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Dian ND, Muhammad AB, Azman EN, Eddie NA, Azmi NI, Yee VCT, Rahim MAFA, Munajat MB, Rakna MIMS, Kasri MRM, Mohamed AI, Ghazali N, Hassan NW, Manap SNAA, Osman E, Wahid W, Chuangchaiya S, Lubis IND, Divis PCS, Chan S, Idris ZM. Evidence of Submicroscopic Plasmodium knowlesi Mono-Infection in Remote Indigenous Communities in Kelantan, Peninsular Malaysia. Am J Trop Med Hyg 2023; 109:1081-1085. [PMID: 37748768 PMCID: PMC10622472 DOI: 10.4269/ajtmh.23-0184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 07/12/2023] [Indexed: 09/27/2023] Open
Abstract
Malaysia has maintained zero cases of indigenous human malaria since 2018. However, zoonotic malaria is still prevalent in underdeveloped areas and hard-to-reach populations. This study aimed to determine the prevalence of malaria among remote indigenous communities in Peninsular Malaysia. A cross-sectional survey was conducted in six settlements in Kelantan state, from June to October 2019. Blood samples were tested for malaria using microscopy and nested polymerase chain reaction (nPCR) targeting the Plasmodium cytochrome c oxidase subunit III (cox3) gene. Of the 1,954 individuals who appeared healthy, no malaria parasites were found using microscopy. However, nPCR revealed seven cases of Plasmodium knowlesi mono-infection (0.4%), and six out of seven infections were in the group of 19 to 40 years old (P = 0.026). No human malaria species were detected by nPCR. Analysis of the DNA sequences also showed high similarity that reflects common ancestry to other P. knowlesi isolates. These findings indicate low submicroscopic P. knowlesi infections among indigenous communities in Malaysia, requiring PCR-based surveillance to support malaria control activities in the country.
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Affiliation(s)
- Nor Diyana Dian
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Ahmad Basyir Muhammad
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Elora Nor Azman
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nur Ashrina Eddie
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nur Iman Azmi
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Valerie Chong Tze Yee
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Mohd Amirul Fitri A. Rahim
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Mohd Bakhtiar Munajat
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | | | | | | | - Nuraffini Ghazali
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Noor Wanie Hassan
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Siti Nor Azreen Abdul Manap
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Emelia Osman
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Wathiqah Wahid
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Sriwipa Chuangchaiya
- Department of Community Health, Faculty of Public Health, Kasetsart University, Chalermphrakiat Sakon Nakhon Province Campus, Sakon Nakhon, Thailand
| | - Inke Nadia D. Lubis
- Department of Paediatric, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Paul C. S. Divis
- Malaria Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Sarawak
, Malaysia
| | - Sherwin Chan
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
| | - Zulkarnain Md Idris
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Rahim MAFA, Munajat MB, Dian ND, Seri Rakna MIM, Wahid W, Ghazali N, Hassan NW, Abdul Manap SNA, Kasri MRM, Mohamed AI, Osman E, Chuangchaiya S, Lubis IND, Divis PCS, Kaneko A, Tetteh KKA, Idris ZM. Naturally acquired antibody response to Plasmodium falciparum and Plasmodium vivax among indigenous Orang Asli communities in Peninsular Malaysia. Front Cell Infect Microbiol 2023; 13:1165634. [PMID: 37153151 PMCID: PMC10157193 DOI: 10.3389/fcimb.2023.1165634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 04/03/2023] [Indexed: 05/09/2023] Open
Abstract
Malaria remains a public health problem in many parts of the world. In Malaysia, the significant progress towards the national elimination programme and effective disease notification on malaria has resulted in zero indigenous human malaria cases since 2018. However, the country still needs to determine the extent of malaria exposure and transmission patterns, particularly in high-risk populations. In this study, a serological method was used to measure transmission levels of Plasmodium falciparum and Plasmodium vivax among indigenous Orang Asli communities in Kelantan, Peninsular Malaysia. A community-based cross-sectional survey was conducted in three Orang Asli communities (i.e., Pos Bihai, Pos Gob, and Pos Kuala Betis) in Kelantan from June to July 2019. Antibody responses to malaria were assessed by enzyme-linked immunosorbent assay (ELISA) using two P. falciparum (PfAMA-1 and PfMSP-119) and two P. vivax (PvAMA-1 and PvMSP-119) antigens. Age-adjusted antibody responses were analysed using a reversible catalytic model to calculate seroconversion rates (SCRs). Multiple logistic regression was used to investigate factors associated with malaria exposure. The overall malaria seroprevalence was 38.8% for PfAMA-1, 36.4% for PfMSP-119, 2.2% for PvAMA-1, and 9.3% for PvMSP-119. Between study areas, the proportion of seropositivity for any P. falciparum and P. vivax antigens was significantly highest in Pos Kuala Betis with 34.7% (p < 0.001) and 13.6% (p < 0.001), respectively. For all parasite antigens except for PvAMA-1, the proportion of seropositive individuals significantly increased with age (all p < 0.001). Based on the SCR, there was a higher level of P. falciparum transmission than P. vivax in the study area. Multivariate regression analyses showed that living in Pos Kuala Betis was associated with both P. falciparum (adjusted odds ratio [aOR] 5.6, p < 0.001) and P. vivax (aOR 2.1, p < 0.001) seropositivities. Significant associations were also found between age and seropositivity to P. falciparum and P. vivax antigens. Analysis of community-based serological data helps describe the level of transmission, heterogeneity, and factors associated with malaria exposure among indigenous communities in Peninsular Malaysia. This approach could be an important adjunct tool for malaria monitoring and surveillance in low malaria transmission settings in the country.
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Affiliation(s)
- Mohd Amirul Fitri A. Rahim
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Mohd Bakhtiar Munajat
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Nor Diyana Dian
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | | | - Wathiqah Wahid
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Nuraffini Ghazali
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Noor Wanie Hassan
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Siti Nor Azreen Abdul Manap
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | | | | | - Emelia Osman
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Sriwipa Chuangchaiya
- Department of Community Health, Faculty of Public Health, Kasetsart University, Sakon Nakhon, Thailand
| | - Inke Nadia D. Lubis
- Department of Paediatric, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Paul C. S. Divis
- Malaria Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Kota Samarahan, Sarawak, Malaysia
| | - Akira Kaneko
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
- Department of Parasitology, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Kevin K. A. Tetteh
- Department of Infection Biology, Faculty of Infectious Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Zulkarnain Md Idris
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
- *Correspondence: Zulkarnain Md Idris,
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Laoprom N, Prathummang S, Chuangchaiya S, Navanesan S, Munajat MB, Suwannatrai AT, Idris ZM. Opisthorchis viverrini metacercarial infection in cyprinid fish in Nakhon Phanom Province, Northeastern Thailand. Trop Biomed 2021; 38:25-30. [PMID: 33973569 DOI: 10.47665/tb.38.2.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Opisthorchiasis is endemic in parts of Southeast Asia, including the northern and northeastern regions of Thailand. In these regions, the transmission by fish intermediate hosts has received little attention. We investigated the intensity of Opisthorchis viverrini metacercariae (OV MC) in wild cyprinid fishes from five districts within the Nakhon Phanom Province, Northeast Thailand. Fishes were procured from local markets in five districts throughout three different seasons (hot, rainy and cold) between February 2018 and January 2019. The samples were identified, counted and weighed before metacercariae detection was performed via the artificial digestion method. A total of 2,149 freshwater fishes, representing 20 species were collected. The fish most commonly contaminated with OV MC were Anematichthys repasson and Hampala dispar. The intensity of OV MC in Nakhon Phanom was 0.23 OV MC/fish and varied among districts, ranging from 0.07 to 0.52. A low intensity of OV MC/fish (defined as <=1 cyst) was found in all three different seasons in the Nakhon Phanom Province; hot season (0.55), cold season (0.22) and the rainy season (0.13). The intensity of OV MC/fish was moderate (defined as >1 cyst) in the Renu Nakhon district (2.5) in the hot season. By fish species, H. dispar yielded the highest, with a moderate intensity of 2.1. In natural freshwater cyprinid fish in Nakhon Phanom, OV MC infection is endemic with intensity rates varying according to district, season and fish species.
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Affiliation(s)
- N Laoprom
- Department of General Science, Faculty of Science and Engineering, Kasetsart University, Chalermphrakiat Sakon Nakhon Province Campus, Sakon Nakhon, 47000, Thailand
| | - S Prathummang
- Hue Phon Health Promotion Hospital, Mueang Nakhon Phanom, Nakhon Phanom, 48000, Thailand
| | - S Chuangchaiya
- Department of Community Health, Faculty of Public Health, Kasetsart University, Chalermphrakiat Sakon Nakhon Province Campus, Sakon Nakhon, 47000, Thailand
| | - S Navanesan
- Secretariat for Medical Research and Innovation, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000 Cheras, Kuala Lumpur, Malaysia
| | - M B Munajat
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti, Kebangsaan Malaysia, 56000 Cheras, Kuala Lumpur, Malaysia
| | - A T Suwannatrai
- Department of Parasitology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002, Thailand
| | - Z M Idris
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti, Kebangsaan Malaysia, 56000 Cheras, Kuala Lumpur, Malaysia
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Munajat MB, Rahim MAFA, Wahid W, Seri Rakna MIM, Divis PCS, Chuangchaiya S, Lubis IND, Osman E, Mohd Kasri MR, Idris ZM. Perceptions and prevention practices on malaria among the indigenous Orang Asli community in Kelantan, Peninsular Malaysia. Malar J 2021; 20:202. [PMID: 33906645 PMCID: PMC8077949 DOI: 10.1186/s12936-021-03741-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 04/19/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Malaysia is on track towards malaria elimination. However, several cases of malaria still occur in the country. Contributing factors and communal aspects have noteworthy effects on any malaria elimination activities. Thus, assessing the community's knowledge, attitudes and practices (KAP) towards malaria is essential. This study was performed to evaluate KAP regarding malaria among the indigenous people (i.e. Orang Asli) in Peninsular Malaysia. METHODS A household-based cross-sectional study was conducted in five remote villages (clusters) of Orang Asli located in the State of Kelantan, a central region of the country. Community members aged six years and above were interviewed. Demographic, socio-economic and KAP data on malaria were collected using a structured questionnaire and analysed using descriptive statistics. RESULTS Overall, 536 individuals from 208 households were interviewed. Household indoor residual spraying (IRS) coverage and bed net ownership were 100% and 89.2%, respectively. A majority of respondents used mosquito bed nets every night (95.1%), but only 50.2% were aware that bed nets were used to prevent malaria. Nevertheless, almost all of the respondents (97.9%) were aware that malaria is transmitted by mosquitoes. Regarding practice for managing malaria, the most common practice adopted by the respondents was seeking treatment at the health facilities (70.9%), followed by self-purchase of medication from a local shop (12.7%), seeking treatment from a traditional healer (10.5%) and self-healing (5.9%). Concerning potential zoonotic malaria, about half of the respondents (47.2%) reported seeing monkeys from their houses and 20.1% reported entering nearby forests within the last 6 months. CONCLUSION This study found that most populations living in the villages have an acceptable level of knowledge and awareness about malaria. However, positive attitudes and practices concerning managing malaria require marked improvement.
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Affiliation(s)
- Mohd Bakhtiar Munajat
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000, Cheras, Kuala Lumpur, Malaysia
| | - Mohd Amirul Fitri A Rahim
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000, Cheras, Kuala Lumpur, Malaysia
| | - Wathiqah Wahid
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000, Cheras, Kuala Lumpur, Malaysia
| | | | - Paul C S Divis
- Malaria Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, 94300, Kota Samarahan, Sarawak, Malaysia
| | - Sriwipa Chuangchaiya
- Department of Community Health, Faculty of Public Health, Kasetsart University, Chalermphrakiat Sakon Nakhon Province Campus, Sakon Nakhon, 47000, Thailand
| | - Inke Nadia D Lubis
- Department of Paediatric, Faculty of Medicine, Universitas Sumatera Utara, Medan, 20154, Indonesia
| | - Emelia Osman
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000, Cheras, Kuala Lumpur, Malaysia
| | | | - Zulkarnain Md Idris
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000, Cheras, Kuala Lumpur, Malaysia.
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5
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Idris ZM, Zainal FNS, Ching LS, Azmin A, Hamdan Z, Kamaruzaman UA, Chan CW, Mohtar MA, Munajat MB, Muhammad Yasin A. Malaria in urban Kuala Lumpur, Malaysia from 2005 to 2017. Travel Med Infect Dis 2021; 41:102055. [PMID: 33823288 DOI: 10.1016/j.tmaid.2021.102055] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 03/30/2021] [Accepted: 03/31/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Zulkarnain Md Idris
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
| | - Fatin Nor Shakila Zainal
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Lee Shu Ching
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Amiruzair Azmin
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Zakiah Hamdan
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Ummi Athirah Kamaruzaman
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Chim W Chan
- Department of Parasitology, Graduate School of Medicine, Osaka City University, Osaka, Japan; Department of Anthropology, Binghamton University, Binghamton, NY, USA
| | - M Aiman Mohtar
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Mohd Bakhtiar Munajat
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Azlin Muhammad Yasin
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Rahim MAFA, Munajat MB, Idris ZM. Malaria distribution and performance of malaria diagnostic methods in Malaysia (1980-2019): a systematic review. Malar J 2020; 19:395. [PMID: 33160393 PMCID: PMC7649001 DOI: 10.1186/s12936-020-03470-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 10/29/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Malaysia has already achieved remarkable accomplishments in reaching zero indigenous human malaria cases in 2018. Prompt malaria diagnosis, surveillance and treatment played a key role in the country's elimination success. Looking at the dynamics of malaria distribution during the last decades might provide important information regarding the potential challenges of such an elimination strategy. This study was performed to gather all data available in term of prevalence or incidence on Plasmodium infections in Malaysia over the last four decades. METHODS A systematic review of the published English literature was conducted to identify malaria distribution from 1980 to June 2019 in Malaysia. Two investigators independently extracted data from PubMed, Scopus, Web of Science and Elsevier databases for original papers. RESULTS The review identified 46 epidemiological studies in Malaysia over the 39-year study period, on which sufficient information was available. The majority of studies were conducted in Malaysia Borneo (31/46; 67.4%), followed by Peninsular Malaysia (13/46; 28.3%) and in both areas (2/46; 4.3%). More than half of all studies (28/46; 60.9%) were assessed by both microscopy and PCR. Furthermore, there was a clear trend of decreases of all human malaria species with increasing Plasmodium knowlesi incidence rate throughout the year of sampling period. The summary estimates of sensitivity were higher for P. knowlesi than other Plasmodium species for both microscopy and PCR. Nevertheless, the specificities of summary estimates were similar for microscopy (40-43%), but varied for PCR (2-34%). CONCLUSIONS This study outlined the epidemiological changes in Plasmodium species distribution in Malaysia. Malaria cases shifted from predominantly caused by human malaria parasites to simian malaria parasites, which accounted for the majority of indigenous cases particularly in Malaysia Borneo. Therefore, malaria case notification and prompt malaria diagnosis in regions where health services are limited in Malaysia should be strengthened and reinforced to achieving the final goal of malaria elimination in the country.
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Affiliation(s)
- Mohd Amirul Fitri A Rahim
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000, Kuala Lumpur, Malaysia
| | - Mohd Bakhtiar Munajat
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000, Kuala Lumpur, Malaysia
| | - Zulkarnain Md Idris
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000, Kuala Lumpur, Malaysia.
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