Malaria Research Centre, Universiti Malaysia Sarawak, Kuching, Sarawak, Malaysia.
Clin Microbiol Rev. 2013 Apr;26(2):165-84. doi: 10.1128/CMR.00079-12.
Plasmodium knowlesi is a malaria parasite that is found in nature in long-tailed and pig-tailed macaques. Naturally acquired human infections were thought to be extremely rare until a large focus of human infections was reported in 2004 in Sarawak, Malaysian Borneo. Human infections have since been described throughout Southeast Asia, and P. knowlesi is now recognized as the fifth species of Plasmodium causing malaria in humans. The molecular, entomological, and epidemiological data indicate that human infections with P. knowlesi are not newly emergent and that knowlesi malaria is primarily a zoonosis. Human infections were undiagnosed until molecular detection methods that could distinguish P. knowlesi from the morphologically similar human malaria parasite P. malariae became available. P. knowlesi infections cause a spectrum of disease and are potentially fatal, but if detected early enough, infections in humans are readily treatable. In this review on knowlesi malaria, we describe the early studies on P. knowlesi and focus on the epidemiology, diagnosis, clinical aspects, and treatment of knowlesi malaria. We also discuss the gaps in our knowledge and the challenges that lie ahead in studying the epidemiology and pathogenesis of knowlesi malaria and in the prevention and control of this zoonotic infection.
疟原虫 knowlesi 是一种自然存在于长尾猕猴和猪尾猕猴体内的疟原虫。直到 2004 年在马来西亚婆罗洲的沙捞越报告了一大波人类感染病例,人们才认为这种自然获得的人类感染极为罕见。此后,东南亚各地都有人类感染的报道,疟原虫 knowlesi 现在被认为是导致人类疟疾的第五种疟原虫。分子、昆虫学和流行病学数据表明,人类感染疟原虫 knowlesi 并非新出现的情况,而知莱氏疟原虫主要是一种人畜共患病。直到能够将疟原虫 knowlesi 与形态相似的人类疟原虫疟疾病原虫 P. malariae 区分开来的分子检测方法问世之前,人类感染一直未被诊断出来。疟原虫 knowlesi 感染会引起一系列疾病,且可能致命,但如果及早发现,人类感染很容易治疗。在这篇关于知莱氏疟原虫的综述中,我们描述了早期对疟原虫 knowlesi 的研究,并重点介绍了知莱氏疟原虫的流行病学、诊断、临床方面和治疗方法。我们还讨论了我们知识中的空白以及在研究知莱氏疟原虫的流行病学和发病机制以及预防和控制这种人畜共患感染方面所面临的挑战。