Ethical aspects of malaria control and research.
Ethical aspects of malaria control and research.
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DOI：
10.1186/s12936-015-1042-3
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发表时间：
2015-12-22
期刊：
影响因子：
3
通讯作者：
Selgelid MJ
中科院分区：
文献类型：
--
作者：
Jamrozik E;de la Fuente-Núñez V;Reis A;Ringwald P;Selgelid MJ
疟疾目前对人类造成的危害比任何其他寄生虫病都大，而且对低收入人口的影响不成比例。与其他主要的贫困疾病相比，控制或消除疟疾的努力提出的伦理问题几乎没有得到明确的分析。虽然与疟疾有关的一些伦理问题类似于其他传染病背景下的争论主题，但疟疾也因其独特的历史、流行病学和生物学而提出了独特的伦理问题。本文对以下特别突出的问题进行了初步的伦理分析：(1)全球卫生公正，(2)普遍获得疟疾控制举措，(3)多药耐药性，包括青蒿素联合疗法(ACT)耐药性，(4)强制筛查，(5)大规模给药，(6)伯氨喹的益处和风险，以及(7)献血和输血方面的疟疾。过去、现在和未来的疟疾研究活动也提出了一些伦理问题，特别是：(I)控制感染研究，(Ii)人类登陆渔获量，(Iii)传播阻断疫苗，和(Iv)转基因蚊子。这篇文章描绘了围绕疟疾控制和消除的这些重大伦理问题的领域。其目标是促进对与疟疾有关的伦理问题的进一步研究和讨论，并协助卫生工作者、研究人员和政策制定者追求合乎伦理的疟疾控制实践和政策。
Malaria currently causes more harm to human beings than any other parasitic disease, and disproportionally affects low-income populations. The ethical issues raised by efforts to control or eliminate malaria have received little explicit analysis, in comparison with other major diseases of poverty. While some ethical issues associated with malaria are similar to those that have been the subject of debate in the context of other infectious diseases, malaria also raises distinct ethical issues in virtue of its unique history, epidemiology, and biology. This paper provides preliminary ethical analyses of the especially salient issues of: (i) global health justice, (ii) universal access to malaria control initiatives, (iii) multidrug resistance, including artemisinin-based combination therapy (ACT) resistance, (iv) mandatory screening, (v) mass drug administration, (vi) benefits and risks of primaquine, and (vii) malaria in the context of blood donation and transfusion. Several ethical issues are also raised by past, present and future malaria research initiatives, in particular: (i) controlled infection studies, (ii) human landing catches, (iii) transmission-blocking vaccines, and (iv) genetically-modified mosquitoes. This article maps the terrain of these major ethical issues surrounding malaria control and elimination. Its objective is to motivate further research and discussion of ethical issues associated with malaria—and to assist health workers, researchers, and policy makers in pursuit of ethically sound malaria control practice and policy.