No evidence of sustained nonzoonotic Plasmodium knowlesi transmission in Malaysia from modelling malaria case data

Kimberly M. Fornace (), Hillary M. Topazian, Isobel Routledge, Syafie Asyraf, Jenarun Jelip, Kim A. Lindblade, Mohammad Saffree Jeffree, Pablo Ruiz Cuenca, Samir Bhatt, Kamruddin Ahmed, Azra C. Ghani and Chris Drakeley
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Kimberly M. Fornace: University of Glasgow
Hillary M. Topazian: Imperial College London
Isobel Routledge: Imperial College London
Syafie Asyraf: Universiti Malaysia Sabah
Jenarun Jelip: Ministry of Health Malaysia
Kim A. Lindblade: World Health Organization
Mohammad Saffree Jeffree: Universiti Malaysia Sabah
Pablo Ruiz Cuenca: London School of Hygiene and Tropical Medicine
Samir Bhatt: Imperial College London
Kamruddin Ahmed: Universiti Malaysia Sabah
Azra C. Ghani: Imperial College London
Chris Drakeley: London School of Hygiene and Tropical Medicine

Nature Communications, 2023, vol. 14, issue 1, 1-8

Abstract: Abstract Reported incidence of the zoonotic malaria Plasmodium knowlesi has markedly increased across Southeast Asia and threatens malaria elimination. Nonzoonotic transmission of P. knowlesi has been experimentally demonstrated, but it remains unknown whether nonzoonotic transmission is contributing to increases in P. knowlesi cases. Here, we adapt model-based inference methods to estimate RC, individual case reproductive numbers, for P. knowlesi, P. falciparum and P. vivax human cases in Malaysia from 2012–2020 (n = 32,635). Best fitting models for P. knowlesi showed subcritical transmission (RC 1) was estimated historically for P. falciparum and P. vivax, with declines in RC estimates observed over time consistent with local elimination. Together, this suggests sustained nonzoonotic P. knowlesi transmission is highly unlikely and that new approaches are urgently needed to control spillover risks.

Date: 2023
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DOI: 10.1038/s41467-023-38476-8

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