Bradley D J
London School of Hygiene and Tropical Medicine, UK.
Parassitologia. 1999 Sep;41(1-3):11-8.
The founding fathers of malariology combined scientific originality, perseverance in research, strong characters, breadth of interest and social concern. A hundred years later research and understanding has made immense progress but the world still bears a huge burden of malaria. For the next century research requires both more specialism and a holistic range if it is to be used in control, requiring multidisciplinary team work. Environmental changes and interventions produce a dynamic and changing pattern of malaria, not the static one of the past. From the original parasite life cycle, research has analysed a series of other cycles at electron microscope, biochemical and genome levels on decreasing size scales and quantitative epidemiological cycles for control. Recent additions to these concepts have been stage-specific antigens, cycles of disease rather than parasites alone, considering populations of parasites rather than just cases, and also genetic variation in each component of the parasite-human host-vector triad. In this volume there emerges for the first time a coherent overall picture of the biomedical aspects of basic malariology as the interacting population genetics of malaria parasites, anophelines and people. This provides a coherent model for the new century dealing with the great biological malaria problems of drug resistance, vaccine development, insecticidal and net control and can feed, with socio-economic work, into the gathering renewal of control efforts. New work on large-scale changes of malaria in space and time enables us to be precise about effects of local and global environmental changes to predict epidemics. Future research will be as much about linking these different scales of understanding as control will be about linking different levels of the health system. The grim situation in poor holoendemic countries also requires practical support of the type that the founders of malariology were involved in. A coherent understanding needs to feed into the new control efforts, from Roll Back Malaria onwards, for the next century.
疟疾学的创始人兼具科学原创性、研究毅力、坚强性格、广泛兴趣和社会关怀。一百年后，研究和认识虽已取得巨大进展，但世界仍承受着沉重的疟疾负担。在接下来的一个世纪里，若要将研究应用于疟疾防控，就既需要更专业化，也需要全面的研究范畴，这需要多学科团队合作。环境变化和干预措施使疟疾呈现出动态变化的模式，而非过去那种静态模式。从最初的寄生虫生命周期开始，研究已在电子显微镜、生化和基因组层面，按照逐渐缩小的规模，分析了一系列其他周期以及用于防控的定量流行病学周期。这些概念最近又增加了阶段特异性抗原、疾病周期而非仅仅是寄生虫周期、考虑寄生虫群体而非仅病例，以及寄生虫 - 人类宿主 - 媒介三元组各组成部分的基因变异。在本卷中，首次呈现出一幅连贯的基础疟疾学生物医学方面的整体图景，即疟原虫、按蚊和人类相互作用的群体遗传学。这为新世纪应对耐药性、疫苗研发、杀虫剂和蚊帐防控等重大疟疾生物学问题提供了一个连贯的模型，并且能够与社会经济工作相结合，推动防控工作的全面复兴。关于疟疾在时空上大规模变化的新研究，使我们能够准确了解局部和全球环境变化的影响，从而预测疫情。未来的研究将同样侧重于将这些不同层面的理解联系起来，正如防控工作将侧重于将卫生系统的不同层面联系起来一样。疟疾高度流行的贫困国家的严峻形势，也需要疟疾学创始人所从事的那种实际支持。在下个世纪，从“遏制疟疾”行动开始，连贯的认识需要融入新的防控工作中。
