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01.12.2018 | Case report | Ausgabe 1/2018 Open Access

Malaria Journal 1/2018

Two clusters of Plasmodium knowlesi cases in a malaria elimination area, Sabang Municipality, Aceh, Indonesia

Malaria Journal > Ausgabe 1/2018
Herdiana Herdiana, Irnawati Irnawati, Farah Novita Coutrier, Alfian Munthe, Mardiati Mardiati, Titik Yuniarti, Elvieda Sariwati, Maria Endang Sumiwi, Rintis Noviyanti, Paul Pronyk, William A. Hawley


In malaria elimination areas, malaria cases are sporadic and consist predominantly of imported cases. Plasmodium knowlesi cases have been reported throughout Southeast Asia where long-tailed and pig-tailed macaques and Anopheles leucosphyrus group mosquitoes are sympatric. The limitation of microscopic examination to diagnose P. knowlesi is well known. In consequence, no P. knowlesi case has previously been reported from routine health facility-based case finding activities in Indonesia. This report describes two clusters of unexpected locally acquired P. knowlesi cases found in an area where Plasmodium falciparum and Plasmodium vivax infection had been eliminated in Sabang Municipality, Aceh, Indonesia. The difficulties in diagnosis and response illustrate challenges that Southeast Asian countries will increasingly face as the formerly common malaria parasites P. falciparum and P. vivax are gradually eliminated from the region.
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