Barber Bridget E, Rajahram Giri S, Grigg Matthew J, William Timothy, Anstey Nicholas M
Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, PO Box 41096, Darwin, NT, 0811, Australia.
Infectious Diseases Society Sabah-Menzies School of Health Research Clinical Research Unit, Queen Elizabeth Hospital, 88200, Kota Kinabalu, Sabah, Malaysia.
Malar J. 2017 Mar 31;16(1):135. doi: 10.1186/s12936-017-1787-y.
The 2016 World Health Organization (WHO) World Malaria Report documents substantial progress towards control and elimination of malaria. However, major challenges remain. In some regions of Southeast Asia, the simian parasite Plasmodium knowlesi has emerged as an important cause of human malaria, and the authors believe this species warrants regular inclusion in the World Malaria Report.
Plasmodium knowlesi is the most common cause of malaria in Malaysia, and cases have also been reported in nearly all countries of Southeast Asia. Outside of Malaysia, P. knowlesi is frequently misdiagnosed by microscopy as Plasmodium falciparum or Plasmodium vivax. Thus, P. knowlesi may be underdiagnosed in affected regions and its true incidence underestimated. Acknowledgement in the World Malaria Report of the regional importance of P. knowlesi will facilitate efforts to improve surveillance of this emerging parasite. Furthermore, increased recognition will likely lead to improved delivery of effective treatment for this potentially fatal infection, as has occurred in Malaysia where P. knowlesi case-fatality rates have fallen despite rising incidence. In a number of knowlesi-endemic countries, substantial progress has been made towards the elimination of P. vivax and P. falciparum. However, efforts to eliminate these human-only species should not preclude efforts to reduce human malaria from P. knowlesi. The regional importance of knowlesi malaria was recognized by the WHO with its recent Evidence Review Group meeting on knowlesi malaria to address strategies for prevention and mitigation.
The WHO World Malaria Report has an appropriate focus on falciparum and vivax malaria, the major causes of global mortality and morbidity. However, the authors hope that in future years this important publication will also incorporate data on the progress and challenges in reducing knowlesi malaria in regions where transmission occurs.
《2016年世界卫生组织（WHO）世界疟疾报告》记录了在疟疾控制和消除方面取得的重大进展。然而，重大挑战依然存在。在东南亚的一些地区，猿猴疟原虫诺氏疟原虫已成为人类疟疾的一个重要病因，作者认为该物种应定期纳入《世界疟疾报告》。
诺氏疟原虫是马来西亚最常见的疟疾病因，几乎东南亚所有国家也都有病例报告。在马来西亚以外地区，诺氏疟原虫常被显微镜误诊为恶性疟原虫或间日疟原虫。因此，在受影响地区，诺氏疟原虫可能未得到充分诊断，其真实发病率被低估。在《世界疟疾报告》中承认诺氏疟原虫在区域内的重要性将有助于努力加强对这种新出现寄生虫的监测。此外，认识的提高可能会带来针对这种潜在致命感染的有效治疗的改善，就像在马来西亚那样，尽管发病率上升，但诺氏疟原虫的病死率已有所下降。在一些诺氏疟原虫流行国家，在消除间日疟原虫和恶性疟原虫方面已取得重大进展。然而，消除这些仅感染人类的疟原虫物种的努力不应排除减少诺氏疟原虫所致人类疟疾的努力。世界卫生组织在其最近关于诺氏疟原虫疟疾的证据审查小组会议上认识到诺氏疟原虫疟疾在区域内的重要性，以讨论预防和缓解策略。
《世界卫生组织世界疟疾报告》适当关注了导致全球死亡和发病的主要原因——恶性疟和间日疟。然而，作者希望在未来几年，这份重要出版物也将纳入有关在疟疾传播地区减少诺氏疟原虫疟疾方面的进展和挑战的数据。
