in Kudat; highlighting the importance of local ecological context. Findings highlight potential trade-offs between maximizing temporal versus spatial breadth when designing entomological surveillance; and provide baseline entomological and epidemiological data to inform future studies of entomological risk factors for human P. knowlesi infection.
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Affiliation(s)
- Rebecca Brown
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Tock H. Chua
- Department of Pathobiology and Medical Diagnostics, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Kimberly Fornace
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Chris Drakeley
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Indra Vythilingam
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Heather M. Ferguson
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
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