Malaria in Uganda: Challenges to control on the long road to elimination I. Epidemiology and current control efforts
Malaria in Uganda: Challenges to control on the long road to elimination I. Epidemiology and current control efforts
复制标题
DOI：
10.1016/j.actatropica.2011.03.004
复制
发表时间：
2012-03-01
期刊：
影响因子：
2.7
通讯作者：
Rosenthal, Philip J.
中科院分区：
文献类型：
--
作者：
Yeka, Adoke;Gasasira, Anne;Rosenthal, Philip J.
疟疾仍然是发展中世界的主要健康问题之一，乌干达承受着这一疾病带来的特别沉重的负担。由于缺乏可靠的数据，我们的了解受到限制，但显然，疟疾感染率、发病率和严重疟疾造成的死亡率仍然很高。乌干达在执行关键的疟疾控制措施方面取得了进展，特别是分发驱虫蚊帐、室内滞留喷洒杀虫剂、利用青蒿素综合疗法治疗无并发症的疟疾以及为孕妇提供间歇性预防治疗。然而，尽管人们对在其他地区消灭疟疾的潜力充满热情，但没有令人信服的证据表明，乌干达近年来疟疾的负担有所减轻。乌干达疟疾防治工作面临的主要挑战包括：疟疾传播强度非常高、保健资源不足、卫生系统薄弱、对疟疾流行病学和防治干预措施的影响认识不足、寄生虫对药物的抗药性和蚊子对杀虫剂的抗药性日益增强、病例管理不当、预防疟疾药物利用不足以及流行病防备和应对措施不足。尽管存在这些挑战，控制疟疾的前景已经改善，随着对潜在挑战的关注，乌干达在控制疟疾方面取得进展是可以预期的。(C)2011 Elsevier B.V.保留所有权利。
Malaria remains one of the leading health problems of the developing world, and Uganda bears a particularly large burden from the disease. Our understanding is limited by a lack of reliable data, but it is clear that the prevalence of malaria infection, incidence of disease, and mortality from severe malaria all remain very high. Uganda has made progress in implementing key malaria control measures, in particular distribution of insecticide-impregnated bednets, indoor residual spraying of insecticides, utilization of artemisinin-based combination therapy to treat uncomplicated malaria, and provision of intermittent preventive therapy for pregnant women. However, despite enthusiasm regarding the potential for the elimination of malaria in other areas, there is no convincing evidence that the burden of malaria has decreased in Uganda in recent years. Major challenges to malaria control in Uganda include very high malaria transmission intensity, inadequate health care resources, a weak health system, inadequate understanding of malaria epidemiology and the impact of control interventions, increasing resistance of parasites to drugs and of mosquitoes to insecticides, inappropriate case management, inadequate utilization of drugs to prevent malaria, and inadequate epidemic preparedness and response. Despite these challenges, prospects for the control of malaria have improved, and with attention to underlying challenges, progress toward the control of malaria in Uganda can be expected. (C) 2011 Elsevier B.V. All rights reserved.