Challenges and prospects for malaria elimination in the Greater Mekong Subregion
Challenges and prospects for malaria elimination in the Greater Mekong Subregion
复制标题
大湄公河次区域消除疟疾的挑战和前景
DOI：
10.1016/j.actatropica.2011.04.006
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发表时间：
2012-03-01
期刊：
影响因子：
2.7
通讯作者：
Zhou, Guofa
中科院分区：
文献类型：
--
作者：
Cui, Liwang;Yan, Guiyun;Zhou, Guofa
尽管大湄公河次区域（GMS）的疟疾情况有了显著改善，但该区域的疟疾控制仍面临诸多挑战。疟疾分布极不均匀，特别是沿国际边界分布，使疾病监测和有针对性的控制变得困难。病媒生物系统也多种多样，栖息地生态、咬人行为和病媒能力存在巨大差异，缺乏有效的传播监测和控制工具。最后，在大量部署以青蒿素为基础的联合疗法的时代，该区域成为耐药性的中心，耐青蒿素恶性疟原虫的出现对区域和全球消除疟疾运动构成威胁。假冒和不合格青蒿素药物的流通进一步加剧了这一问题。因此，这个由美国和区域研究机构组成的东南亚疟疾研究中心提出了四个相互关联的项目，以解决疟疾控制中这些最紧迫的问题。这些项目的目标将有助于大大提高我们对疟疾流行病学、病媒系统及其在疟疾传播中的作用以及寄生虫耐药机制的理解。通过培训下一代疟疾研究科学家，该项目将帮助建立和加强区域研究基础设施和能力，这对该地区持续控制疟疾至关重要。(C) 2011 Elsevier B.V.版权所有
Despite significant improvement in the malaria situation of the Greater Mekong Subregion (GMS), malaria control for the region continues to face a multitude of challenges. The extremely patchy malaria distribution, especially along international borders, makes disease surveillance and targeted control difficult. The vector systems are also diverse with dramatic differences in habitat ecology, biting behavior, and vectorial capacity, and there is a lack of effective transmission surveillance and control tools. Finally, in an era of heavy deployment of artemisinin-based combination therapies, the region acts as an epicenter of drug resistance, with the emergence of artemisinin resistant Plasmodium falciparum posing a threat to both regional and global malaria elimination campaigns. This problem is further exacerbated by the circulation of counterfeit and substandard artemisinin drugs. Accordingly, this Southeast Asian Malaria Research Center, consisting of a consortium of US and regional research institutions, has proposed four interlinked projects to address these most urgent problems in malaria control. The aims of these projects will help to substantially improve our understanding of malaria epidemiology, vector systems and their roles in malaria transmission, as well as the mechanisms of drug resistance in parasites. Through the training of next-generation scientists in malaria research, this program will help build up and strengthen regional research infrastructure and capacities, which are essential for sustained malaria control in this region. (C) 2011 Elsevier B.V. All rights reserved.