{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T22:12:32Z","timestamp":1791756752182,"version":"4.3.4"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2019,1,8]],"date-time":"2019-01-08T00:00:00Z","timestamp":1546905600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Australian National Health and Medical Research Council"},{"name":"Australian Government Prestigious International Research Tuition Scholarship"},{"name":"University Postgraduate Research Scholarship"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,10,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Plasmodium knowlesi causes severe and fatal malaria, and incidence in Southeast Asia is increasing. Factors associated with death are not clearly defined.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>All malaria deaths in Sabah, Malaysia, from 2015 to 2017 were identified from mandatory reporting to the Sabah Department of Health. Case notes were reviewed, and a systematic review of these and all previously reported fatal P. knowlesi cases was conducted. Case fatality rates (CFRs) during 2010\u20132017 were calculated using incidence data from the Sabah Department of Health.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Six malaria deaths occurred in Sabah during 2015\u20132017, all from P. knowlesi. Median age was 40 (range, 23\u201358) years; 4 cases (67%) were male. Three (50%) had significant cardiovascular comorbidities and 1 was pregnant. Delays in administering appropriate therapy contributed to 3 (50%) deaths. An additional 26 fatal cases were included in the systematic review. Among all 32 cases, 18 (56%) were male; median age was 56 (range, 23\u201384) years. Cardiovascular-metabolic disease, microscopic misdiagnosis, and delay in commencing intravenous treatment were identified in 11 of 32 (34%), 26 of 29 (90%), and 11 of 31 (36%) cases, respectively. The overall CFR during 2010\u20132017 was 2.5\/1000: 6.0\/1000 for women and 1.7\/1000 for men (P = .01). Independent risk factors for death included female sex (odds ratio, 2.6; P = .04), and age \u226545 years (odds ratio, 4.7; P &lt; .01).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Earlier presentation, more rapid diagnosis, and administration of intravenous artesunate may avoid fatal outcomes, particularly in females, older adults, and patients with cardiovascular comorbidities.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciz011","type":"journal-article","created":{"date-parts":[[2019,1,8]],"date-time":"2019-01-08T10:15:18Z","timestamp":1546942518000},"page":"1703-1711","source":"Crossref","is-referenced-by-count":70,"title":["Deaths From Plasmodium knowlesi Malaria: Case Series and Systematic Review"],"prefix":"10.1093","volume":"69","author":[{"given":"Giri S","family":"Rajahram","sequence":"first","affiliation":[{"name":"Infectious Diseases Unit, Queen Elizabeth Hospital, Malaysia"},{"name":"Infectious Diseases Society Kota Kinabalu Sabah-Menzies School of Health Research Clinical Research Unit, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3643-7605","authenticated-orcid":false,"given":"Daniel J","family":"Cooper","sequence":"additional","affiliation":[{"name":"Infectious Diseases Society Kota Kinabalu Sabah-Menzies School of Health Research Clinical Research Unit, Malaysia"},{"name":"Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Northern Territory, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"William","sequence":"additional","affiliation":[{"name":"Jesselton Medical Centre, Kota Kinabalu, Sabah, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J","family":"Grigg","sequence":"additional","affiliation":[{"name":"Infectious Diseases Society Kota Kinabalu Sabah-Menzies School of Health Research Clinical Research Unit, Malaysia"},{"name":"Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Northern Territory, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas M","family":"Anstey","sequence":"additional","affiliation":[{"name":"Infectious Diseases Society Kota Kinabalu Sabah-Menzies School of Health Research Clinical Research Unit, Malaysia"},{"name":"Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Northern Territory, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bridget E","family":"Barber","sequence":"additional","affiliation":[{"name":"Infectious Diseases Society Kota Kinabalu Sabah-Menzies School of Health Research Clinical Research Unit, Malaysia"},{"name":"Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Northern Territory, Australia"},{"name":"QIMR Berghofer Medical Research Institute, Brisbane, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,1,8]]},"reference":[{"key":"2019103013370115800_CIT0001","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1128\/CMR.00079-12","article-title":"Human infections and detection of Plasmodium knowlesi","volume":"26","author":"Singh","year":"2013","journal-title":"Clin Microbiol Rev"},{"key":"2019103013370115800_CIT0002","doi-asserted-by":"crossref","first-page":"e0004915","DOI":"10.1371\/journal.pntd.0004915","article-title":"Estimating geographical variation in the risk of zoonotic Plasmodium knowlesi infection in countries eliminating malaria","volume":"10","author":"Shearer","year":"2016","journal-title":"PLoS Negl Trop 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