Landscape drives zoonotic malaria prevalence in non-human primates

Zoonotic disease dynamics in wildlife hosts are rarely quantified at macroecological scales due to the lack of systematic surveys. Non-human primates (NHPs) hostPlasmodium knowlesi,a zoonotic malaria of public health concern and the main barrier to malaria elimination in Southeast Asia. Understanding of regionalP. knowlesiinfection dynamics in wildlife is limited. Here, we systematically assemble reports of NHPP. knowlesiand investigate geographic determinants of prevalence in reservoir species. Meta-analysis of 6322 NHPs from 148 sites reveals that prevalence is heterogeneous across Southeast Asia, with low overall prevalence and high estimates for Malaysian Borneo. We find that regions exhibiting higher prevalence in NHPs overlap with human infection hotspots. In wildlife and humans, parasite transmission is linked to land conversion and fragmentation. By assembling remote sensing data and fitting statistical models to prevalence at multiple spatial scales, we identify novel relationships betweenP. knowlesiin NHPs and forest fragmentation. This suggests that higher prevalence may be contingent on habitat complexity, which would begin to explain observed geographic variation in parasite burden. These findings address critical gaps in understanding regionalP. knowlesiepidemiology and indicate that prevalence in simian reservoirs may be a key spatial driver of human spillover risk.