Improving the design and analysis of drug efficacy/effectiveness studies in malaria and in selected neglected tropical diseases (NTDs).

传染性热带疾病给许多人带来巨大负担。绝大多数此类感染可以通过药物成功治疗和/或控制，因此持续提供有效药物是这些环境中医疗服务的重要组成部分。此类研究通常在人口移动的和基础设施差的地区进行，这意味着患者随访具有挑战性，而且往往不完整，高再感染率往往掩盖了成功的治疗结果。我们认为，目前的方法来衡量药物的疗效/有效性，在这些设置显然可以改善在一些领域。我们首先调查一个重要的范例物种，恶性疟疾，这是“三大”传染性杀手之一，然后转移到所谓的“被忽视的热带疾病”，最初的重点是shistosomes（一种“蠕虫”感染，通过接触含有蜗牛中间宿主的水传播）。我们还考虑了如何从正式药物临床试验以外的研究中获得药物疗效/有效性的信息，例如间歇性治疗方案。

Infectious tropical diseases place an enormous burden on many human populations. The vast majority of such infections can be successfully treated and/or controlled by drugs so the continued provision of effective drugs is an essential component of medical provision in these settings. Such studies often take place in areas where mobile human populations and poor infrastructure mean that patient follow-up is challenging and often incomplete, and where high re-infection rates often obscure successful treatment outcomes. We argue that current methods of measuring drug efficacy/effectiveness in these settings could clearly be improved in a number of areas. We start by investigating an important paradigm species, falciparum malaria, which is one of the 'big three' infective killers, and then move onto the so-called 'neglected tropical diseases' with initial emphasis on shistosomes (a 'worm' infection spread by contact with water containing the snail intermediate hosts). We also consider how information on drug efficacy/effectiveness can be obtained from studies outside of formal drug clinical trials, such such as intermittent treatment programmes.