The de novo selection of drug-resistant malaria parasites
The de novo selection of drug-resistant malaria parasites
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DOI：
10.1098/rspb.2002.2241
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发表时间：
2003-03-07
影响因子：
4.7
通讯作者：
Pongtavornpinyo, W
中科院分区：
文献类型：
--
作者：
White, NJ;Pongtavornpinyo, W
抗疟药耐药性主要在疟疾传播率低的地区重新出现。由于人类疟疾感染中寄生虫数量呈对数分布，未得到充分治疗的高生物量感染是新产生抗疟药耐药性的主要来源，而使用抗疟药预防可提供低耐药性选择风险。缓慢消灭的抗疟药主要是通过为从其他地方获得的耐药寄生虫提供选择性过滤，而不是通过选择重新产生耐药性，从而鼓励耐药性。可通过使用抗疟药物组合来预防耐药性的重新出现。青蒿素衍生物组合尤其有效。确保对相对较少的严重感染患者进行适当治疗将减缓耐药性的出现。
Antimalarial drug resistance emerges de novo predominantly in areas of low malaria transmission. Because of the logarithmic distribution of parasite numbers in human malaria infections, inadequately treated high biomass infections are a major source of de novo antimalarial resistance, whereas use of antimalarial prophylaxis provides a low resistance selection risk. Slowly eliminated antimalarials encourage resistance largely by providing a selective filter for resistant parasites acquired from others, and not by selecting resistance de novo. The de novo emergence of resistance can be prevented by use of antimalarial combinations. Artemisinin derivative combinations are particularly effective. Ensuring adequate treatment of the relatively few heavily infected patients would slow the emergence of resistance.