World Malaria Report: time to acknowledge Plasmodium knowlesi malaria.

Area of Science:

• Tropical medicine
• Infectious diseases
• Parasitology

Background:

• The World Health Organization (WHO) World Malaria Report highlights progress in malaria control but faces challenges.
• Plasmodium knowlesi, a simian malaria parasite, is an emerging cause of human malaria in Southeast Asia, particularly in Malaysia.
• P. knowlesi is often misdiagnosed as P. falciparum or P. vivax, leading to underestimation of its true incidence.

Purpose of the Study:

• To advocate for the regular inclusion of Plasmodium knowlesi data in the WHO World Malaria Report.
• To emphasize the need for improved surveillance and recognition of P. knowlesi malaria in endemic regions.
• To highlight the importance of addressing P. knowlesi alongside P. falciparum and P. vivax in global malaria control efforts.

Main Methods:

• Review of existing malaria surveillance data and reports.
• Analysis of P. knowlesi prevalence and misdiagnosis rates in Southeast Asia.
• Assessment of the impact of P. knowlesi recognition on case fatality rates in Malaysia.

Main Results:

• P. knowlesi is the most common malaria cause in Malaysia and reported across Southeast Asia.
• Misdiagnosis of P. knowlesi is frequent, suggesting underdiagnosis and underestimation of its incidence.
• Improved recognition and reporting in Malaysia have coincided with reduced P. knowlesi case fatality rates.

Conclusions:

• Regular inclusion of P. knowlesi in the World Malaria Report is warranted.
• Enhanced surveillance and reporting are essential for effective P. knowlesi control and mitigation strategies.
• Efforts to eliminate P. falciparum and P. vivax should not overshadow the need to address P. knowlesi malaria.