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Severe Plasmodium knowlesi malaria in a tertiary care hospital, Sabah, Malaysia

William, Timothy, Menon, Jayaram, Rajahram, Giri, Chan, Leslie, Ma, Gordon, Donaldson, Samantha, Khoo, Serena, Fredrick, Charlie, Jelip, Jenarun, Anstey, Nicholas M. and Yeo, Tsin W. (2011). Severe Plasmodium knowlesi malaria in a tertiary care hospital, Sabah, Malaysia. Emerging Infectious Diseases,17(7):1248-1255.

Document type: Journal Article
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Title Severe Plasmodium knowlesi malaria in a tertiary care hospital, Sabah, Malaysia
Author William, Timothy
Menon, Jayaram
Rajahram, Giri
Chan, Leslie
Ma, Gordon
Donaldson, Samantha
Khoo, Serena
Fredrick, Charlie
Jelip, Jenarun
Anstey, Nicholas M.
Yeo, Tsin W.
Journal Name Emerging Infectious Diseases
Publication Date 2011
Volume Number 17
Issue Number 7
ISSN 1080-6040   (check CDU catalogue open catalogue search in new window)
Start Page 1248
End Page 1255
Total Pages 8
Place of Publication United States
Publisher U.S. Department of Health and Human Services, Centers for Disease Control and Prevention
HERDC Category C1 - Journal Article (DEST)
Abstract The simian parasite Plasmodium knowlesi causes severe human malaria; the optimal treatment remains unknown. We describe the clinical features, disease spectrum, and response to antimalarial chemotherapy, including artemether-lumefantrine and artesunate, in patients with P. knowlesi malaria diagnosed by PCR during December 2007–November 2009 at a tertiary care hospital in Sabah, Malaysia. Fifty-six patients had PCR-confirmed P. knowlesi monoinfection and clinical records available for review. Twenty-two (39%) had severe malaria; of these, 6 (27%) died. Thirteen (59%) had respiratory distress; 12 (55%), acute renal failure; and 12, shock. None experienced coma. Patients with uncomplicated disease received chloroquine, quinine, or artemether-lumefantrine, and those with severe disease received intravenous quinine or artesunate. Parasite clearance times were 1–2 days shorter with either artemether-lumefantrine or artesunate treatment. P. knowlesi is a major cause of severe and fatal malaria in Sabah. Artemisinin derivatives rapidly clear parasitemia and are efficacious in treating uncomplicated and severe knowlesi malaria.
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