Menzies School of Health Research and Charles Darwin University, PO Box 41096, Casuarina 0810, Northern Territory, Australia; Infectious Diseases Society Sabah-Menzies School of Health Research Clinical Research Unit, Kota Kinabalu 88586, Sabah, Malaysia.
Infectious Diseases Society Sabah-Menzies School of Health Research Clinical Research Unit, Kota Kinabalu 88586, Sabah, Malaysia; Queen Elizabeth Hospital Clinical Research Centre, Kota Kinabalu 88586, Sabah, Malaysia; Jesselton Medical Centre, Kota Kinabalu 88300, Sabah, Malaysia.
Trends Parasitol. 2017 Mar;33(3):242-253. doi: 10.1016/j.pt.2016.09.002. Epub 2016 Oct 1.
Plasmodium knowlesi occurs across Southeast Asia and is the most common cause of malaria in Malaysia. High parasitaemias can develop rapidly, and the risk of severe disease in adults is at least as high as in falciparum malaria. Prompt initiation of effective treatment is therefore essential. Intravenous artesunate is highly effective in severe knowlesi malaria and in those with moderately high parasitaemia but otherwise uncomplicated disease. Both chloroquine and artemisinin-combination therapy (ACT) are highly effective for uncomplicated knowlesi malaria, with faster parasite clearance times and lower anaemia rates with ACT. Given the difficulties with microscope diagnosis of P. knowlesi, a unified treatment strategy of ACT for all Plasmodium species is recommended in coendemic regions.
疟原虫 knowlesi 分布于整个东南亚，是马来西亚最常见的疟疾病因。高寄生虫血症可能迅速发展，成年人罹患重症疾病的风险至少与恶性疟原虫疟疾一样高。因此，迅速启动有效的治疗至关重要。静脉内青蒿琥酯对重症 knowlesi 疟疾和寄生虫血症中等偏高但无其他并发症的疾病非常有效。氯喹和青蒿素类联合疗法 (ACT) 对无并发症的 knowlesi 疟疾非常有效，ACT 可更快清除寄生虫并降低贫血发生率。鉴于疟原虫 knowlesi 的显微镜诊断困难，在共患地区建议对所有疟原虫采用 ACT 统一治疗策略。
