Background

Agricultural expansion and deforestation have resulted in land use change linked to altered dynamics and distribution of malaria and other vector-borne diseases globally threatening related sustainable development goals.

In Southeast Asia, Plasmodium knowlesi is an emerging malaria parasite of the long-tailed and pigtailed macaques and is transmitted by the Anopheles leucosphyrus group of mosquitoes. P. knowlesi is now the most common cause of human malaria in Malaysia, with agricultural occupation reported as a predictor of a higher P. knowlesi parasitaemia, a key risk factor for severe disease.

In Indonesia, zoonotic transmission of P. knowlesi has been molecularly confirmed from preliminary studies in western Indonesia, including Sumatra and Aceh and case reports from Kalimantan. Importantly, in these studies, P. knowlesi has been universally misdiagnosed by microscopy as other human-only species, with no P. knowlesi cases previously reported through the current national malaria notification system.

Critical information regarding the epidemiology and transmission dynamics of P. knowlesi remain poorly defined, hindering effective regional and local control responses. This project will facilitate sustainable agricultural development by addressing the direct association between agricultural activities and zoonotic malaria transmission in Indonesia, with the aim of informing intersectoral interventions.

Aims

The specific objectives of this study are:

1. To strengthen the national public health system surveillance detection for zoonotic malaria and to define the disease burden.
2. To evaluate agricultural and land-use factors associated with zoonotic malaria transmission.
3. To evaluate mosquito vectors transmitting zoonotic malaria and the association with agricultural land types and practices on their behaviour.