{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T12:02:34Z","timestamp":1791460954401,"version":"4.3.4"},"reference-count":19,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"5","license":[{"start":{"date-parts":[[2023,11,1]],"date-time":"2023-11-01T00:00:00Z","timestamp":1698796800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,11,1]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>Malaysia has maintained zero cases of indigenous human malaria since 2018. However, zoonotic malaria is still prevalent in underdeveloped areas and hard-to-reach populations. This study aimed to determine the prevalence of malaria among remote indigenous communities in Peninsular Malaysia. A cross-sectional survey was conducted in six settlements in Kelantan state, from June to October 2019. Blood samples were tested for malaria using microscopy and nested polymerase chain reaction (nPCR) targeting the <jats:italic>Plasmodium<\/jats:italic> cytochrome c oxidase subunit III (<jats:italic>cox3<\/jats:italic>) gene. Of the 1,954 individuals who appeared healthy, no malaria parasites were found using microscopy. However, nPCR revealed seven cases of <jats:italic>Plasmodium knowlesi<\/jats:italic> mono-infection (0.4%), and six out of seven infections were in the group of 19 to 40\u2009years old (<jats:italic>P<\/jats:italic> = 0.026). No human malaria species were detected by nPCR. Analysis of the DNA sequences also showed high similarity that reflects common ancestry to other <jats:italic>P. knowlesi<\/jats:italic> isolates. These findings indicate low submicroscopic <jats:italic>P. knowlesi<\/jats:italic> infections among indigenous communities in Malaysia, requiring PCR-based surveillance to support malaria control activities in the country.<\/jats:p>","DOI":"10.4269\/ajtmh.23-0184","type":"journal-article","created":{"date-parts":[[2023,9,25]],"date-time":"2023-09-25T11:38:16Z","timestamp":1695641896000},"page":"1081-1085","source":"Crossref","is-referenced-by-count":5,"title":["Evidence of Submicroscopic Plasmodium knowlesi Mono-Infection in Remote Indigenous Communities in Kelantan, Peninsular Malaysia"],"prefix":"10.4269","volume":"109","author":[{"given":"Nor Diyana","family":"Dian","sequence":"first","affiliation":[{"name":"Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad Basyir","family":"Muhammad","sequence":"additional","affiliation":[{"name":"Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elora Nor","family":"Azman","sequence":"additional","affiliation":[{"name":"Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nur Ashrina","family":"Eddie","sequence":"additional","affiliation":[{"name":"Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nur Iman","family":"Azmi","sequence":"additional","affiliation":[{"name":"Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerie Chong Tze","family":"Yee","sequence":"additional","affiliation":[{"name":"Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohd Amirul Fitri A.","family":"Rahim","sequence":"additional","affiliation":[{"name":"Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohd Bakhtiar","family":"Munajat","sequence":"additional","affiliation":[{"name":"Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohd Ikhwan Mukmin Seri","family":"Rakna","sequence":"additional","affiliation":[{"name":"District Health Office of Gua Musang, Kelantan, Malaysia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhd Rafiq Mohd","family":"Kasri","sequence":"additional","affiliation":[{"name":"District Health Office of Gua Musang, Kelantan, Malaysia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad Imran","family":"Mohamed","sequence":"additional","affiliation":[{"name":"District Health Office of Gua Musang, Kelantan, Malaysia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuraffini","family":"Ghazali","sequence":"additional","affiliation":[{"name":"Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noor Wanie","family":"Hassan","sequence":"additional","affiliation":[{"name":"Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siti Nor Azreen Abdul","family":"Manap","sequence":"additional","affiliation":[{"name":"Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emelia","family":"Osman","sequence":"additional","affiliation":[{"name":"Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wathiqah","family":"Wahid","sequence":"additional","affiliation":[{"name":"Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sriwipa","family":"Chuangchaiya","sequence":"additional","affiliation":[{"name":"Department of Community Health, Faculty of Public Health, Kasetsart University, Chalermphrakiat Sakon Nakhon Province Campus, Sakon Nakhon, Thailand;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inke Nadia D.","family":"Lubis","sequence":"additional","affiliation":[{"name":"Department of Paediatric, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul C. S.","family":"Divis","sequence":"additional","affiliation":[{"name":"Malaria Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Sarawak , Malaysia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sherwin","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zulkarnain Md","family":"Idris","sequence":"additional","affiliation":[{"name":"Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","year":"2021"},{"key":"b2","series-title":"Int J Environ Res Public Health","first-page":"7888","article-title":"Non-human primate malaria infections: a review on the epidemiology in 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malaria diagnostic methods in Malaysia (1980-2019): a systematic review","volume":"19","author":"Rahim","year":"2020"},{"key":"b11","series-title":"Am J Trop Med Hyg","first-page":"61","article-title":"The impact of emerging Plasmodium knowlesi on accurate diagnosis by light microscopy: a systematic review and modeling analysis","volume":"108","author":"Huber","year":"2022"},{"key":"b12","series-title":"Sci Rep","first-page":"18546","article-title":"A survey of simian Plasmodium infections in humans in West Kalimantan, Indonesia","volume":"12","author":"Sugiarto","year":"2022"},{"key":"b13","series-title":"Lancet Planet Health","first-page":"e97","article-title":"Individual-level factors associated with the risk of acquiring human Plasmodium knowlesi malaria in Malaysia: a case-control study","volume":"1","author":"Grigg","year":"2017"},{"key":"b14","series-title":"PLoS Negl Trop Dis","first-page":"e0006432","article-title":"Exposure and infection to Plasmodium knowlesi in case study 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humans","volume":"10","author":"Manin","year":"2016"},{"key":"b19","series-title":"Sains Malays","first-page":"437","article-title":"Analysis of the relationship between climate change and land use change using the ESA CCI land cover maps in Sungai Kelantan Basin, Malaysia","volume":"51","author":"Tew","year":"2022"}],"container-title":["The American Journal of Tropical Medicine and 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