Towards an effective malaria vaccine
Towards an effective malaria vaccine
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DOI：
10.1136/adc.2005.092551
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发表时间：
2007-06-01
影响因子：
5.2
通讯作者：
Alonso, Pedro L.
中科院分区：
文献类型：
--
作者：
Aide, Pedro;Bassat, Quique;Alonso, Pedro L.
1955 年，疟疾学家保罗·拉塞尔毫不犹豫地预测疟疾即将终结，他几乎没有想到半个世纪后疟疾仍然是世界上最重要的公共卫生挑战之一。 21世纪初，生活在100个国家的疟疾流行地区的30亿人（几乎占世界人口的一半）面临风险，其中最大的疾病和死亡负担集中在非洲国家。据信每年会发生 300 至 5 亿临床病例和多达 270 万人死亡。 2 3 尽管感染人类的疟原虫有四种，但只有两种（间日疟原虫和恶性疟原虫）会引起严重疾病，几乎所有死亡都是由恶性疟原虫引起的。是否需要接种疟疾疫苗？上个世纪，疟疾已从世界许多地区消失，而在某些地方，这是由于采取了控制措施。然而，在这种感染仍然发生的地区，我们看到由于人口增长，疟疾病例总数有所增加，这意味着今天死于这种疾病的人数比 40 年前还要多。 4 这种复苏的原因有很多。疟原虫对最常见的抗疟药物的耐药性不断扩大且不断增强，蚊子对广泛使用的杀虫剂产生了耐药性，制药业迄今为止对开发新药兴趣不足，现有控制措施的实施存在缺陷，国家疟疾控制计划的崩溃以及旅游业的增长和非免疫人群向疟疾流行地区的迁移，所有这些都导致了疟疾病例的普遍上升。 5 尽管有效的疟疾控制工具越来越多，这应该对大流行的动态产生综合积极影响，但显然需要一种更好、更明确的方法来应对这种疾病。疫苗传统上被认为是一流的公共卫生工具，价格相对便宜，易于购买
When in 1955 the malariologist Paul Russell predicted without hesitation the imminent end of malaria, 1 little could he have imagined that half a century later malaria would still be one of the most important public health challenges in the world. At the beginning of the 21st century, 3000 million people (almost half the world’s population) living in malaria endemic areas in 100 countries are at risk, with the biggest burden of both disease and death concentrated in African countries. Between 300 and 500 million clinical cases and up to 2.7 million deaths are believed to occur annually. 2 3 Although there are four species of Plasmodium that infect humans, only two (P vivax and P falciparum) cause significant disease, with nearly all deaths being caused by P falciparum.IS A MALARIA VACCINE NECESSARY? Over the last century, malaria has disappeared from significant areas of the world, and in some places this has been due to the use of control measures. Nevertheless, in areas where this infection still occurs, we are witnessing an increase in the total number of malaria cases due to population growth, which implies that today more people die from this disease than 40 years ago. 4 The causes of this resurgence are many. The parasite’s extended and increasing resistance to the most common antimalarial drugs, the mosquito’s resistance to the widely used insecticides, the hitherto insufficient interest of the pharmaceutical industry in developing new drugs, the shortcomings in the implementation of available control measures, the collapse of national malaria control programmes and the increase in tourism and the migration of non-immune populations to malaria endemic areas, have all contributed to the general rise in malaria cases. 5 Despite the increasing availability of effective malaria control tools, which should have a combined positive effect on the dynamics of the pandemic, a better and definitive approach to deal with this disease is clearly needed. Vaccines, traditionally considered first-class public health tools, are relatively cheap, easy to