Public health impact of drug resistant Plasmodium falciparum malaria
Public health impact of drug resistant Plasmodium falciparum malaria
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DOI：
10.1016/j.actatropica.2005.04.015
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发表时间：
2005-06-01
期刊：
影响因子：
2.7
通讯作者：
Bhattarai, A
中科院分区：
文献类型：
--
作者：
Björkman, AB;Bhattarai, A
恶性疟原虫对常用抗疟疾药物的抗药性惊人地增加，这是一个重大的公共卫生威胁。然而，这种影响难以量化。在低传播地区，急性症状（“流行病”）的增加往往很快就很明显，由于现有寄生虫种群面临的药物压力很大，抗药性迅速蔓延。在高传播地区，临床影响主要是长期/慢性感染，严重贫血的风险增加。非洲公共卫生记录中的死亡率估计数一般表明，当抗药性产生和蔓延时，儿童中与疟疾有关的死亡率会大幅增加（从2倍增加到11倍）。医院就诊和入院情况显示出类似的趋势。为了防止数百万非洲儿童的死亡，有必要在比以前假设的更早的阶段（从10%的治疗失败）改变政策，采用根治性的替代有效治疗。尽早改用青蒿素类联合疗法就是这样一项重要而紧迫的战略。(c)2005年由Elsevier B. V.出版
The alarming increase in Plasmodium falciparum resistance to commonly used anti-malarial drugs represents a major public health threat. The impact is however difficult to quantify. In low transmission areas, an increase in acute manifestations ("epidemic") is often quickly apparent and resistance is rapidly propagated due to high drug pressure on existing parasite populations. In high transmission areas, the clinical effects are mainly prolonged/chronic infections with increasing risk of severe anemia. Mortality estimates from public health records in Africa generally suggest significant increases (from 2- to 11-fold) in malaria-associated mortality among children when resistance develops and spreads. Hospital attendances and admissions show similar trends. Change of policy to alternative efficacious treatment with radical cure is necessary at an earlier stage (from 10% treatment failure) than previously assumed in order to prevent deaths in millions of African children. Early switch to artemisinin based combination therapy (ACT) represents such a critical and urgent strategy. (c) 2005 Published by Elsevier B.V.