The role of anti-malarial drugs in eliminating malaria.
The role of anti-malarial drugs in eliminating malaria.
复制标题
抗疟疾药物在消除疟疾中的作用。
DOI：
10.1186/1475-2875-7-s1-s8
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发表时间：
2008-12-11
期刊：
影响因子：
3
通讯作者：
White NJ
中科院分区：
文献类型：
--
作者：
White NJ
有效的抗疟疾药物治疗可减少疟疾传播。仅这一点就可以减少疟疾的发病率和流行率，尽管在低传播地区效果更大，因为在这些地区，有更多的传染源出现症状并接受抗疟疾治疗。有效治疗对恶性疟疾的传播有更大的影响，因为恶性疟疾的配子体发生延迟，而其他人类疟疾的配子体和传播性峰值与无性寄生虫密度峰值重合。成熟的恶性疟原虫配子体更耐药，仅受青蒿素和8-氨基喹啉类药物的影响。目前的关键业务问题是，是否应在治疗恶性疟疾的青蒿素综合疗法中加入伯氨喹，以进一步降低所治疗感染的传染性。伯氨喹根治在消灭间日疟和卵形疟方面发挥着关键作用。需要更多的证据来证明伯氨喹在不进行G6 PD缺乏症筛查的情况下给药的安全性，以便在消除疟疾方案的背景下为个人和大规模治疗方法提供信息。
Effective anti-malarial drug treatment reduces malaria transmission. This alone can reduce the incidence and prevalence of malaria, although the effects are greater in areas of low transmission where a greater proportion of the infectious reservoir is symptomatic and receives anti-malarial treatment. Effective treatment has greater effects on the transmission of falciparum malaria, where gametocytogenesis is delayed, compared with the other human malarias in which peak gametocytaemia and transmissibility coincides with peak asexual parasite densities. Mature Plasmodium falciparum gametocytes are more drug resistant and affected only by artemisinins and 8-aminoquinolines. The key operational question now is whether primaquine should be added to artemisinin combination treatments for the treatment of falciparum malaria to reduce further the transmissibility of the treated infection. Radical treatment with primaquine plays a key role in the eradication of vivax and ovale malaria. More evidence is needed on the safety of primaquine when administered without screening for G6PD deficiency to inform individual and mass treatment approaches in the context of malaria elimination programmes.