Implications of Plasmodium vivax Biology for Control, Elimination, and Research.
Implications of Plasmodium vivax Biology for Control, Elimination, and Research.
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DOI：
10.4269/ajtmh.16-0160
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发表时间：
2016-12-28
期刊：
影响因子：
--
通讯作者：
Wongsrichanalai C
中科院分区：
文献类型：
--
作者：
Olliaro PL;Barnwell JW;Barry A;Mendis K;Mueller I;Reeder JC;Shanks GD;Snounou G;Wongsrichanalai C
本文总结了我们目前对间日疟原虫生物学的理解，它与恶性疟原虫的不同之处，以及这些差异如何解释需要间日疟原虫量身定制的干预措施。文章进一步指出了需要投资研究以帮助确定和制定此类具体干预措施的知识差距。减少和最终消灭间日疟原虫的主要障碍在于：1）与恶性疟原虫相比，间日疟原虫的媒介能力更强，因为它能够在较低温度下发育，在媒介中的孢子生殖周期更短，从而允许在温带传播，并使其对媒介控制措施不太敏感，而这些措施对恶性疟原虫是有效的; 2）休眠的肝脏形式的存在（催眠虫），从一次感染性叮咬持续多次复发发作，无法诊断，对除伯氨喹外的任何可用抗疟药都不敏感，常规使用受毒性限制; 3）低寄生虫密度，其难以用当前诊断检测，导致漏诊和延迟治疗（和延长的传播），加上4）在感染被诊断之前，在急性感染早期发生的传播阶段（配子体）。
This paper summarizes our current understanding of the biology of Plasmodium vivax, how it differs from Plasmodium falciparum, and how these differences explain the need for P. vivax-tailored interventions. The article further pinpoints knowledge gaps where investments in research are needed to help identify and develop such specific interventions. The principal obstacles to reduce and eventually eliminate P. vivax reside in 1) its higher vectorial capacity compared with P. falciparum due to its ability to develop at lower temperature and over a shorter sporogonic cycle in the vector, allowing transmission in temperate zones and making it less sensitive to vector control measures that are otherwise effective on P. falciparum; 2) the presence of dormant liver forms (hypnozoites), sustaining multiple relapsing episodes from a single infectious bite that cannot be diagnosed and are not susceptible to any available antimalarial except primaquine, with routine deployment restricted by toxicity; 3) low parasite densities, which are difficult to detect with current diagnostics leading to missed diagnoses and delayed treatments (and protracted transmission), coupled with 4) transmission stages (gametocytes) occurring early in acute infections, before infection is diagnosed.
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影响因子：
64.8
作者：
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影响因子：
3
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82.9
作者：
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3.3
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