{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T20:05:25Z","timestamp":1787169925403,"version":"build-2736575974"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,10]]},"abstract":"\n Background & objectives:<\/jats:title>\n \n Severe malaria is a medical emergency and can lead to severe complications and death if not treated promptly and appropriately. Along with\n Plasmodium falciparum<\/jats:italic>\n ,\n P. knowlesi<\/jats:italic>\n is increasingly recognised as a significant cause of fatal and severe malaria.\n <\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n We performed a retrospective review on 54 cases of severe malaria in a district hospital in Kapit, Sarawak, from January 2018 to May 2019. The patients\u2019 demographics, clinical features, complications based on organ involvement, and treatment outcomes were examined.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n There were 54 cases of severe malaria, with the majority being male (70%) and between the ages of 40 and 49 (26%). All patients with severe malaria were febrile or had a history of pyrexia except for one patient.\n P. knowlesi<\/jats:italic>\n (81.5%) was the most common species causing severe malaria in our study, followed by\n P. falciparum<\/jats:italic>\n (13%), and\n P. vivax<\/jats:italic>\n (5.5%). There were no cases of severe malaria caused by\n P. ovale<\/jats:italic>\n or\n P. malariae<\/jats:italic>\n . Hyperparasitaemia was present in 76% of patients and the median parasitemia value at hospital admission was 33,944 parasites\/\u03bcL (interquartile range: 19,920-113,285 parasites\/\u03bcL). Circulatory shock was observed in 17 patients (31.5%). There were eight patients with acute renal failure and six patients with respiratory distress. One patient died as a result of severe malaria with multiorgan involvement (1.9% fatality rate).\n <\/jats:p>\n <\/jats:sec>\n \n Interpretation & conclusion:<\/jats:title>\n \n P. knowlesi<\/jats:italic>\n is the most common cause of severe malaria in Kapit, Sarawak, Malaysia. Recognizing symptoms of severe malaria and prompt administration of antimalarial are critical for good clinical outcomes.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/0972-9062.374238","type":"journal-article","created":{"date-parts":[[2023,4,14]],"date-time":"2023-04-14T07:39:43Z","timestamp":1681457983000},"page":"432-434","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":8,"title":["Clinical characteristics and outcome of severe malaria in Kapit, Sarawak, Malaysian Borneo"],"prefix":"10.4103","volume":"60","author":[{"given":"Chee Yik","family":"Chang","sequence":"first","affiliation":[{"name":"Medical Department, Hospital Kapit, Jalan Mamora, Kapit, Sarawak, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,12,26]]},"reference":[{"issue":"9414","key":"R1-20240830","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.1016\/S0140-6736(04)15836-4","article-title":"A large focus of naturally acquired Plasmodium knowlesi infections in human beings","volume":"363","author":"Singh","year":"2004","journal-title":"Lancet"},{"issue":"1","key":"R3-20240830","doi-asserted-by":"crossref","first-page":"186","DOI":"10.55519\/JAMC-01-11418","article-title":"Afebrile Plasmodium knowlesi severe malaria with a fatal outcome","volume":"35","author":"Chang","year":"2023","journal-title":"J Ayub Med Coll Abbottabad"},{"issue":"4","key":"R4-20240830","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1186\/cc2183","article-title":"Clinical review: Severe malaria","volume":"7","author":"Trampuz","year":"2003","journal-title":"Crit 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Dis"},{"issue":"1","key":"R8-20240830","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1186\/s40249-020-00727-x","article-title":"Prevalence of severe Plasmodium knowlesi infection and risk factors related to severe complications compared with non-severe Plasmodium knowlesi and severe Plasmodium falciparum malaria: a systematic review and meta-analysis","volume":"9","author":"Kotepui","year":"2020","journal-title":"Infect Dis Poverty"},{"issue":"3","key":"R9-20240830","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1093\/cid\/cis902","article-title":"A prospective comparative study of knowlesi, falciparum, and vivax malaria in Sabah, Malaysia: high proportion with severe disease from Plasmodium knowlesi and Plasmodium vivax but no mortality with early referral and artesunate therapy","volume":"56","author":"Barber","year":"2013","journal-title":"Clin Infect Dis"},{"issue":"1","key":"R10-20240830","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1186\/s12936-018-2600-2","article-title":"Spontaneous splenic rupture in Plasmodium knowlesi malaria","volume":"17","author":"Chang","year":"2018","journal-title":"Malar J"},{"issue":"2","key":"R11-20240830","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1086\/524888","article-title":"Plasmodium knowlesi malaria in humans is widely distributed and potentially life threatening","volume":"46","author":"Cox-Singh","year":"2008","journal-title":"Clin Infect Dis"},{"key":"R12-20240830","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1186\/1475-2875-13-60","article-title":"Evaluation of three rapid diagnostic tests for the detection of human infections with Plasmodium knowlesi","volume":"13","author":"Foster","year":"2014","journal-title":"Malar J"},{"issue":"7-8","key":"R13-20240830","doi-asserted-by":"crossref","first-page":"1250","DOI":"10.1345\/aph.1M732","article-title":"Intravenous artesunate for the treatment of severe malaria","volume":"44","author":"Hess","year":"2010","journal-title":"Ann Pharmacother"}],"container-title":["Journal of Vector Borne Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/0972-9062.374238","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:15:03Z","timestamp":1787166903000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/0972-9062.374238"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10]]},"references-count":12,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.4103\/0972-9062.374238","relation":{},"ISSN":["0972-9062"],"issn-type":[{"value":"0972-9062","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10]]},"assertion":[{"value":"2022-12-07","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-02-16","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}