Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
District Health Office of Gua Musang, Kelantan, Malaysia.
Am J Trop Med Hyg. 2023 Sep 25;109(5):1081-1085. doi: 10.4269/ajtmh.23-0184. Print 2023 Nov 1.
Malaysia has maintained zero cases of indigenous human malaria since 2018. However, zoonotic malaria is still prevalent in underdeveloped areas and hard-to-reach populations. This study aimed to determine the prevalence of malaria among remote indigenous communities in Peninsular Malaysia. A cross-sectional survey was conducted in six settlements in Kelantan state, from June to October 2019. Blood samples were tested for malaria using microscopy and nested polymerase chain reaction (nPCR) targeting the Plasmodium cytochrome c oxidase subunit III (cox3) gene. Of the 1,954 individuals who appeared healthy, no malaria parasites were found using microscopy. However, nPCR revealed seven cases of Plasmodium knowlesi mono-infection (0.4%), and six out of seven infections were in the group of 19 to 40 years old (P = 0.026). No human malaria species were detected by nPCR. Analysis of the DNA sequences also showed high similarity that reflects common ancestry to other P. knowlesi isolates. These findings indicate low submicroscopic P. knowlesi infections among indigenous communities in Malaysia, requiring PCR-based surveillance to support malaria control activities in the country.
马来西亚自 2018 年以来一直保持无本土人类疟疾病例。然而，动物源性疟疾在欠发达地区和难以到达的人群中仍然流行。本研究旨在确定马来半岛偏远土著社区的疟疾患病率。2019 年 6 月至 10 月，在吉兰丹州的 6 个定居点进行了横断面调查。使用显微镜和针对疟原虫细胞色素 c 氧化酶亚基 III (cox3) 基因的巢式聚合酶链反应 (nPCR) 检测血液样本是否存在疟疾。在 1954 名看似健康的个体中，显微镜未发现疟原虫。然而，nPCR 显示 7 例感染伯氏疟原虫（0.4%），其中 6 例感染发生在 19 至 40 岁人群中（P = 0.026）。nPCR 未检测到任何人类疟疾病种。DNA 序列分析也显示出高度相似性，反映了与其他伯氏疟原虫分离株的共同起源。这些发现表明马来西亚土著社区中存在低亚微观的伯氏疟原虫感染，需要基于 PCR 的监测来支持该国的疟疾控制活动。
