title: Plasmodium knowlesi- an emerging pathogen.
abstract: Ten years have passed since the publication of a large focus ofPlasmodium knowlesiinfections in the human population. The discovery was made during a molecular investigation of atypicalP. malariaecases in the Kapit Health Division, Sarawak, Malaysian Borneo. Patients were more symptomatic with higher parasite counts than expected inP. malariaeinfections. The investigation found onlyP. knowlesiDNA present in patient blood samples. Morphological similarity had allowedP. knowlesito masquerade asP. malariaeduring routine diagnostic microscopy for malaria.P. knowlesi, a malaria parasite of macaque monkeys, had entered the human population. The subsequent development ofP. knowlesispecies-specific PCR assays soon demonstrated that the entry was not confined to the Kapit Division but extended across island and mainland Southeast Asia. Relevant clinical descriptions and guidelines for the treatment and management of patents withP. knowlesimalaria were not available. Nor was it clear whetherP. knowlesihad undergone a host switch event into the human population or if infections were zoonotic. The outputs of studies onP. knowlesimalaria during the past 10 years will be summarized, highlighting major findings within the context of pathophysiology, virulence, host switch events, treatment, control and importantly malaria elimination.
authors.affiliation: School of Medicine, University of St Andrews St Andrews, UK.
authors.forename: M A
authors.initials: MA
authors.lastname: Ahmed
authors.affiliation: Department of Parasitology, Faculty of Medicine, University of Malaya Kuala Lumpur, Malaysia.
authors.forename: J
authors.initials: J
authors.lastname: Cox-Singh
keywords: Plasmodium; knowlesi; malaria; pathophysiology; virulence; zoonosis