{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T18:05:39Z","timestamp":1775844339210,"version":"3.50.1"},"reference-count":108,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"2","license":[{"start":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T00:00:00Z","timestamp":1770163200000},"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":[[2026,2,4]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>\n                    Accurate molecular tools are essential for estimating zoonotic malaria transmission in Southeast Asia. This study applied ultrasensitive reverse-transcriptase real-time polymerase chain reaction (PCR) to detect zoonotic malaria in febrile patients from health facilities across three mainland districts (Batubara, Tanjung Balai, and Central Tapanuli) and separately on Mursala Island, North Sumatra, Indonesia. Among 64 participants on Mursala, 7 (10.9%) adults had\n                    <jats:italic>Plasmodium knowlesi<\/jats:italic>\n                    infections (including 5 agricultural workers and 2 adults with severe WHO anemia), and 2 (3.1%) adults had\n                    <jats:italic>Plasmodium vivax<\/jats:italic>\n                    infections. All were negative by microscopy and panparasite lactate dehydrogenase rapid diagnostic tests. No\n                    <jats:italic>P. knowlesi<\/jats:italic>\n                    infections were identified among 947 participants from mainland sites; PCR detected confirmed\n                    <jats:italic>Plasmodium<\/jats:italic>\n                    species in 26%, including\n                    <jats:italic>P. vivax<\/jats:italic>\n                    (17.5%) and\n                    <jats:italic>Plasmodium falciparum<\/jats:italic>\n                    (7.5%), with 30% of cases being submicroscopic. No\n                    <jats:italic>Plasmodium cynomolgi<\/jats:italic>\n                    infections were identified.\n                    <jats:italic>Plasmodium knowlesi<\/jats:italic>\n                    transmission is low in North Sumatra; however, it may cause WHO-defined severe malaria. Molecular diagnostics remain crucial for identifying zoonotic malaria and should be integrated into surveillance systems to inform public health control measures.\n                  <\/jats:p>","DOI":"10.4269\/ajtmh.25-0493","type":"journal-article","created":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T18:57:21Z","timestamp":1764874641000},"page":"292-301","source":"Crossref","is-referenced-by-count":0,"title":["Submicroscopic Burden of Zoonotic Plasmodium knowlesi Malaria on Mursala Island and Plasmodium falciparum and Plasmodium vivax Transmission in Mainland North Sumatra, Indonesia"],"prefix":"10.4269","volume":"114","author":[{"given":"Inke Nadia Diniyanti","family":"Lubis","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia;"},{"name":"Duke\u2013National University of Singapore, Singapore;"},{"name":"Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ranti","family":"Permatasari","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lambok","family":"Siahaan","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R. Andika Dwi","family":"Cahyadi","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irbah Rhea Alvieda","family":"Nainggolan","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rycha Dwi","family":"Syafutri","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monica Nadya","family":"Sinambela","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia","family":"Jauharah","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agatha","family":"Lestari","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia;"},{"name":"The Roslin Institute, Royal (Dick) School of Veterinary Studies, University of Edinburgh, Edinburgh, United Kingdom;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Minerva","family":"Theodora","sequence":"additional","affiliation":[{"name":"National Malaria Control Programme, Directorate of Communicable Disease Control, Ministry of Health Republic of Indonesia, Jakarta, Indonesia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hellen","family":"Prameswari","sequence":"additional","affiliation":[{"name":"National Malaria Control Programme, Directorate of Communicable Disease Control, Ministry of Health Republic of Indonesia, Jakarta, Indonesia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kim A.","family":"Piera","sequence":"additional","affiliation":[{"name":"Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bridget E.","family":"Barber","sequence":"additional","affiliation":[{"name":"Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia;"},{"name":"QIMR, Brisbane, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas M.","family":"Anstey","sequence":"additional","affiliation":[{"name":"Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew J.","family":"Grigg","sequence":"additional","affiliation":[{"name":"Global and Tropical Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Australia;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","article-title":"World Malaria Report 2024.","year":"2024"},{"key":"b2","series-title":"Trends Parasitol","first-page":"406","article-title":"Knowlesi malaria: Newly emergent and of public health importance?","volume":"24","author":"Cox-Singh","year":"2008"},{"key":"b3","series-title":"PLoS Negl Trop Dis","first-page":"e0011570","article-title":"Updating estimates of Plasmodium knowlesi malaria risk in response to changing land use patterns across Southeast Asia","volume":"18","author":"Tobin","year":"2024"},{"key":"b4","series-title":"One Health","first-page":"100389","article-title":"Primate malaria: An emerging challenge of zoonotic malaria in Indonesia","volume":"14","author":"Lempang","year":"2022"},{"key":"b5","series-title":"Parasit Vectors","first-page":"242","article-title":"Predicting the geographical distributions of the macaque hosts and mosquito vectors of Plasmodium knowlesi malaria in forested and non-forested areas","volume":"9","author":"Moyes","year":"2016"},{"key":"b6","series-title":"eLife","first-page":"e47602","article-title":"Local human movement patterns and land use impact exposure to zoonotic malaria in Malaysian Borneo","volume":"8","author":"Fornace","year":"2019"},{"key":"b7","series-title":"Proc Biol Sci","first-page":"20182351","article-title":"Predictive analysis across spatial scales links zoonotic malaria to deforestation","volume":"286","author":"Brock","year":"2019"},{"key":"b8","series-title":"Plos Negl Trop Dis","first-page":"e0006432","article-title":"Exposure and infection to Plasmodium knowlesi in case study communities in Northern Sabah, Malaysia and Palawan, The Philippines","volume":"12","author":"Fornace","year":"2018"},{"key":"b9","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":"b10","series-title":"PLoS Negl Trop Dis","first-page":"e0006924","article-title":"Laboratory challenges of Plasmodium species identification in Aceh Province, Indonesia, a malaria elimination setting with newly discovered P. knowlesi.","volume":"12","author":"Coutrier","year":"2018"},{"key":"b11","series-title":"J Infect Dis","first-page":"1148","article-title":"Contribution of Plasmodium knowlesi to multispecies human malaria infections in North Sumatera, Indonesia","volume":"215","author":"Lubis","year":"2017"},{"key":"b12","series-title":"Front Cell Infect Microbiol","first-page":"1023219","article-title":"Diagnostic accuracy and limit of detection of ten malaria parasite lactate dehydrogenase-based rapid tests for Plasmodium knowlesi and P. falciparum.","volume":"12","author":"Tan","year":"2022"},{"key":"b13","series-title":"J Clin Microbiol","first-page":"1118","article-title":"Evaluation of the sensitivity of a pLDH-based and an aldolase-based rapid diagnostic test for diagnosis of uncomplicated and severe malaria caused by PCR-confirmed Plasmodium knowlesi, Plasmodium falciparum, and Plasmodium vivax.","volume":"51","author":"Barber","year":"2013"},{"key":"b14","series-title":"J Clin Microbiol","first-page":"2053","article-title":"Combining parasite lactate dehydrogenase-based and histidine-rich protein 2-based rapid tests to improve specificity for diagnosis of malaria due to Plasmodium knowlesi and other Plasmodium species in Sabah, Malaysia","volume":"52","author":"Grigg","year":"2014"},{"key":"b15","series-title":"Lancet","first-page":"1017","article-title":"A large focus of naturally acquired Plasmodium knowlesi infections in human beings","volume":"363","author":"Singh","year":"2004"},{"key":"b16","series-title":"Malar J","first-page":"468","article-title":"Malaria risk factor assessment using active and passive surveillance data from Aceh Besar, Indonesia, a low endemic, malaria elimination setting with Plasmodium knowlesi, Plasmodium vivax, and Plasmodium falciparum.","volume":"15","author":"Herdiana","year":"2016"},{"key":"b17","series-title":"Malar J","first-page":"186","article-title":"Two clusters of Plasmodium knowlesi cases in a malaria elimination area, Sabang Municipality, Aceh, Indonesia","volume":"17","author":"Herdiana","year":"2018"},{"key":"b18","series-title":"Sel J Penelit Kesehat","first-page":"47","article-title":"Epidemiological study of P. knowlesi in Aceh from 2018\u20132019","volume":"8","author":"Ramadhan","year":"2021"},{"key":"b19","series-title":"J Kesehat Lingkung Indones","first-page":"25","article-title":"Classification of Aceh Province region based on vulnerability levels of malaria cases in 2015\u20132018","volume":"18","author":"Zohra","year":"2019"},{"key":"b20","series-title":"Malar J","first-page":"316","article-title":"The presence of Plasmodium malariae and Plasmodium knowlesi in near malaria elimination setting in western Indonesia","volume":"21","author":"Nainggolan","year":"2022"},{"key":"b21","series-title":"Jurnal Biotek Medisiana Indonesia","first-page":"39","article-title":"Kasus Baru Plasmodium knowlesi pada Manusia di Jambi","volume":"6","author":"Salwati","year":"2017"},{"key":"b22","series-title":"Emerg Infect Dis","first-page":"672","article-title":"Plasmodium knowlesi in human, Indonesian Borneo","volume":"16","author":"Figtree","year":"2010"},{"key":"b23","series-title":"Emerg Infect Dis","first-page":"1033","article-title":"Diagnostic difficulties with Plasmodium knowlesi infection in humans","volume":"16","author":"Sulistyaningsih","year":"2010"},{"key":"b24","series-title":"Bull Health Res Ministry Health Indonesia","first-page":"1","article-title":"First finding of human Plasmodium knowlesi malaria cases in Central Kalimantan","volume":"43","author":"Ompusunggu","year":"2015"},{"key":"b25","series-title":"Malar J","first-page":"218","article-title":"A zoonotic human infection with simian malaria, Plasmodium knowlesi, in Central Kalimantan, Indonesia","volume":"15","author":"Setiadi","year":"2016"},{"key":"b26","article-title":"Severe and Uncomplicated Plasmodium knowlesi Malaria in North Kalimantan and Sabang, Aceh, and Suspected Anopheles Vectors across Kalimantan, Indonesia.","author":"Trianty","year":"2025"},{"key":"b27","series-title":"Adv Public Health","first-page":"2703477","article-title":"The changing incidence of malaria in Indonesia: A 9\u2010year analysis of surveillance data","volume":"2024","author":"Aisyah","year":"2024"},{"key":"b28","series-title":"Parasite Epidemiol Control","first-page":"e00405","article-title":"Emerging malaria in Indonesia: An overview of Plasmodium knowlesi infections","volume":"28","author":"Fauziah","year":"2024"},{"key":"b29","series-title":"BMC Infect Dis","first-page":"259","article-title":"Preliminary review on the prevalence, proportion, geographical distribution, and characteristics of naturally acquired Plasmodium cynomolgi infection in mosquitoes, macaques, and humans: A systematic review and meta-analysis","volume":"21","author":"Kotepui","year":"2021"},{"key":"b30","series-title":"J Infect Dis","first-page":"679","article-title":"Zoonotic malaria: The better you look, the more you find","volume":"219","author":"Anstey","year":"2019"},{"key":"b31","article-title":"Akses Profil Kesehatan Provinsi Sumatera Utara Tahun 2023.","year":"2023"},{"key":"b32","series-title":"Trop Med Int Health","first-page":"7","article-title":"Severe malaria","volume":"19","year":"2014"},{"key":"b33","article-title":"Microscopy for the Detection, Identification and Quantification of Malaria Parasites on Stained Thick and Thin Blood Films in Research Settings (Version 1.0): Procedure: Methods Manual.","year":"2015"},{"key":"b34","article-title":"Buku Saku Penatalaksanaan Kasus Malaria.","year":"2017"},{"key":"b35","series-title":"PLoS Negl Trop Dis","first-page":"e0012129","article-title":"Improved limit of detection for zoonotic Plasmodium knowlesi and P. cynomolgi surveillance using reverse transcription for total nucleic acid preserved samples or dried blood spots","volume":"19","author":"Braima","year":"2025"},{"key":"b36","series-title":"J Clin Microbiol","first-page":"4173","article-title":"Spurious amplification of a Plasmodium vivax small-subunit RNA gene by use of primers currently used to detect P. knowlesi.","volume":"47","author":"Imwong","year":"2009"},{"key":"b37","series-title":"PLoS Pathog","first-page":"e1002015","article-title":"Plasmodium knowlesi: Reservoir hosts and tracking the emergence in humans and macaques","volume":"7","author":"Lee","year":"2011"},{"key":"b38","series-title":"Am J Trop Med Hyg","first-page":"687","article-title":"A genus- and species-specific nested polymerase chain reaction malaria detection assay for epidemiologic studies","volume":"60","author":"Singh","year":"1999"},{"key":"b39","article-title":"Sumatera Utara Province in Figures 2020.","year":"2020"},{"key":"b40","article-title":"Haemoglobin Concentrations for the Diagnosis of Anaemia and Assessment of Severity.","year":"2011"},{"key":"b41","series-title":"Emerg Infect Dis","first-page":"201","article-title":"Association between landscape factors and spatial patterns of Plasmodium knowlesi infections in Sabah, Malaysia","volume":"22","author":"Fornace","year":"2016"},{"key":"b42","series-title":"Sci Rep","first-page":"20117","article-title":"A comparison of the clinical, laboratory and epidemiological features of two divergent subpopulations of Plasmodium knowlesi.","volume":"11","author":"Hu","year":"2021"},{"key":"b43","series-title":"Malar J","first-page":"109","article-title":"Zoonotic malaria transmission and land use change in Southeast Asia: What is known about the vectors","volume":"21","author":"Straat","year":"2022"},{"key":"b44","series-title":"Parasit Vectors","first-page":"267","article-title":"The potential for zoonotic malaria transmission in five areas of Indonesia inhabited by non-human primates","volume":"16","author":"Permana","year":"2023"},{"key":"b45","series-title":"eLife","first-page":"RP88616","article-title":"Landscape drives zoonotic malaria prevalence in non-human primates","volume":"12","author":"Johnson","year":"2024"},{"key":"b46","series-title":"PLoS Negl Trop Dis","first-page":"e0004915","article-title":"Estimating geographical variation in the risk of zoonotic Plasmodium knowlesi infection in countries eliminating malaria","volume":"10","author":"Shearer","year":"2016"},{"key":"b47","series-title":"Parasitology","first-page":"139","article-title":"Immunity to malaria in an era of declining malaria transmission","volume":"143","author":"Fowkes","year":"2016"},{"key":"b48","series-title":"Malar J","first-page":"371","article-title":"Anaemia and malaria","volume":"17","author":"White","year":"2018"},{"key":"b49","series-title":"Malar J","first-page":"312","article-title":"Loss of complement regulatory proteins on red blood cells in mild malarial anaemia and in Plasmodium falciparum induced blood-stage infection","volume":"18","author":"Oyong","year":"2019"},{"key":"b50","series-title":"Clin Infect Dis","first-page":"383","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"},{"key":"b51","series-title":"Clin Infect Dis","first-page":"350","article-title":"Age-related clinical spectrum of Plasmodium knowlesi malaria and predictors of severity","volume":"67","author":"Grigg","year":"2018"},{"key":"b52","series-title":"Adv Parasit","first-page":"1","article-title":"Knowlesi malaria: Human risk factors, clinical spectrum, and pathophysiology","volume":"113","author":"Anstey","year":"2021"},{"key":"b53","article-title":"National Malaria Guidelines \u201cBuku Saku Tata Laksana Kasus Malaria.\u201d","year":"2023"},{"key":"b54","series-title":"J Infect Dis","first-page":"1946","article-title":"Natural human infections with Plasmodium cynomolgi and other malaria species in an elimination setting in Sabah, Malaysia","volume":"220","author":"Grignard","year":"2019"},{"key":"b1","article-title":"World Malaria Report 2024.","year":"2024"},{"key":"b2","series-title":"Trends Parasitol","first-page":"406","article-title":"Knowlesi malaria: Newly emergent and of public health importance?","volume":"24","author":"Cox-Singh","year":"2008"},{"key":"b3","series-title":"PLoS Negl Trop Dis","first-page":"e0011570","article-title":"Updating estimates of Plasmodium knowlesi malaria risk in response to changing land use patterns across Southeast Asia","volume":"18","author":"Tobin","year":"2024"},{"key":"b4","series-title":"One Health","first-page":"100389","article-title":"Primate malaria: An emerging challenge of zoonotic malaria in Indonesia","volume":"14","author":"Lempang","year":"2022"},{"key":"b5","series-title":"Parasit Vectors","first-page":"242","article-title":"Predicting the geographical distributions of the macaque hosts and mosquito vectors of Plasmodium knowlesi malaria in forested and non-forested areas","volume":"9","author":"Moyes","year":"2016"},{"key":"b6","series-title":"eLife","first-page":"e47602","article-title":"Local human movement patterns and land use impact exposure to zoonotic malaria in Malaysian Borneo","volume":"8","author":"Fornace","year":"2019"},{"key":"b7","series-title":"Proc Biol Sci","first-page":"20182351","article-title":"Predictive analysis across spatial scales links zoonotic malaria to deforestation","volume":"286","author":"Brock","year":"2019"},{"key":"b8","series-title":"Plos Negl Trop Dis","first-page":"e0006432","article-title":"Exposure and infection to Plasmodium knowlesi in case study communities in Northern Sabah, Malaysia and Palawan, The Philippines","volume":"12","author":"Fornace","year":"2018"},{"key":"b9","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":"b10","series-title":"PLoS Negl Trop Dis","first-page":"e0006924","article-title":"Laboratory challenges of Plasmodium species identification in Aceh Province, Indonesia, a malaria elimination setting with newly discovered P. knowlesi.","volume":"12","author":"Coutrier","year":"2018"},{"key":"b11","series-title":"J Infect Dis","first-page":"1148","article-title":"Contribution of Plasmodium knowlesi to multispecies human malaria infections in North Sumatera, Indonesia","volume":"215","author":"Lubis","year":"2017"},{"key":"b12","series-title":"Front Cell Infect Microbiol","first-page":"1023219","article-title":"Diagnostic accuracy and limit of detection of ten malaria parasite lactate dehydrogenase-based rapid tests for Plasmodium knowlesi and P. falciparum.","volume":"12","author":"Tan","year":"2022"},{"key":"b13","series-title":"J Clin Microbiol","first-page":"1118","article-title":"Evaluation of the sensitivity of a pLDH-based and an aldolase-based rapid diagnostic test for diagnosis of uncomplicated and severe malaria caused by PCR-confirmed Plasmodium knowlesi, Plasmodium falciparum, and Plasmodium vivax.","volume":"51","author":"Barber","year":"2013"},{"key":"b14","series-title":"J Clin Microbiol","first-page":"2053","article-title":"Combining parasite lactate dehydrogenase-based and histidine-rich protein 2-based rapid tests to improve specificity for diagnosis of malaria due to Plasmodium knowlesi and other Plasmodium species in Sabah, Malaysia","volume":"52","author":"Grigg","year":"2014"},{"key":"b15","series-title":"Lancet","first-page":"1017","article-title":"A large focus of naturally acquired Plasmodium knowlesi infections in human beings","volume":"363","author":"Singh","year":"2004"},{"key":"b16","series-title":"Malar J","first-page":"468","article-title":"Malaria risk factor assessment using active and passive surveillance data from Aceh Besar, Indonesia, a low endemic, malaria elimination setting with Plasmodium knowlesi, Plasmodium vivax, and Plasmodium falciparum.","volume":"15","author":"Herdiana","year":"2016"},{"key":"b17","series-title":"Malar J","first-page":"186","article-title":"Two clusters of Plasmodium knowlesi cases in a malaria elimination area, Sabang Municipality, Aceh, Indonesia","volume":"17","author":"Herdiana","year":"2018"},{"key":"b18","series-title":"Sel J Penelit Kesehat","first-page":"47","article-title":"Epidemiological study of P. knowlesi in Aceh from 2018\u20132019","volume":"8","author":"Ramadhan","year":"2021"},{"key":"b19","series-title":"J Kesehat Lingkung Indones","first-page":"25","article-title":"Classification of Aceh Province region based on vulnerability levels of malaria cases in 2015\u20132018","volume":"18","author":"Zohra","year":"2019"},{"key":"b20","series-title":"Malar J","first-page":"316","article-title":"The presence of Plasmodium malariae and Plasmodium knowlesi in near malaria elimination setting in western Indonesia","volume":"21","author":"Nainggolan","year":"2022"},{"key":"b21","series-title":"Jurnal Biotek Medisiana Indonesia","first-page":"39","article-title":"Kasus Baru Plasmodium knowlesi pada Manusia di Jambi","volume":"6","author":"Salwati","year":"2017"},{"key":"b22","series-title":"Emerg Infect Dis","first-page":"672","article-title":"Plasmodium knowlesi in human, Indonesian Borneo","volume":"16","author":"Figtree","year":"2010"},{"key":"b23","series-title":"Emerg Infect Dis","first-page":"1033","article-title":"Diagnostic difficulties with Plasmodium knowlesi infection in humans","volume":"16","author":"Sulistyaningsih","year":"2010"},{"key":"b24","series-title":"Bull Health Res Ministry Health Indonesia","first-page":"1","article-title":"First finding of human Plasmodium knowlesi malaria cases in Central Kalimantan","volume":"43","author":"Ompusunggu","year":"2015"},{"key":"b25","series-title":"Malar J","first-page":"218","article-title":"A zoonotic human infection with simian malaria, Plasmodium knowlesi, in Central Kalimantan, Indonesia","volume":"15","author":"Setiadi","year":"2016"},{"key":"b26","article-title":"Severe and Uncomplicated Plasmodium knowlesi Malaria in North Kalimantan and Sabang, Aceh, and Suspected Anopheles Vectors across Kalimantan, Indonesia.","author":"Trianty","year":"2025"},{"key":"b27","series-title":"Adv Public Health","first-page":"2703477","article-title":"The changing incidence of malaria in Indonesia: A 9\u2010year analysis of surveillance data","volume":"2024","author":"Aisyah","year":"2024"},{"key":"b28","series-title":"Parasite Epidemiol Control","first-page":"e00405","article-title":"Emerging malaria in Indonesia: An overview of Plasmodium knowlesi infections","volume":"28","author":"Fauziah","year":"2024"},{"key":"b29","series-title":"BMC Infect Dis","first-page":"259","article-title":"Preliminary review on the prevalence, proportion, geographical distribution, and characteristics of naturally acquired Plasmodium cynomolgi infection in mosquitoes, macaques, and humans: A systematic review and meta-analysis","volume":"21","author":"Kotepui","year":"2021"},{"key":"b30","series-title":"J Infect Dis","first-page":"679","article-title":"Zoonotic malaria: The better you look, the more you find","volume":"219","author":"Anstey","year":"2019"},{"key":"b31","article-title":"Akses Profil Kesehatan Provinsi Sumatera Utara Tahun 2023.","year":"2023"},{"key":"b32","series-title":"Trop Med Int Health","first-page":"7","article-title":"Severe malaria","volume":"19","year":"2014"},{"key":"b33","article-title":"Microscopy for the Detection, Identification and Quantification of Malaria Parasites on Stained Thick and Thin Blood Films in Research Settings (Version 1.0): Procedure: Methods Manual.","year":"2015"},{"key":"b34","article-title":"Buku Saku Penatalaksanaan Kasus Malaria.","year":"2017"},{"key":"b35","series-title":"PLoS Negl Trop Dis","first-page":"e0012129","article-title":"Improved limit of detection for zoonotic Plasmodium knowlesi and P. cynomolgi surveillance using reverse transcription for total nucleic acid preserved samples or dried blood spots","volume":"19","author":"Braima","year":"2025"},{"key":"b36","series-title":"J Clin Microbiol","first-page":"4173","article-title":"Spurious amplification of a Plasmodium vivax small-subunit RNA gene by use of primers currently used to detect P. knowlesi.","volume":"47","author":"Imwong","year":"2009"},{"key":"b37","series-title":"PLoS Pathog","first-page":"e1002015","article-title":"Plasmodium knowlesi: Reservoir hosts and tracking the emergence in humans and macaques","volume":"7","author":"Lee","year":"2011"},{"key":"b38","series-title":"Am J Trop 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