Updates on malaria incidence and profile in Malaysia from 2013 to 2017

Abstract

Background: To date, most of the recent publications on malaria in Malaysia were conducted in Sabah, East Malaysia focusing on the emergence of Plasmodium knowlesi. This analysis aims to describe the incidence, mortality and case fatality rate of malaria caused by all Plasmodium species between Peninsular Malaysia and East Malaysia (Sabah and Sarawak) over a 5-year period (2013-2017). Methods: This is a secondary data review of all diagnosed and reported malaria confirmed cases notified to the Ministry of Health, Malaysia between January 2013 and December 2017. Results: From 2013 to 2017, a total of 16,500 malaria cases were notified in Malaysia. The cases were mainly contributed from Sabah (7150; 43.3%) and Sarawak (5684; 34.4%). Majority of the patients were male (13,552; 82.1%). The most common age group in Peninsular Malaysia was 20 to 29 years (1286; 35.1%), while Sabah and Sarawak reported highest number of malaria cases in age group of 30 to 39 years (2776; 21.6%). The top two races with malaria in Sabah and Sarawak were Bumiputera Sabah (5613; 43.7%) and Bumiputera Sarawak (4512; 35.1%), whereas other ethnic group (1232; 33.6%) and Malays (1025; 28.0%) were the two most common races in Peninsular Malaysia. Plasmodium knowlesi was the commonest species in Sabah and Sarawak (9902; 77.1%), while there were more Plasmodium vivax cases (1548; 42.2%) in Peninsular Malaysia. The overall average incidence rate, mortality rate and case fatality rates for malaria from 2013 to 2017 in Malaysia were 0.106/1000, 0.030/100,000 and 0.27%, respectively. Sarawak reported the highest average incidence rate of 0.420/1000 population followed by Sabah (0.383/1000). Other states in Peninsular Malaysia reported below the national average incidence rate with less than 0.100/1000. Conclusions: There were different trends and characteristics of notified malaria cases in Peninsular Malaysia and Sabah and Sarawak. They provide useful information to modify current prevention and control measures so that they are customised to the peculiarities of disease patterns in the two regions in order to successfully achieve the preelimination of human-only species in the near future.

Comparative evaluation of two commercial real-time PCR kits (QuantiFast™ and abTES™) for the detection of Plasmodium knowlesi and other Plasmodium species in Sabah, Malaysia

“…The use of con rmatory molecular detection methods have enabled accurate reporting of malaria trends in Malaysia demonstrating increasing P. knowlesi incidence [3], and have also provided reliable data on national and sub-national progress towards achieving elimination of other human-only Plasmodium species [2]. In other co-endemic settings in Southeast Asia, the incorporation of P. knowlesi detection into existing nucleic acid-based detection protocols would improve their use in targeted malaria surveillance strategies and accuracy of case reporting, particularly on those reported as P. malariae or indeterminate Plasmodium species infections from point-of-care microscopy [13,19].…”

“…However, the emergence of zoonotic transmission of the monkey parasite Plasmodium knowlesi has been less tractable to conventional malaria control efforts [2]. Within Malaysia, P. knowlesi is now the most common cause of malaria in humans, accounting for almost all reported malaria cases [1,3], including over 2000 noti cations in the state of Sabah in 2017 [2]. Con rmed P. knowlesi human infections have now been reported in all areas of Southeast Asia where the primary reservoir macaque hosts and Anopheles leucosphyrus group mosquitoes are present [4][5][6].…”

Malaria distribution and performance of malaria diagnostic methods in Malaysia (1980–2019): a systematic review

“…Even though malaria control activities have significantly reduced human malaria incidence in Malaysia, the resurgence of the malaria parasite P. knowlesi still remains as a main public health problem in the less developed areas of the country, especially in Malaysia Borneo [ 5 – 7 ] and among hard-to-reach populations of indigenous people in Peninsular Malaysia [ 8 – 11 ]. About one-third (32%) of total malaria cases occur in Peninsular Malaysia, and the majority of these are found in the central, south-eastern and northern coastal regions [ 6 ]. The remaining 68 percent of cases are found in Malaysian Borneo, primarily the states of Sabah and Sarawak [ 5 ].…”

New vectors in northern Sarawak, Malaysian Borneo, for the zoonotic malaria parasite, Plasmodium knowlesi

“…Knowlesi malaria cases have been reported from different locations in Malaysia [2][3][4][5][6][7], in almost all countries in Southeast Asia [8][9][10][11][12][13][14][15][16][17] except Timor Leste, and also in the Nicobar and Andaman Islands of India [18]. This simian malaria parasite is now the most common cause for malaria admissions to hospitals in Malaysia, where in the years 2017-2019, 10,968 cases were reported, with 87% occurring in the states of Sabah and Sarawak in Malaysian Borneo (unpublished data, Ministry of Health Malaysia) [19]. Despite now being recognised as a signi cant cause of malaria in humans and an additional challenge to malaria elimination in Southeast Asia [20][21][22][23], there remains a paucity of information regarding the vectors of P. knowlesi in nature.…”