Plasmodium knowlesi malaria in children

Plasmodium knowlesi can cause severe malaria in adults; however, descriptions of clinical disease in children are lacking. We reviewed case records of children (age <15 years) with a malaria diagnosis at Kudat District Hospital, serving a largely deforested area of Sabah, Malaysia, during January...

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Published inEmerging infectious diseases Vol. 17; no. 5; pp. 814 - 820
Main Authors Barber, Bridget E, William, Timothy, Jikal, Mohammad, Jilip, Jenarun, Dhararaj, Prabakaran, Menon, Jayaram, Yeo, Tsin W, Anstey, Nicholas M
Format Journal Article
LanguageEnglish
Published United States U.S. National Center for Infectious Diseases 01.05.2011
Centers for Disease Control and Prevention
Subjects
Adolescent
Age Factors
Anemia - etiology
Antimalarials - therapeutic use
Causes of
Child
Child, Preschool
children
Chloroquine - therapeutic use
Distribution
Female
Genetic aspects
Health aspects
Humans
Malaria
Malaria - complications
Malaria - diagnosis
Malaria - drug therapy
Malaria - physiopathology
Malaria - transmission
Malaria, Falciparum - drug therapy
Malaria, Falciparum - physiopathology
Malaysia
Male
parasites
Plasmodium
Plasmodium falciparum
Plasmodium knowlesi
Plasmodium knowlesi - physiology
Polymerase chain reaction
Primaquine - therapeutic use
Retrospective Studies
Sex Factors
Thrombocytopenia - etiology
Treatment Outcome
Malaysia
Indonesia
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Summary:Plasmodium knowlesi can cause severe malaria in adults; however, descriptions of clinical disease in children are lacking. We reviewed case records of children (age <15 years) with a malaria diagnosis at Kudat District Hospital, serving a largely deforested area of Sabah, Malaysia, during January-November 2009. Sixteen children with PCR-confirmed P. knowlesi monoinfection were compared with 14 children with P. falciparum monoinfection diagnosed by microscopy or PCR. Four children with knowlesi malaria had a hemoglobin level at admission of <10.0 g/dL (minimum lowest level 6.4 g/dL). Minimum level platelet counts were lower in knowlesi than in falciparum malaria (median 76,500/μL vs. 156,000/mL; p = 0.01). Most (81%) children with P. knowlesi malaria received chloroquine and primaquine; median parasite clearance time was 2 days (range 1-5 days). P. knowlesi is the most common cause of childhood malaria in Kudat. Although infection is generally uncomplicated, anemia is common and thrombocytopenia universal. Transmission dynamics in this region require additional investigation.
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ISSN:1080-6040
1080-6059
DOI:10.3201/eid1705.101489