Contribution of Plasmodium knowlesi to Multispecies Human Malaria Infections in North Sumatera, Indonesia

Background. As Indonesia works toward the goal of malaria elimination, information is lacking on malaria epidemiology from some western provinces. As a basis for studies of antimalarial efficacy, we set out to survey parasite carriage in 3 communities in North Sumatera Province. Methods. A combinati...

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Bibliographic Details
Published in:The Journal of infectious diseases 2017-04, Vol.215 (7), p.1148-1155
Main Authors: Lubis, Inke N. D., Wijaya, Hendri, Lubis, Munar, Lubis, Chairuddin P., Divis, Paul C. S., Beshir, Khalid B., Sutherland, Colin J.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Female
Humans
Indonesia - epidemiology
Major
Malaria - epidemiology
Malaria - parasitology
Male
Microscopy
PARASITES
Plasmodium falciparum - genetics
Plasmodium knowlesi - genetics
Plasmodium vivax - genetics
Polymerase Chain Reaction
RNA, Ribosomal - genetics
Young Adult
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Summary:Background. As Indonesia works toward the goal of malaria elimination, information is lacking on malaria epidemiology from some western provinces. As a basis for studies of antimalarial efficacy, we set out to survey parasite carriage in 3 communities in North Sumatera Province. Methods. A combination of active and passive detection of infection was carried out among communities in Batubara, Langkat, and South Nias regencies. Finger-prick blood samples from consenting individuals of all ages provided blood films for microscopic examination and blood spots on filter paper. Plasmodium species were identified using nested polymerase chain reaction (PCR) of ribosomal RNA genes and a novel assay that amplifies a conserved sequence specific for the sicavar gene family of Plasmodium knowlesi. Results. Of 3731 participants, 614 (16.5%) were positive for malaria parasites by microscopy. PCR detected parasite DNA in samples from 1169 individuals 31.3%). In total, 377 participants (11.8%) harbored P. knowlesi. Also present were Plasmodium vivax (14.3%), Plasmodium falciparum (10.5%) and Plasmodium malariae (3.4%). Conclusions. Amplification of sicavar is a specific and sensitive test for the presence of P. knowlesi DNA in humans. Subpatent and asymptomatic multispecies parasitemia is relatively common in North Sumatera, so PCR-based surveillance is required to support control and elimination activities.
ISSN:0022-1899
1537-6613
DOI:10.1093/infdis/jix091