‘Monkeybar’ project beginning to find answers to malaria

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KOTA KINABALU: Scientists from Malaysia, the Philippines, United Kingdom and Australia came together last week for a workshop at Hospital Queen Elizabeth here to review the “Monkeybar” project investigating a new malaria found in Sabah.

The Monkeybar project is using an interdisciplinary research approach to investigate the emerging malaria, Plasmodium knowlesi, in Sabah, Malaysia and Palawan, the Philippines.

P. knowlesi has recently been added to the list of known human malarias. The natural hosts of this malaria are macaque monkeys in Southeast Asia, but over the last 10 years it has been found in the human population. It is now the most common human malaria in Malaysian Borneo.

Over the past two decades, Malaysia has made extraordinary progress in eliminating malaria. It is only because of this success that the importance of P. knowlesi has become apparent.

Because the importance of P. knowlesi in people has only recently been recognised, relatively little is known about how and why it has crossed over into the human population.

Monkeybar investigators in Malaysia from the Ministry of Health, Sabah Wildlife Department, Universiti Malaysia Sabah and University Malaya are working with scientists from the UK, Australia and the Philippines to better understand the workings of this malaria parasite and the risk it poses to the human population of Sabah.

The five-year project is now in its third year, and is in the midst of collecting some unique data. A case control study in Sabah is providing clinical information on people with malaria.

“By identifying where these people live, we can collect the best data on human movement (collected using handheld GPS devices), monkey movement (from GPS collars on wild monkeys), mosquito densities and biting behaviours (from mosquito traps placed in a variety of habitats), and land use (using a drone, or unmanned aerial vehicle, to map the area) in order to see where and when the disease is being transmitted,” said Professor Chris Drakeley of the London School of Hygiene and Tropical Medicine.

Preliminary results from the clinical study have found that whilst the majority of cases are in adults, there are some cases in children, which is an important finding for public health.

Macaque movement has shown that they will move when the forest they are in is disturbed, which supports the theory that changes in land use are somehow implicated in transmission to humans – although the experts agreed this needs more work before any conclusions can be made.

“There is currently no evidence to say tourists are at increased risk, nor that people can transmit the disease to other people [via mosquitoes]– transmission so far always seems to be purely zoonotic, i.e. it requires the monkey hosts to be involved in the transmission pathway,” explained Drakeley, adding that the disease has also been shown to respond well to current malaria treatments.

The plans formed at last week’s workshop will determine what work needs to be done in the final two years of the project to see how much of the disease is really present in Sabah and what the risk factors are for acquiring it.

The workshop was hosted by Dr Timothy William, Principal Investigator for the Malaysian activities, from the Malaysian Ministry of Health; and Professor Chris Drakeley, lead Principal Investigator from the London School of Hygiene and Tropical Medicine in the United Kingdom.