Co-infections with Plasmodium spp., Myanmar | CDC EID

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Volume 16, Number 9–September 2010
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Co-infections with Plasmodium knowlesi and Other Malaria Parasites, Myanmar
Ning Jiang,1 Qiaocheng Chang,1 Xiaodong Sun,1 Huijun Lu, Jigang Yin, Zaixing Zhang, Mats Wahlgren, and Qijun Chen
Author affiliations: Jilin University, Changchun, People’s Republic of China (N. Jiang, Q. Chang, H. Lu, J. Yin, Q. Chen); Chinese Academy of Medical Sciences, Beijing, People’s Republic of China (X. Sun, Z. Zhang, Q. Chen); Institute for Parasitic Disease Control, Puer City, People’s Republic of China (X. Sun, Z. Zhang); and Karolinska Institutet, Stockholm, Sweden (M. Wahlgren, Q. Chen)

Suggested citation for this article

Abstract
To determine the frequency of co-infections with Plasmodium species in southern Myanmar, we investigated the prevalence of P. knowlesi. More than 20% of patients with malaria had P. knowlesi infection, which occurred predominantly as a co-infection with either P. falciparum or P. vivax.
Plasmodium species are co-endemic to regions of Southeast Asia (1,2). This finding is believed to be underestimated because of insufficient sensitivity of microscopic detection of parasites. The prevalence of mixed infections with malaria parasites in the border regions between Thailand and Myanmar was recently found to be <24% (3). Identification of P. knowlesi as the fifth human malaria pathogen, which is prevalent in countries in Southeast Asia, has complicated this situation. P. knowlesi is a parasite that infects mainly long-tailed macaques (Macaca fascicularis) and pig-tailed macaques (M. nemestrina) in Southeast Asia (4). The parasite has developed the capacity to naturally infect humans, and infections in some persons have been life-threatening (5,6). Furthermore, infections with P. knowlesi in travelers to this region have been increasing (7,8).

P. knowlesi isolates obtained from humans have been frequently misidentified as P. falciparum or P. malariae because of the morphologic similarities of these parasites (2). Use of PCRs specific for 18S small subunit (SSU) rRNA genes of malaria parasites has identified suspected cases (2,9). P. knowlesi infection in humans in the border area between the People’s Republic of China and Myanmar has been reported (10), but the prevalence is unknown. We investigated the frequency of co-infections with P. knowlesi and other Plasmodium spp. in this region.

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Suggested Citation for this Article
Jiang N, Chang Q, Sun X, Lu H, Yin J, Zhang Z, et al. Co-infections with Plasmodium knowlesi and other malaria parasites, Myanmar. Emerg Infect Dis [serial on the Internet]. 2010 Sep [date cited]. http://www.cdc.gov/EID/content/16/9/1476.htm

DOI: 10.3201/eid1609.100339

These authors contributed equally to this article.