On World Malaria Day is commemorated 25 April the world is reminded of malaria remains a major public health problem.

More than 500 million people worldwide are infected annually with malaria and more than a million people per year died.

Most malaria cases are in Africa and some Asian countries, including Indonesia. The fight against these countries, malaria is increasingly been challenged by a new type of malaria caused by Plasmodium knowlesi. Malaysia's first deal with P knowlesi infections.

There are four types of malaria parasites in humans is known, namely P falciparum, P vivax, P malariae, and P ovale. The parasite is transmitted to humans through the bite of an infected Anopheles mosquito.

Now P knowlesi which is known only in long-tailed monkeys (Macaca fascicularis), were also found in the human body. An international research team that published the journal Clinical Infectious Diseases explained, the results of tests on 150 patients with malaria in a hospital in Sarawak, Malaysia, July 2006 to January 2008 shows, two thirds of cases of malaria caused by P knowlesi infections.

The case allegedly P knowlesi infections also occurred in China, Thailand, Philippines, Myanmar, and Indonesia. Journal of Emerging Infectious Diseased (CDC) includes study called Plasmodium knowlesi in Human, Indonesian Borneo. The article was about an Australian tourist infected with P knowlesi after to Borneo.

The team from the Health Research and Development Ministry of Health are investigating the case of P knowlesi in Central Kalimantan. There are six blood samples allegedly positive and is still awaiting further test results.

Coordinator of the Global Fund Project Management Unit Malaria Directorate General of Disease Control and Environmental Health Ministry of Health as well as doctoral field malariologi, Lukman Hakim, said:

malaria symptoms do not get out of the Plasmodium life cycle. Broadly speaking, in the human body parasites that divide (first phase) in the liver. Following from the liver, the parasite attacks the red blood cells and divide a few times in the red blood cell granules. When cleavage, produced substances that affect the regulator in the brain. "It causes fever in people," said Lukman.

Death can occur if the parasite attacks the brain, as in malaria due to P falcifarum. The parasites attach to and can clog the delicate capillary blood vessels. "Capillary blood vessels associated with vital organs such as brain and kidneys," he said.

Various studies have shown, the P knowlesi infection, the cycle of asexual reproduction (fission itself in humans or animals) occurs within 24 hours. Faster than the 48 hour cycle in P vivax, P ovale, and P falciparum, whereas 72 hours in P malariae. Every time cells divide will be an attack of fever.

Symptoms of P knowlesi infections mentioned are similar to severe P falciparum malaria. This was revealed in the study entitled Clinical and Laboratory Features of Human Plasmodium knowlesi infection by a number of researchers Malaysia and Australia in the Kapit Hospital, Sarawak, Malaysia.

Non-specific symptoms, including fever and chills. Sometimes you experience difficulty breathing and coughing. In addition, there is thrombocytopenia, which reduced the number of pieces of red blood cells in 98 percent of patients. Originally three patients in the study did not experience tromobositopenia and low levels of parasites in the body. However, only within 24 hours all patients had thrombocytopenia. There is also a disturbance in the liver. The standard treatment of malaria to cure the disease.

In an article in human Plasmodium knowlesi malaria is widely distributed and Potentially life-threatening disclosed, P knowlesi is more difficult to detect because of the appearance under the microscope is similar with P malariae. As a result, an error occurred identified as P malariae is associated with low parasitemia and clinical symptoms are not severe. On the other hand, the disease is getting worse. This triggers a series of studies in Malaysia.

The move to human

Lukman said the first mosquitoes do not suck human blood, just blood sucking animals. However, with the growing human population and the proximity of animals and humans, mosquitoes suck human blood. The disease jumped from animals to humans.

Based on the results of recent studies, known to P falciparum came from gorillas. There are several types of Plasmodium that until now there has not been found in monkeys and in humans.

Deforestation is threatening the habitat of monkeys and the addition of a population believed to influence the outbreak of P knowlesi to humans.

Malaria expert and author of books on malaria who received an award from the Ministry of Health for his services in the elimination of malaria on April 25, 2011, Paul Harijanto, said the presence of a new type of malaria was not free from microbes that evolved behavior. "Various factors, such as climate change, did influence. Another example, known as P falciparum causing severe malaria. However, later P vivax infection can also be severe, "said Paul who practiced at Bethesda Hospital, Tomohon, North Sulawesi.

He said the deal with P knowlesi no different than other types of malaria. Throughout handled properly and promptly, malaria of any type should not end with the death of the sufferer.