Falling Plasmodium knowlesi Malaria Death Rate among Adults despite Rising Incidence, Sabah, Malaysia, 2010–2014

Deaths from Plasmodium knowlesi malaria have been linked to delayed parenteral treatment. In Malaysia, early intravenous artesunate is now recommended for all severe malaria cases. We describe P. knowlesi fatalities in Sabah, Malaysia, during 2012–2014 and report species-specific fatality rates base...

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Bibliographic Details
Main Authors: Giri S. Rajahram, Bridget E. Barber, Timothy William, Matthew J. Grigg, Jayaram Menon, Tsin W. Yeo, Nicholas M. Anstey
Format: Article
Language:English
Published: Centers for Disease Control and Prevention 2016-01-01
Series:Emerging Infectious Diseases
Subjects:
Online Access:https://wwwnc.cdc.gov/eid/article/22/1/15-1305_article
Description
Summary:Deaths from Plasmodium knowlesi malaria have been linked to delayed parenteral treatment. In Malaysia, early intravenous artesunate is now recommended for all severe malaria cases. We describe P. knowlesi fatalities in Sabah, Malaysia, during 2012–2014 and report species-specific fatality rates based on 2010–2014 case notifications. Sixteen malaria-associated deaths (caused by PCR-confirmed P. knowlesi [7], P. falciparum [7], and P. vivax [1] and microscopy-diagnosed “P. malariae” [1]) were reported during 2012–2014. Six patients with severe P. knowlesi malaria received intravenous artesunate at hospital admission. For persons >15 years of age, overall fatality rates during 2010–2014 were 3.4, 4.2, and 1.0 deaths/1,000 P. knowlesi, P. falciparum, and P. vivax notifications, respectively; P. knowlesi–associated fatality rates fell from 9.2 to1.6 deaths/1,000 notifications. No P. knowlesi–associated deaths occurred among children, despite 373 notified cases. Although P. knowlesi malaria incidence is rising, the notification-fatality rate has decreased, likely due to improved use of intravenous artesunate.
ISSN:1080-6040
1080-6059