Severe Plasmodium knowlesi malaria in a tertiary care hospital in Sabah, Malaysian BorneoArchived
56 adult patients with PCR confirmed P. knowlesi malaria from Sabah are described. 22 (39%) of these had strictly defined severe malaria including respiratory distress, acute renal failure and shock. None had cerebral malaria. Eighteen patients were pregnant. Overall, six patients with severe malaria (27%) died, giving a case fatality rate of 27% for severe knowlesi malaria.
William T, Menon J, Rajahram G, Chan L, Ma G, Donaldson S, et al. Emerg Infect Dis. 2011 Jul;17(7):1248-55
ECDC comment: Although the proportion with severe disease is likely to have been biased by the fact that this report came from a referral hospital, this report emphasises how P. knowlesi can cause severe malaria and the case fatality rate is on a par with severe falciparum. The high proportion of pregnant women is also reminiscent of falciparum although cerebral disease is less common and respiratory distress more common in severe knowlesi disease. There are now two substantive reports of severe knowlesi disease from different geographical locations (the other been from Sarawak State, Malaysian Borneo) and it is becoming clear that in patients in certain parts of the world (and certain travellers to those regions), P. knowlesi is a potentially important cause of mortality and morbidity. The study also points out that artemisinin derivatives rapidly clear parasitemia and are efficacious in treating uncomplicated and severe knowlesi malaria.
Expert opinion: Is screening for malaria necessary among asymptomatic refugees and immigrants coming from endemic countries?Archived
31 May 2011 - This article assesses the findings of a recent Canadian study which measured malaria prevalence among recently arrived asymptomatic refugees.
Artemisinin resistance: the clock is tickingArchived
16 May 2011 - Artemisinin resistance in falciparum malaria has emerged in western Cambodia exactly where chloroquine resistance arose 50 years ago. Similarly to the resistance to chloroquine that spread to Africa, the experts are wondering whether artemisinin resistance will spread as widely. In such a case the consequences would be disastrous.
Case Report: Imported Plasmodium knowlesi Malaria in a French Tourist Returning from ThailandArchived
16 May 2011 - The authors describe a case of imported Plasmodium knowlesi infection in a French tourist acquired in Thailand. The patient had spent a three month beach holiday on the west coast of Thailand including a one month stay on the Island of Ko Payam.