The Treatment of Plasmodium knowlesi Malaria

Barber BE 1 , Grigg MJ 1 , William T 2 , Yeo TW 3 , Anstey NM 4

Affiliations 

  • 1 Menzies School of Health Research and Charles Darwin University, PO Box 41096, Casuarina 0810, Northern Territory, Australia; Infectious Diseases Society Sabah-Menzies School of Health Research Clinical Research Unit, Kota Kinabalu 88586, Sabah, Malaysia
  • 2 Infectious Diseases Society Sabah-Menzies School of Health Research Clinical Research Unit, Kota Kinabalu 88586, Sabah, Malaysia; Queen Elizabeth Hospital Clinical Research Centre, Kota Kinabalu 88586, Sabah, Malaysia; Jesselton Medical Centre, Kota Kinabalu 88300, Sabah, Malaysia
  • 3 Menzies School of Health Research and Charles Darwin University, PO Box 41096, Casuarina 0810, Northern Territory, Australia; Infectious Diseases Society Sabah-Menzies School of Health Research Clinical Research Unit, Kota Kinabalu 88586, Sabah, Malaysia; Lee Kong Chian School of Medicine, Nanyang Technological University, 639798 Singapore; Communicable Disease Centre, Institute of Infectious Diseases and Epidemiology, Tan Tock Seng Hospital, 308433 Singapore
  • 4 Menzies School of Health Research and Charles Darwin University, PO Box 41096, Casuarina 0810, Northern Territory, Australia; Infectious Diseases Society Sabah-Menzies School of Health Research Clinical Research Unit, Kota Kinabalu 88586, Sabah, Malaysia. Electronic address: nicholas.anstey@menzies.edu.au
Trends Parasitol, 2017 03;33(3):242-253.
PMID: 27707609 DOI: 10.1016/j.pt.2016.09.002

Abstract

Plasmodium knowlesi occurs across Southeast Asia and is the most common cause of malaria in Malaysia. High parasitaemias can develop rapidly, and the risk of severe disease in adults is at least as high as in falciparum malaria. Prompt initiation of effective treatment is therefore essential. Intravenous artesunate is highly effective in severe knowlesi malaria and in those with moderately high parasitaemia but otherwise uncomplicated disease. Both chloroquine and artemisinin-combination therapy (ACT) are highly effective for uncomplicated knowlesi malaria, with faster parasite clearance times and lower anaemia rates with ACT. Given the difficulties with microscope diagnosis of P. knowlesi, a unified treatment strategy of ACT for all Plasmodium species is recommended in coendemic regions.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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