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The pathogen has a natural host reservoir in certain macaque species and is transmitted to humans via mosquitoes of the <jats:italic>Anopheles<\/jats:italic> Leucosphyrus Group. The risk of human <jats:italic>P<\/jats:italic>. <jats:italic>knowlesi<\/jats:italic> infection varies across Southeast Asia and is dependent upon environmental factors. Understanding this geographic variation in risk is important both for enabling appropriate diagnosis and treatment of the disease and for improving the planning and evaluation of malaria elimination. However, the data available on <jats:italic>P<\/jats:italic>. <jats:italic>knowlesi<\/jats:italic> occurrence are biased towards regions with greater surveillance and sampling effort. Predicting the spatial variation in risk of <jats:italic>P<\/jats:italic>. <jats:italic>knowlesi<\/jats:italic> malaria requires methods that can both incorporate environmental risk factors and account for spatial bias in detection.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods &amp; results<\/jats:title>\n<jats:p>We extend and apply an environmental niche modelling framework as implemented by a previous mapping study of <jats:italic>P<\/jats:italic>. <jats:italic>knowlesi<\/jats:italic> transmission risk which included data up to 2015. We reviewed the literature from October 2015 through to March 2020 and identified 264 new records of <jats:italic>P<\/jats:italic>. <jats:italic>knowlesi<\/jats:italic>, with a total of 524 occurrences included in the current study following consolidation with the 2015 study. The modelling framework used in the 2015 study was extended, with changes including the addition of new covariates to capture the effect of deforestation and urbanisation on <jats:italic>P<\/jats:italic>. <jats:italic>knowlesi<\/jats:italic> transmission.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Discussion<\/jats:title>\n<jats:p>Our map of <jats:italic>P<\/jats:italic>. <jats:italic>knowlesi<\/jats:italic> relative transmission suitability estimates that the risk posed by the pathogen is highest in Malaysia and Indonesia, with localised areas of high risk also predicted in the Greater Mekong Subregion, The Philippines and Northeast India. These results highlight areas of priority for <jats:italic>P<\/jats:italic>. <jats:italic>knowlesi<\/jats:italic> surveillance and prospective sampling to address the challenge the disease poses to malaria elimination planning.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pntd.0011570","type":"journal-article","created":{"date-parts":[[2024,1,22]],"date-time":"2024-01-22T18:31:45Z","timestamp":1705948305000},"page":"e0011570","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":36,"title":["Updating estimates of Plasmodium knowlesi malaria risk in response to changing land use patterns across Southeast Asia"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5202-240X","authenticated-orcid":true,"given":"Ruarai J.","family":"Tobin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucinda E.","family":"Harrison","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meg K.","family":"Tully","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inke N. 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