title: Plasmodium knowlesi malaria during pregnancy.
abstract: BACKGROUND
  Plasmodium knowlesi is the commonest cause of malaria in Malaysia, but little is known regarding infection during pregnancy.
  
  
  METHODS
  To investigate comparative risk and consequences of knowlesi malaria during pregnancy, we reviewed (1) Sabah Health Department malaria-notification records created during 2012-2013, (2) prospectively collected data from all females with polymerase chain reaction (PCR)-confirmed malaria who were admitted to a Sabah tertiary care referral hospital during 2011-2014, and (3) malaria microscopy and clinical data recorded at a Sabah tertiary care women and children's hospital during 2010-2014.
  
  
  RESULTS
  During 2012-2013, 774 females with microscopy-diagnosed malaria were notified, including 252 (33%), 172 (20%), 333 (43%), and 17 (2%) with Plasmodium falciparum infection, Plasmodium vivax infection, Plasmodium malariae/Plasmodium knowlesi infection, and mixed infection, respectively. Among females aged 15-45 years, pregnancy was reported in 18 of 124 (14.5%), 9 of 93 (9.7%), and 4 of 151 (2.6%) P. falciparum, P. vivax, and P. malariae/P. knowlesi notifications respectively (P = .002). Three females with knowlesi malaria were confirmed as pregnant: 2 had moderate anemia, and 1 delivered a preterm low-birth-weight infant. There were 17, 7, and 0 pregnant women with falciparum, vivax, and knowlesi malaria, respectively, identified from the 2 referral hospitals.
  
  
  CONCLUSIONS
  Although P. knowlesi is the commonest malaria species among females in Sabah, P. knowlesi infection is relatively rare during pregnancy. It may however be associated with adverse maternal and pregnancy outcomes.
authors.affiliation: Menzies School of Health Research, Charles Darwin University, Infectious Diseases Society Sabah-Menzies School of Health Research Clinical Research Unit.
authors.forename: Bridget E
authors.initials: BE
authors.lastname: Barber
authors.affiliation: Infectious Diseases Society Sabah-Menzies School of Health Research Clinical Research Unit.
authors.forename: Elspeth
authors.initials: E
authors.lastname: Bird
authors.affiliation: Infectious Diseases Society Sabah-Menzies School of Health Research Clinical Research Unit.
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Wilkes
authors.affiliation: Infectious Diseases Society Sabah-Menzies School of Health Research Clinical Research Unit Infectious Diseases Unit.
authors.forename: Timothy
authors.initials: T
authors.lastname: William
authors.affiliation: Menzies School of Health Research, Charles Darwin University, Infectious Diseases Society Sabah-Menzies School of Health Research Clinical Research Unit.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Grigg
authors.affiliation: Menzies School of Health Research, Charles Darwin University, Infectious Diseases Society Sabah-Menzies School of Health Research Clinical Research Unit.
authors.forename: Uma
authors.initials: U
authors.lastname: Paramaswaran
authors.affiliation: Department of Medicine, Clinical Research Centre, Queen Elizabeth Hospital.
authors.forename: Jayaram
authors.initials: J
authors.lastname: Menon
authors.affiliation: Sabah Department of Health, Kota Kinabalu, Malaysia.
authors.forename: Jenarun
authors.initials: J
authors.lastname: Jelip
authors.affiliation: Menzies School of Health Research, Charles Darwin University, Infectious Diseases Society Sabah-Menzies School of Health Research Clinical Research Unit Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.
authors.forename: Tsin W
authors.initials: TW
authors.lastname: Yeo
authors.affiliation: Menzies School of Health Research, Charles Darwin University, Royal Darwin Hospital, Australia Infectious Diseases Society Sabah-Menzies School of Health Research Clinical Research Unit.
authors.forename: Nicholas M
authors.initials: NM
authors.lastname: Anstey
mesh_terms: D000293:Adolescent; D000328:Adult; D000740:Anemia; D016054:DNA, Protozoan / Q000235:genetics; D018563:Disease Notification; D005260:Female; D005843:Geography; D006801:Humans; D008288:Malaria / Q000453:epidemiology* / Q000469:parasitology; D008296:Malaysia / Q000453:epidemiology; D008875:Middle Aged; D016790:Plasmodium knowlesi / Q000235:genetics / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000453:epidemiology* / Q000469:parasitology; D011446:Prospective Studies; D062606:Tertiary Care Centers; D055815:Young Adult
chemical_list: D016054:DNA, Protozoan
keywords: Plasmodium knowlesi; malaria; maternal anemia; pregnancy; preterm delivery