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    Universitas Sumatera Utara Medical Studies on “One Health” approach to deal with Knowlesi Malaria and Other Emerging Infectious Diseases

    The emergence of new diseases calls for new preparations. While viral diseases like avian flu, zika, and Ebola have not reached the pandemic status of Covid-19, records of their epidemic have been numerous. Covid-19 proves that no viral diseases should be underestimated; new strains could emerge almost without warning and the best vigilance is always understanding what to expect and how to respond. As a major university in North Sumatra, Universitas Sumatera Utara (USU) needs to contribute medical studies to look for ways to improving human well-being and quality of life through disease prevention.

    Many emerging infectious diseases are zoonotic: deriving from pathogens present in animals through changes in the ecosystems and land use, intensification of agriculture, urbanization, international travel, and trade. A collaborative and multi-disciplinary approach, cutting across boundaries of animal, human, and environmental health, is needed to understand the ecology of each emerging zoonotic diseases to undertake risk assessment and develop response strategies. Recognizing this scope, USU has adopted a “One Health” approach in medical studies by building a multidisciplinary collaboration to achieve optimal health outcomes by recognizing the interconnection between people, animals, plants, and their shared environment. Currently, USU is undertaking medical research on Knowlesi malaria directed by Dr. Inke Nadia D. Lubis, Ph.D, a medical specialist and researcher from USU and is conducted in USU Medical Research Facility Center.

    Knowlesi malaria is a novel emerging disease in Southeast Asia. It is a malaria parasite of the long-tailed (Macaca fasicularis) and pig-tailed (M. nemestrina) macaque monkeys and is transmitted by the Anopheles leucosphyrus group of mosquitoes. First identified as an emergent public health threat in 2004, human malaria from P. knowlesi has now been reported throughout the region in countries where the macaque hosts and mosquito vectors are found. Dr. Inke has confirmed the presence of this malaria in North Sumatera, where it has contributed to 32% of malaria cause in studied areas. She and her team has been developing a rigorous molecular detection tool that targets the schizont-infected cell agglutination variant antigens (SICAvar) as a unique gene to P. knowlesi. This increases its recognition and identification in humans, enabling quicker response and more detailed monitoring.

    USU is collaborating with the Indonesia Ministry of Health, Ministry of Agriculture, and Australia Menzies School of Health Research as part of its “One Health” approach to strengthen the surveillance of zoonotic malaria in Indonesia. North Sumatra is home to two national parks in which some forests had been impacted by changes in land use to plantations and farming, making it one of the places best suited to this study. This international collaboration evaluates the disease burden, agricultural practices, and mosquito vectors associated with knowlesi transmission. The study would help identify the type of intervention measures needed to control knowlesi malaria, prevent the introduction of other zoonotic diseases to the population while ensuring that agricultural development remains sustainable.

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