Defining the biomedical, environmental and social risk factors for human infection with Plasmodium knowlesi; opportuniti

疟疾是由一种主要在宿主血液中发现的单细胞寄生虫引起的，通过蚊子的叮咬在宿主之间传播。现存100多种疟疾，感染许多不同的动物。直到最近，人类还被认为是四种疟疾的自然宿主。然而，自2004年以来，出现了由一种寄生虫引起的人类疟疾感染的报告，这种寄生虫以前在东南亚的某些类型的猕猴中发现。这一物种是诺氏疟原虫，虽然在其自然猴子宿主中是良性的，但它已经在一定比例的人类患者中引起了严重甚至致命的疾病。目前，我们对这种猕猴寄生虫造成的真正疾病负担知之甚少，也不知道它为什么会成为人类的病原体。对人类感染诺氏疟原虫的初步描述表明，他们是在林区工作时被叮咬并感染的，这种情况在东南亚许多国家很常见。然而，马来西亚婆罗洲最近的一项研究表明，尽管那里几乎没有森林存在，但那里的社区也在受到感染。可能有许多因素与环境、该地区蚊子的类型、人-S的行为或运动以及他们与猕猴成群的距离有关，这些因素将影响他们感染疟原虫知识的风险。我们已经建立了一个由来自英国、菲律宾、马来西亚和澳大利亚的不同技能和专业知识的研究人员组成的网络，通过协调一致的方法来解决不同的知识差距。我们计划在菲律宾(巴拉望岛)和马来西亚婆罗洲的沙巴州进行研究。与巴拉望州相比，沙巴州发现了更多的诺氏疟原虫感染病例，我们将试图找出为什么这里的社区似乎面临更高的风险。在治疗他们的感染时，我们可以制定指南，帮助面临这种疾病的其他临床医生。我们还想研究猕猴，传播寄生虫的蚊子，以及感染发生的环境，以便给我们提供整体情况，并制作描述不同地区存在的风险因素的地图。我们希望这将为卫生部努力在受影响地区控制疟疾并防止进一步爆发源自灵长类动物的疟疾提供重要信息。

Malaria is caused by a single celled parasite found predominantly in the blood of its host, and is transmitted between hosts by the bite of a mosquito. Greater than 100 species of malaria exist, infecting many different animals. Until recently, humans were thought to be the natural hosts for 4 malaria species. However, since 2004 reports appeared of malaria infections in humans that are caused by a parasite species found previously in certain types of macaque in Southeast Asia. This species is Plasmodium knowlesi and, although benign in its natural monkey host, it has caused severe and even fatal disease in a proportion of human sufferers.Currently, we know little about the true burden of disease caused by this macaque parasite, or why it has emerged as a human pathogen. Initial descriptions of humans with Plasmodium knowlesi malaria suggested that they had been bitten and infected while working in forested areas, common in many countries of Southeast Asia. However, a more recent study in Malaysian Borneo shows that communities there are also being infected, even though there is little forest in existence. There may be a number of factors related to the environment, the types of mosquito in the area, people?s behaviour or movement and their proximity to troops of macaques that will have an effect on how at risk they are to being infected with Plasmodium knowlesi.We have built a network of researchers with different skills and expertise from the UK, the Philippines, Malaysia and Australia to tackle the various knowledge gaps by working together in a concerted approach. We plan to conduct studies in both the Philippines (on Palawan island) and in Sabah, a region of Malaysian Borneo. A larger number of cases of human Plasmodium knowlesi infection have been found in Sabah, compared to Palawan, and we will attempt to find out why communities here seem at higher risk. In treating their infections we can produce guidelines to help other clinicians faced with this disease. We also want to study the macaques, the mosquitoes that transmit the parasite, and the environment in which the infections occur to give us the whole picture and to produce maps that describe the risk factors existing in the different areas. We hope this will provide important information to ministries of health trying to control malaria disease in the affected regions and prevent further outbreaks of malaria originating from primates.