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Volume 22, Number 1—January 2016
CME ACTIVITY - Research

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

Giri S. Rajahram1, Bridget E. Barber1Comments to Author , Timothy William, Matthew J. Grigg, Jayaram Menon, Tsin W. Yeo, and Nicholas M. Anstey
Author affiliations: Queen Elizabeth Hospital, Kota Kinabalu, Malaysia (G.S. Rajahram, T. William, J. Menon); Infectious Diseases Society Sabah–Menzies School of Health Research Clinical Research Unit, Kota Kinabalu (B.E. Barber, T. William, M.J. Grigg, T.W. Yeo, N.M. Anstey); Menzies School of Health Research, Darwin, Northern Territory, Australia (B.E. Barber, M.J. Grigg, T.W. Yeo, N.M. Anstey); Charles Darwin University, Darwin (B.E. Barber, M.J. Grigg, T.W. Yeo, N.M. Anstey); Jesselton Medical Centre, Kota Kinabalu (T. William); Nanyang Technological University, Singapore (T.W. Yeo)

Main Article

Table

CFRs among persons with notified cases of Plasmodium spp. malaria, Sabah, Malaysia, 2010–2014*

Age group, year P. knowlesi†
 P. falciparum
 P. vivax
No. notifications No. deaths Notified CFR‡ No. notifications No. deaths Notified CFR No. notifications No. deaths Notified CFR
Persons >15 y of age
2010 327 3 9.17 736 2 2.72 720 0 0.00
2011 608 3 4.93 467 2 4.28 479 1 2.09
2012 744 4§ 5.38 543 2 3.68 390 0
2013 927 1 1.08 239 1 4.18 211 1 4.74
2014 1,246 2 1.61 173 2 11.56 165 0
Total
 3,852
 13
 3.37
2,158
 9
 4.17
1,965
 2
 1.02
Persons <15 y of age
2010 57 0 – 355 2 5.63 262 0 –
2011 95 0 – 138 1 7.25 149 0 –
2012 73 0 – 171 2 11.70 88 0 –
2013 69 0 – 58 0 – 52 0 –
2014 79 0 – 21 0 – 60 0 –
Total 373 0 – 743 5 6.73 611 0 –

*Notified CFR, case-fatality rate determined on the basis of the no. of PCR-confirmed malaria-associated deaths/1,000 notifications of microscopy-based malaria cases.
†Includes all cases notified as P. knowlesi or P. malariae. PCR-confirmed P. malariae infection is rare in Sabah, accounting for <1% of clinical samples diagnosed by microscopy as P. malariae or P. knowlesi (1); thus, most notifications of P. malariae/P. knowlesi can be assumed to be P. knowlesi.
‡p = 0.110 (χ2 test for trend) for reduction in P. knowlesi fatality rate among adults during 2010–2014.
§Excludes 1 fatal case of microscopy-diagnosed P. malariae. The notified CFR in 2012 with this case included as a P. knowlesi–associated death was 6.72 deaths/1,000 notifications, and the overall notified CFR for P. malariae/P. knowlesi in adults was 3.63 deaths/1,000 notifications. The p value for the test for trend is unchanged at 0.11

Main Article

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Main Article

1These co-first authors contributed equally to this article.

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Page updated: December 17, 2015
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