Mak J W, Jegathesan M, Lim P K, Hakim S L, Rain A N, Ambu S, Chong H K
Institute for Medical Research, Kuala Lumpur, Malaysia.
Southeast Asian J Trop Med Public Health. 1992 Dec;23(4):572-7.
In spite of more than 30 years of control activities, malaria continues to be the most important parasitic infection in Malaysia, accounting for 39,189 confirmed cases in 1991, giving an annual parasite incidence rate of 2.2 per 1,000 population. Some factors contributing to the continued transmission of malaria are the development of drug resistant Plasmodium falciparum, changes in vector behavior, and ecological changes due to socio-economic reasons. Malaria parasite rates are higher among the Aborigines, land scheme settlers and those in intimate contact with the jungle, like loggers. There has been no substantial change in the proportion of the three common malaria species responsible for infections, P. falciparum, P. vivax, P. malariae and mixed infections accounting for about 70%, 28%, 1% and 1%, respectively of all infections. Drug resistant P. falciparum is unevenly distributed in Malaysia, but based on clinical experience and in vitro drug sensitivity studies, chloroquine resistance is frequently encountered. There has been clinical and laboratory evidence of resistance to sulfadoxine/pyrimethamine combination as well as quinine, but all these have so far been successfully treated with a combination of quinine and tetracycline. The eradication of the disease is impossible in the near future but there is confidence that with better surveillance techniques and the use of alternative control measures like permethrin impregnated bed-nets to complement existing ones, the target of bringing down the annual parasite incidence to 2 per 1,000 population during the Sixth Malaysian Plan period (1991-1995) can be achieved.
尽管开展了30多年的防治活动，但疟疾仍是马来西亚最重要的寄生虫感染疾病。1991年确诊病例达39,189例，年寄生虫发病率为每1000人2.2例。导致疟疾持续传播的一些因素包括抗药恶性疟原虫的出现、病媒行为的改变以及社会经济原因引起的生态变化。原住居民、垦殖计划定居者以及与丛林密切接触的人群（如伐木工）的疟疾寄生虫感染率较高。引起感染的三种常见疟原虫种类，即恶性疟原虫、间日疟原虫、三日疟原虫以及混合感染，在所有感染病例中所占比例分别约为70%、28%、1%和1%，这一比例并无实质性变化。抗药恶性疟原虫在马来西亚的分布并不均匀，但根据临床经验和体外药敏试验，氯喹耐药情况屡见不鲜。已有临床和实验室证据表明对磺胺多辛/乙胺嘧啶合剂以及奎宁存在耐药性，但到目前为止，所有这些病例均通过奎宁和四环素联合用药成功治愈。在不久的将来根除该疾病是不可能的，但人们相信，通过采用更好的监测技术以及使用诸如经氯菊酯处理的蚊帐等替代防治措施来补充现有措施，在马来西亚第六个五年计划期间（1991 - 1995年）将年寄生虫发病率降至每1000人2例的目标是可以实现的。
