AS World Malaria Day falls on April 25, the spotlight once again turns to the ongoing battle against malaria, a disease that continues to affect millions of lives worldwide.
While significant progress has been made in combating human-to-human transmission of malaria through mosquito bites, a new concern has emerged on the horizon.
Monkey malaria, caused by the Plasmodium knowlesi parasite, has been steadily increasing in Sarawak and Malaysia, posing fresh challenges for researchers and public health officials.
On this World Malaria Day, it is imperative to shed light on the rise of zoonotic malaria and the efforts being made to control its spread.
As we delve into the intricacies of this growing threat, the importance of prevention, early detection, and effective treatment cannot be overstated.
Join us as we explore the latest developments and insights from experts in the field, striving to protect vulnerable communities and pave the way towards a malaria-free future.
THE increasing concern over the transmission of monkey malaria, caused by the Plasmodium knowlesi parasite, has taken centre stage in Sarawak and Malaysia. While the number of cases of human-to-human transmission of malaria by mosquitoes has significantly decreased, the rise of zoonotic malaria from monkeys to humans has become a more pressing issue.
According to Professor Dr Balbir Singh, the founding director of the Malaria Research Centre at Universiti Malaysia Sarawak (UNIMAS), there have been no local cases of human malaria since 2018, thanks to successful efforts in reducing human-to-human transmission.
However, the emergence of the monkey malaria parasite, Plasmodium knowlesi, has become a new menace, leading to malaria cases with potentially fatal consequences.
In 2004, Dr. Balbir and his research team from UNIMAS first reported a significant number of human cases of monkey malaria, or zoonotic malaria, at Kapit Hospital.
Since then, these cases have been reported across Southeast Asia and have been responsible for all malaria cases in Sarawak and Malaysia since 2018.
The numbers are alarming, with zoonotic malaria cases ranging from 1,813 to 4,214 between 2012 and 2022, a steady increase from the 509 cases reported in 2010.
Contrary to popular belief, climate change is not the primary concern in Sarawak and Southeast Asia.
Instead, zoonotic malaria, driven by a high number of monkeys infected with Plasmodium knowlesi and other malaria parasites, poses the greatest threat.
Recent findings have revealed the existence of six other species of Plasmodium found in monkeys that can infect humans, further complicating efforts to control zoonotic malaria.
While children in Africa and highly endemic malaria countries are more prone to severe malaria and its fatal consequences, in Sarawak, it is primarily adults engaged in forest-related activities who are at a higher risk of contracting zoonotic malaria.
The Anopheles mosquitoes, which transmit monkey malaria, predominantly bite in the evenings and at night, leading to increased vulnerability for adults involved in forest and forest fringe activities.
Dr. Balbir and his team have made significant discoveries highlighting knowlesi malaria as a prevalent zoonotic disease in Southeast Asia, with the potential for fatality.
However, amidst this concerning situation, Dr. Balbir emphasizes the precautions the public can take to avoid contracting malaria.
To prevent mosquito bites from Anopheles mosquitoes, which are found in rural areas rather than urban settings like Aedes mosquitoes, personal protection measures such as wearing mosquito repellent, long-sleeved shirts, and trousers are recommended.
However, these precautions can be impractical when venturing into the forest or forest fringes.
Additionally, taking antimalarial drugs before engaging in activities such as trekking, hunting, logging, and farming in jungle areas is advised but might be unaffordable and impractical for many.
While malaria is a treatable disease, early detection is crucial to prevent severe outcomes.
Dr. Balbir stresses the importance of informing doctors, particularly in urban areas, about any travel to rural regions so that malaria can be considered during diagnosis. Failure to test for malaria due to misdiagnosis, such as assuming dengue fever, can have severe consequences.
The World Malaria Report 2022 by the World Health Organization (WHO) reported 247 million cases of malaria worldwide, resulting in 625,000 deaths in 2021.
Dr Balbir’s extensive research on knowlesi malaria has gained international recognition, with coverage by media agencies such as Reuters, BBC, Bloomberg, Nature, ProMED, Al Jazeera News, and the Australian Broadcasting Corporation.
His contributions have also been acknowledged nationally, with accolades such as being elected as a Fellow of the Academy of Sciences Malaysia, being recognized as one of the Top Research Scientists Malaysia 2012, and receiving the prestigious Merdeka Award for his pioneering work on knowlesi malaria.
Furthermore, he has served as a commissioner for The Lancet Commission on Malaria Eradication and as an advisor to the WHO on zoonotic malaria.
In conclusion, as zoonotic malaria cases continue to rise in Sarawak and Malaysia, the focus has shifted from human-to-human transmission by mosquitoes to the transmission of monkey malaria parasites.
The efforts to control zoonotic malaria face significant challenges due to the presence of multiple malaria parasite species in monkeys. Public awareness, personal protection measures, early detection, and appropriate treatment remain crucial in combating this emerging threat to public health.
