Disertasi

Malaria zoonotik: Identifikasi vektor dan interaksi parasit-inang = Zoonotic Malaria: Vector Identification and Parasite–Host Interaction.

Latar Belakang : Malaria zoonotik merupakan malaria pada manusia yang disebabkan oleh spesies Plasmodium yang secara alami menginfeksi satwa primata dan ditularkan melalui gigitan vektor nyamuk Anopheles sp.. Dalam beberapa dekade terakhir, kasus malaria zoonotik semakin meningkat di wilayah Asia Tenggara, termasuk Indonesia. Penelitian ini bertujuan untuk mengidentifikasi Plasmodium, vektor penular, dan satwa primata yang berperan dalam penularan malaria zoonotik di Indonesia. Eksplorasi interaksi molekuler antara ligan Plasmodium dan reseptor inang sebagai faktor penentu invasi dan potensi infeksi limpahan. Metode : Penelitian ini merupakan studi potong lintang yang dilakukan di tiga wilayah Indonesia (Aceh, Kalimantan Tengah, dan Sulawesi Tenggara) selama tahun 2020-2024. Pengumpulan data meliputi sampel darah dari manusia (n=366) dan satwa primata (n=46), survei entomologi, serta analisis molekuler terhadap gen DARC, DBP, dan uji serologi terhadap antibodi PfMSP1 dan PvMSP1 . Hasil : Prevalensi malaria pada satwa primata relatif tinggi dan bervariasi antar lokasi (42-100%), dengan spesies yang teridentifikasi meliputi Plasmodium inui, Plasmodium cynomolgi, Plasmodium knowlesi, Plasmodium coatneyi, dan Plasmodium simiovale. Tidak ditemukan infeksi malaria pada manusia berdasarkan pemeriksaan PCR. Analisis gen DARC menunjukkan tidak ditemukan mutasi pada daerah promotor yang menyebabkan fenotipe Duffy negatif. Genotipe dominan adalah FY*A/FY*A, sementara genotipe FY*B/FY*B menunjukkan hubungan signifikan dengan kerentanan terhadap infeksi P. knowlesi (P < 0,05). Kadar antibodi MSP1 lebih tinggi di Sulawesi Tenggara dibanding Aceh dan Kalimantan Tengah. Nyamuk Anopheles sulawesi yang berasal dari Sulawesi Tenggara ditemukan positif P. inui (8%), sedangkan An. letifer yang beasal dari Kalimantan Tengah positif Plasmodium spp. (1,01%). Kesimpulan : Keberadaan satwa primata terinfeksi Plasmodium, vektor malaria, dan manusia dalam wilayah yang sama menimbulkan potensi penularan malaria zoonotik. Kerentanan populasi di tiap lokasi bervariasi, yang tercermin dari distribusi genotipe DARC dan tingkat imunitas. Strategi pengendalian berbasis One Health yang melibatkan pemantauan satwa primata, vektor, dan lingkungan sangat dibutuhkan.
Kata kunci: Malaria zoonotik, satwa primata, nyamuk vektor, DARC, DBP, One Health.


Background: Zoonotic malaria occurs when humans are infected by Plasmodium species that naturally infect primates and are transmitted through the bite of Anopheles mosquito vectors. In recent decades, cases of zoonotic malaria have been rising in Southeast Asia, including Indonesia. This study aims to identify the Plasmodium species, vector mosquitoes, and primate hosts involved in the transmission of zoonotic malaria in Indonesia. Additionally, the molecular interactions between Plasmodium ligands and host receptors have been examined as factors in invasion and spillover potential. Methods: This cross-sectional study was conducted in three provinces in Indonesia, Aceh, Central Kalimantan, and Southeast Sulawesi, between 2020 and 2024. Data collection included blood samples from human subjects (n = 366) and primates (n = 46), as well as entomological surveys and molecular analysis of the DARC and DBP genes. Additionally, serological testing was conducted to detect antibodies against PfMSP1 and PvMSP1. Results: Malaria prevalence in primates was relatively high and varied across locations (42–100%), with identified species including Plasmodium inui, Plasmodium cynomolgi, Plasmodium knowlesi, Plasmodium coatneyi, and Plasmodium simiovale. No malaria infections were detected in humans based on PCR testing. Analysis of the DARC gene showed no mutations in the promoter region causing the Duffy negative phenotype. The dominant genotype was FY*A/FY*A, while the FY*B/FY*B genotype was significantly associated with susceptibility to P. knowlesi infection (P < 0.05). MSP1 antibody levels were higher in Southeast Sulawesi than in Aceh and Central Kalimantan. Anopheles sulawesi mosquitoes from Southeast Sulawesi tested positive for P. inui (8%), while An. letifer from Central Kalimantan tested positive for Plasmodium spp. (1.01%). Conclusion: The presence of Plasmodium-infected primates, malaria vectors, and humans in the same area poses a risk for zoonotic malaria transmission. The susceptibility of populations in different locations varies, as indicated by the distribution of DARC genotypes and immunity levels. An integrated One Health strategy that includes monitoring primates, vectors, and the environment is urgently necessary.
Keywords: Zoonotic malaria, non-human primates, mosquito vectors, DARC, DBP, One Health.