Trends in antimalarial drug use in Africa.

Trends in antimalarial drug use in Africa.
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DOI:
10.4269/ajtmh.13-0129
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发表时间:
2013-11
期刊:
The American journal of tropical medicine and hygiene
影响因子:
--
通讯作者:
Guerin PJ
Guerin PJ
中科院分区:
其他
文献类型:
--
作者:
Flegg JA;Metcalf CJE;Gharbi M;Venkatesan M;Shewchuk T;Hopkins Sibley C;Guerin PJ

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对氯喹(CQ)和磺胺嘧啶-乙胺嘧啶(SP)的耐药性导致世界卫生组织(世卫组织)建议修改国家药物政策。政策变化和政策实施之间的时间间隔对计划的影响有着深刻的影响。我们开发了一个基于抗疟治疗数据的模型,这些数据来自家庭调查和文献中的国家抗疟政策信息。对1999-2011年期间每个国家的毒品使用情况以及政策改变后CQ使用减少的趋势进行了估计。SP使用估计值与SP耐药相关的分子标记物的患病率相关。政策改变后,国家一级的CQ使用减少率没有空间模式。在东非,使用SP药物与耐药性密切相关。如果青蒿素耐药性蔓延到非洲或在非洲出现,这一方法将成为估计实际药物使用及其对药物疗效变化的影响的宝贵工具。
Resistance to chloroquine (CQ) and sulphadoxine-pyrimethamine (SP) led the World Health Organization (WHO) to recommend changes in national drug policies. The time between policy changes and their implementation profoundly affects program impact. We developed a model based on data on antimalarial treatments, extracted from household surveys and national antimalarial policy information from the literature. Drug use in each country during the time period 1999–2011 and the trend in reduction of CQ use after policy change were estimated. The SP use estimates were correlated with the prevalence of a molecular marker associated with SP resistance. There was no spatial pattern in the country-level rate of reduction of CQ use, after policy change. In East Africa SP drug use was strongly correlated to resistance. If artemisinin resistance spreads to, or emerges in, Africa this methodology will be a valuable tool to estimate actual drug use and its impact on changes in drug efficacy.
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