Chapter 13 : : the Fifth Human Malarial Parasite

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parasitizes Old World monkeys, typically the long- and pig-tailed macaques of Southeast Asia. A study in Thailand reported species in long-tailed macaques from three geographically distinct areas. Therefore, to provide comprehensive information on epidemiology, patients of Southeast Asia should be included in molecular studies. The study concluded that zoonotic malaria was rare and not a threat to malaria eradication programs initiated by the WHO in a previous era. At the time when atypical was noticed, sensitive and specific PCR-based tools and comparative genetics were well-established methods, particularly useful when investigating new or atypical infections. Knowlesi-specific PCR was developed for inclusion in molecular screening assays for malaria and may be used on DNA extracted from blood collected onto filter papers from even the most remote communities in the region. Therefore, for accurate epidemiology, it is possible to distinguish from using PCR-based assays. Patients reporting to health care facilities with symptomatic suspected on microscopy are the most likely group to be infected with . The definition of what constitutes hyperparasitemia, based on our current experience, should be as for nonimmune falciparum patients. Therefore, one of the most exciting opportunities in the study of pathophysiology in humans is the ability to test correlates of pathophysiology in representative animal models. The first large focus of human cases of knowlesi malaria was identified in Sarawak, Malaysian Borneo.

Citation: Cox-Singh J, Singh B, Krishna S. 2010. : the Fifth Human Malarial Parasite, p 261-271. In Scheld W, Grayson M, Hughes J (ed), Emerging Infections 9. ASM Press, Washington, DC. doi: 10.1128/9781555816803.ch13
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Figure 1.

transmission. The range of the group of mosquitoes in Southeast Asia falls within the area outlined by the solid gray line. The northern border of the natural hosts of , long- and pig-tailed macaques, is shown as a hatched line, with two smaller foci of pig-tailed macaques further north (areas within white circles). Nonhuman primates are not found beyond the Wallace line, the lower hatched line. Adapted from reference .

Citation: Cox-Singh J, Singh B, Krishna S. 2010. : the Fifth Human Malarial Parasite, p 261-271. In Scheld W, Grayson M, Hughes J (ed), Emerging Infections 9. ASM Press, Washington, DC. doi: 10.1128/9781555816803.ch13
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Figure 2.

Parasitemias from knowlesi malaria patients with well-characterized disease outcomes (uncomplicated, = 95; complicated, = 8; fatal, = 9) were compared. The geometric mean parasitemias (horizontal black lines) were significantly different between the 3 groups ( = <0.0001) using the Kruskal-Wallis test.

Citation: Cox-Singh J, Singh B, Krishna S. 2010. : the Fifth Human Malarial Parasite, p 261-271. In Scheld W, Grayson M, Hughes J (ed), Emerging Infections 9. ASM Press, Washington, DC. doi: 10.1128/9781555816803.ch13
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