Wannigama D.L.Amarasiri M.Phattharapornjaroen P.Hurst C.Modchang C.Cynthia B.Miyanaga K.Cui L.Fernandez S.Melhem N.M.Luk-in S.Singer A.C.Ragupathi N.K.D.Htun T.S.Sei K.Ngamwongsatit N.Hui N.S.Shimotai Y.Ounjai P.Kanthawee P.Tacharoenmuang R.Kauba A.Eang C.Romone L.Dharne M.de Araujo J.C.Ndatuwong L.G.Werawatte W.K.C.P.Chanthasiri T.Zhao J.Mori H.Besa J.J.V.Kurt Ö.Kanjanabuch T.Zahraei-Ramazani A.R.Higgins P.G.Aoyagi T.Kicic A.Trowsdale S.Hongsing P.Yang X.Wang Y.Khatib A.Sano D.Shibuya K.Abe S.Hamamoto H.Mahidol University2026-05-272026-05-272026-05-15Journal of Infectious Diseases Vol.233 No.5 (2026) , e1238-e124300221899https://repository.li.mahidol.ac.th/handle/123456789/116944We conducted the noninvasive surveillance of Plasmodium knowlesi in wild macaques using 4752 fecal samples collected across 9 endemic countries. Parasite DNA was detected in 390 samples (8.2%), with positivity rates ranging from 1.4% to 18.4%. This provides the first field-based evidence that P. knowlesi DNA in feces shed by macaques and present under natural conditions can be detected. These findings validate fecal sampling as a practical and scalable tool for tracking zoonotic-malaria. The results support integration into forest-runoff and rural wastewater surveillance systems, offering new opportunities for early detection of pathogens and environmental monitoring at the human–wildlife interface.MedicineArticleSCOPUS10.1093/infdis/jiag1282-s2.0-1050391788821537661341766625