Host and Environmental Factors that Influence Plasmodium knowlesi Malaria Infection in Humans: A Systematic Review


  • Michal Christina Steven
  • Glen Wendel Sibadogil
  • Syed Sharizman Syed Abdul Rahim
  • Richard Avoi
  • Fredie Robinson
  • Awang Setia Musleh
  • Mohammad Saffree Jeffree
  • Mohd Rohaizat Hassan


Plasmodium knowlesi, Zoonotic malaria, Malaria elimination, Human-environment interaction, Systematic review


Introduction: Plasmodium knowlesi (P.knowlesi) is a zoonotic malaria parasite, transmitted between non-human primate hosts by the Anopheles (An.) mosquitos, and causing spill-over infections in humans where the parasite, vector, host, and human converge.

Methods: The search was done electronically to explore for appropriate papers via PubMed, and Science Direct for articles published up to March 2020, containing the words “factors associated” or “environmental factors” or “individual factors” or “ecological factors” and “P.knowlesi” and “human” including synonyms and Medical Subject Heading (MeSH) terms. A total of 27 articles from PubMed Databases and 18 articles from Science Direct were selected to be assessed for eligibility. Out of it, a total of 13 articles were selected to be analysed.

Results: Host factors such as sex and age, as well as occupation as individual factors, while environmental factors such as rainfall and geographic elevation have some association with P.knowlesi infection in humans. This zoonotic malaria poses unique challenges that will need to be addressed if all forms of malaria are to be eliminated based on the sustainable development goal (SDG).

Conclusion: This article highlights the importance of disease ecologies such as climate and landscape and human-environment interactions such as the land use patterns, such as agriculture or infrastructure activities) to reduce the further increase of cases and mortality globally due to P.knowlesi infection. This review focuses mainly on the host and environmental factors that influence P.knowlesi Malaria Infection in Humans.