Phillips R S
Division of Infection and Immunity, University of Glasgow, Glasgow G12 8QQ, United Kingdom.
Clin Microbiol Rev. 2001 Jan;14(1):208-26. doi: 10.1128/CMR.14.1.208-226.2001.
Malaria remains one of the world's worst health problems with 1.5 to 2.7 million deaths annually; these deaths are primarily among children under 5 years of age and pregnant women in sub-Saharan Africa. Of significance, more people are dying from malaria today than 30 years ago. This review considers the factors which have contributed to this gloomy picture, including those which relate to the vector, the female anopheline mosquito; to human activity such as creating new mosquito breeding sites, the impact of increased numbers of people, and how their migratory behavior can increase the incidence and spread of malaria; and the problems of drug resistance by the parasites to almost all currently available antimalarial drugs. In a selective manner, this review describes what is being done to ameliorate this situation both in terms of applying existing methods in a useful or even crucial role in control and prevention and in terms of new additions to the antimalarial armory that are being developed. Topics covered include biological control of mosquitoes, the use of insecticide-impregnated bed nets, transgenic mosquitoes manipulated for resistance to malaria parasites, old and new antimalarial drugs, drug resistance and how best to maintain the useful life of antimalarials, immunity to malaria and the search for antimalarial vaccines, and the malaria genome project and the potential benefits to accrue from it.
疟疾仍然是世界上最严重的健康问题之一，每年导致150万至270万人死亡；这些死亡主要发生在撒哈拉以南非洲地区5岁以下儿童和孕妇中。值得注意的是，如今死于疟疾的人数比30年前更多。本综述探讨了导致这一严峻局面的因素，包括与传播媒介（雌性按蚊）相关的因素；人类活动，如创造新的蚊子滋生地、人口增加的影响以及其迁徙行为如何增加疟疾的发病率和传播；以及疟原虫对几乎所有现有抗疟药物产生耐药性的问题。本综述有选择地描述了为改善这种状况所采取的措施，一方面是在控制和预防中运用现有方法发挥有益甚至关键作用，另一方面是开发新的抗疟药物。涵盖的主题包括蚊子的生物防治、使用浸有杀虫剂的蚊帐、经过基因改造具有抗疟原虫能力的转基因蚊子、新旧抗疟药物、耐药性以及如何最好地延长抗疟药物的使用寿命、对疟疾的免疫力和寻找抗疟疫苗，以及疟疾基因组计划及其可能带来的潜在益处。
