Genetic surveillance for monitoring the impact of drug use on Plasmodium falciparum populations.

Genetic surveillance for monitoring the impact of drug use on Plasmodium falciparum populations.
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DOI:
10.1016/j.ijpddr.2021.07.004
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发表时间:
2021-12
期刊:
International journal for parasitology. Drugs and drug resistance
影响因子:
--
通讯作者:
Volkman SK
Volkman SK
中科院分区:
其他
文献类型:
--
作者:
Ndiaye YD;Hartl DL;McGregor D;Badiane A;Fall FB;Daniels RF;Wirth DF;Ndiaye D;Volkman SK

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使用抗疟药物是防治疟疾的一项有效战略。然而,抗药性寄生虫的选择是继续使用这种方法的持续威胁。抗疟疾药物不仅用于治疗感染,而且也是减少疟疾传播以消除疟疾的人口战略的一部分。虽然有强有力的证据表明,持续使用抗疟药物增加了抗药性寄生虫出现和传播的风险,但尚不清楚人口一级使用基于药物的干预措施,如季节性疟疾化学预防(SMC)或大规模药物管理(MDA)可能会导致抗药性或药物疗效的丧失。对持续使用以药物为基础的减轻疟疾负担的战略至关重要的是监测与减少传播和抗药性选择有关的人口一级信号。在这里,我们专注于恶性疟原虫,并讨论了与传播变化相关的寄生虫种群的遗传特征,并与药物压力和耐药性有关。我们回顾了MDA和SMC有助于减轻疟疾负担和耐药选择的证据,并研究了这些干预措施在塞内加尔的使用和影响。在整个过程中,我们认为最好的策略,在不同的寄生虫种群参数的背景下,人口和耐药性信号进行监测。最后,我们提出了一个路线图,在人口水平的药物为基础的干预措施,以减少全球疟疾负担的持续监测。有效的抗疟药物使用减少了恶性疟原虫的遗传多样性。在人口一级使用基于药物的干预措施会导致耐药性。校准药物监测,以减少传播和耐药选择。监测季节性疟疾化学预防和大规模药物管理的使用。
The use of antimalarial drugs is an effective strategy in the fight against malaria. However, selection of drug resistant parasites is a constant threat to the continued use of this approach. Antimalarial drugs are used not only to treat infections but also as part of population-level strategies to reduce malaria transmission toward elimination. While there is strong evidence that the ongoing use of antimalarial drugs increases the risk of the emergence and spread of drug-resistant parasites, it is less clear how population-level use of drug-based interventions like seasonal malaria chemoprevention (SMC) or mass drug administration (MDA) may contribute to drug resistance or loss of drug efficacy. Critical to sustained use of drug-based strategies for reducing the burden of malaria is the surveillance of population-level signals related to transmission reduction and resistance selection. Here we focus on Plasmodium falciparum and discuss the genetic signatures of a parasite population that are correlated with changes in transmission and related to drug pressure and resistance as a result of drug use. We review the evidence for MDA and SMC contributing to malaria burden reduction and drug resistance selection and examine the use and impact of these interventions in Senegal. Throughout we consider best strategies for ongoing surveillance of both population and resistance signals in the context of different parasite population parameters. Finally, we propose a roadmap for ongoing surveillance during population-level drug-based interventions to reduce the global malaria burden. Effective antimalarial drug use decreases Plasmodium falciparum genetic diversity. Population-level use of drug-based interventions can contribute to drug resistance. Calibrate drug surveillance for transmission reduction and resistance selection. Monitor use of seasonal malaria chemoprevention and mass drug administration.
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影响因子: 3.7
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