Tools to accelerate falciparum malaria elimination in Cambodia: a meeting report
Tools to accelerate falciparum malaria elimination in Cambodia: a meeting report
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DOI：
10.1186/s12936-020-03197-6
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发表时间：
2020-04-15
期刊：
影响因子：
3
通讯作者：
Guintran, Jean-Olivier
中科院分区：
文献类型：
--
作者：
Lek, Dysoley;Callery, James J.;Guintran, Jean-Olivier
柬埔寨的目标是到2025年消除疟疾。迅速消除疟疾将取决于能否成功地查明和清除与森林有关的疟疾疫源地。在可预见的未来，扩大和维持普遍获得早期诊断和有效治疗仍然是大湄公河次区域控制和最终消除疟疾的关键。大众药物管理局(MDA)在快速减少恶性疟原虫感染方面有一定的希望，但需要投入大量的资源和时间来动员目标社区。此外，GMS中最实用的治疗丙二醛的药物方案--三轮DHA/哌喹--已经失去了一些疗效。大规模筛查和治疗通过清除慢性感染使无症状的恶性疟原虫携带者受益，但在目前的形式下，消除疟疾的希望不大。人们希望“高度敏感”的诊断测试将在筛查和治疗计划方面取得实质性进展，但事实证明，这种希望是错误的。为了减轻在林区工作的人感染恶性疟原虫和间日疟原虫的负担，应探索在森林工人中使用疟疾预防的新方法。2019年10月在金边举行的研讨会期间，研究人员和政策制定者审查了针对疟疾疫源地和阻断恶性疟原虫传播的干预措施的可接受性、可行性和有效性的证据，并讨论了方案执行的业务要求和条件。
Cambodia targets malaria elimination by 2025. Rapid elimination will depend on successfully identifying and clearing malaria foci linked to forests. Expanding and maintaining universal access to early diagnosis and effective treatment remains the key to malaria control and ultimately malaria elimination in the Greater Mekong Subregion (GMS) in the foreseeable future. Mass Drug Administration (MDA) holds some promise in the rapid reduction of Plasmodium falciparum infections, but requires considerable investment of resources and time to mobilize the target communities. Furthermore, the most practical drug regimen for MDA in the GMS-three rounds of DHA/piperaquine-has lost some of its efficacy. Mass screening and treatment benefits asymptomatic P. falciparum carriers by clearing chronic infections, but in its current form holds little promise for malaria elimination. Hopes that "highly sensitive" diagnostic tests would provide substantial advances in screen and treat programmes have been shown to be misplaced. To reduce the burden on P. falciparum and Plasmodium vivax infections in people working in forested areas novel approaches to the use of malaria prophylaxis in forest workers should be explored. During an October 2019 workshop in Phnom Penh researchers and policymakers reviewed evidence of acceptability, feasibility and effectiveness of interventions to target malaria foci and interrupt P. falciparum transmission and discussed operational requirements and conditions for programmatic implementation.