Unveiling the Diversity and Zoonotic Potential of Plasmodium inui: a Comprehensive Review of Insights from Indonesia and Southeast Asia

Purpose
Plasmodium inui is a type of malaria that is endemic in simian populations in Southeast Asia, primarily infecting nonhuman primates, one of which is Macaca fascicularis, or the long-tailed macaque. Plasmodium inui, a malaria parasite endemic to simian populations in Southeast Asia, predominantly targets non-human primates. The escalating rates of deforestation and urban expansion, which facilitate increased interactions between humans and primates, have intensified concerns regarding its zoonotic potential. Despite receiving comparatively less scholarly attention than P. knowlesi, P. inui is distinguished by its substantial strain diversity and capacity to infect various macaque species. This review investigates the potential for crossspecies transmission of P. inui to humans, concentrating on the regions of Indonesia and Southeast Asia.

Methods
We evaluate the ecological and epidemiological determinants influencing the distribution and transmission dynamics of P. inui among macaques while also considering the implications for human infection based on a literature review obtained from PubMed, Google Scholar, and Scopus.

Results
Although no documented human cases have emerged in Indonesia, cases in humans have only been detected in Malaysia and Thailand, the review underscores the zoonotic risk associated with P. inui, drawing comparisons to other simian malaria species that have successfully infiltrated human populations. The lack of systematic surveillance and detailed molecular investigations concerning P. inui in these regions accentuates the imperative for further scholarly inquiry.

Conclusion
This review emphasizes the need for ongoing monitoring and research to enhance the understanding of zoonotic threats associated with P. inui, and informs future public health initiatives in Southeast Asia through a comprehensive evaluation of the genetic diversity of the parasite and its potential implications for public health.