title: Plasmodium knowlesi transmission: integrating quantitative approaches from epidemiology and ecology to understand malaria as a zoonosis.
abstract: The public health threat posed by zoonotic Plasmodium knowlesi appears to be growing: it is increasingly reported across South East Asia, and is the leading cause of malaria in Malaysian Borneo. Plasmodium knowlesi threatens progress towards malaria elimination as aspects of its transmission, such as spillover from wildlife reservoirs and reliance on outdoor-biting vectors, may limit the effectiveness of conventional methods of malaria control. The development of new quantitative approaches that address the ecological complexity of P. knowlesi, particularly through a focus on its primary reservoir hosts, will be required to control it. Here, we review what is known about P. knowlesi transmission, identify key knowledge gaps in the context of current approaches to transmission modelling, and discuss the integration of these approaches with clinical parasitology and geostatistical analysis. We highlight the need to incorporate the influences of fine-scale spatial variation, rapid changes to the landscape, and reservoir population and transmission dynamics. The proposed integrated approach would address the unique challenges posed by malaria as a zoonosis, aid the identification of transmission hotspots, provide insight into the mechanistic links between incidence and land use change and support the design of appropriate interventions.
authors.affiliation: Institute of Biodiversity Animal Health and Comparative Medicine,College of Medical Veterinary and Life Sciences,University of Glasgow,Glasgow,UK.
authors.forename: P M
authors.initials: PM
authors.lastname: Brock
authors.affiliation: London School of Hygiene and Tropical Medicine,London,UK.
authors.forename: K M
authors.initials: KM
authors.lastname: Fornace
authors.affiliation: Institute of Biodiversity Animal Health and Comparative Medicine,College of Medical Veterinary and Life Sciences,University of Glasgow,Glasgow,UK.
authors.forename: M
authors.initials: M
authors.lastname: Parmiter
authors.affiliation: London School of Hygiene and Tropical Medicine,London,UK.
authors.forename: J
authors.initials: J
authors.lastname: Cox
authors.affiliation: London School of Hygiene and Tropical Medicine,London,UK.
authors.forename: C J
authors.initials: CJ
authors.lastname: Drakeley
authors.affiliation: Institute of Biodiversity Animal Health and Comparative Medicine,College of Medical Veterinary and Life Sciences,University of Glasgow,Glasgow,UK.
authors.forename: H M
authors.initials: HM
authors.lastname: Ferguson
authors.affiliation: Institute of Biodiversity Animal Health and Comparative Medicine,College of Medical Veterinary and Life Sciences,University of Glasgow,Glasgow,UK.
authors.forename: R R
authors.initials: RR
authors.lastname: Kao
mesh_terms: D000818:Animals; D001210:Asia, Southeastern / Q000453:epidemiology; D009033:Culicidae / Q000469:parasitology; D003710:Demography; D004197:Disease Reservoirs / Q000469:parasitology; D004463:Ecology / Q000639:trends*; D006802:Human Activities; D006801:Humans; D007303:Insect Vectors / Q000469:parasitology; D008251:Macaca / Q000469:parasitology*; D008288:Malaria / Q000453:epidemiology / Q000469:parasitology / Q000635:transmission*; D008954:Models, Biological; D008992:Monkey Diseases / Q000453:epidemiology / Q000469:parasitology* / Q000635:transmission; D016790:Plasmodium knowlesi / Q000472:pathogenicity / Q000502:physiology; D012307:Risk Factors; D015047:Zoonoses / Q000453:epidemiology / Q000469:parasitology* / Q000635:transmission
keywords: Plasmodium knowlesi; R
                 0; infectious disease transmission; macaque; malaria; mathematical model; mosquito; reproduction number; vector; zoonosis
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