Khan M Aslam, Smego Raymond A, Razi Syed Tabish, Beg M Asim
Department of Medicine, The Aga Khan University Hospital, Karachi.
J Coll Physicians Surg Pak. 2004 May;14(5):319-24.
The increasing prevalence of multi-resistant Plasmodium falciparum malaria worldwide is a serious public health threat to the global control of malaria, especially in poor countries like Pakistan. In many countries choloroquine-resistance is a huge problem, accounting for more than 90% of malaria cases. In Pakistan, resistance to choloroquin is on the rise and reported in up to 16- 62% of Plasmodium falciparum. four to 25% of Plasmodium falciparum also reported to be resistant to sulfadoxine-pyrimethamine and several cases of delayed parasite clearance have been observed in patients with Plasmodium falciparum malaria treated with quinine. In this article we have introduced the concept of artemisinin- based combination therapy (ACT) and emphasize the use of empiric combination therapy for all patients with Plasmodium falciparum malaria to prevent development of drug resistance and to obtain additive and synergistic killing of parasite.
全球多重耐药恶性疟原虫疟疾的患病率不断上升，对全球疟疾控制构成严重的公共卫生威胁，尤其是在巴基斯坦等贫穷国家。在许多国家，氯喹耐药是一个巨大问题，占疟疾病例的90%以上。在巴基斯坦，对氯喹的耐药性正在上升，在高达16%至62%的恶性疟原虫中有所报告。据报告，4%至25%的恶性疟原虫对磺胺多辛-乙胺嘧啶也有耐药性，在用奎宁治疗的恶性疟原虫疟疾患者中观察到几例寄生虫清除延迟的情况。在本文中，我们介绍了以青蒿素为基础的联合疗法（ACT）的概念，并强调对所有恶性疟原虫疟疾患者使用经验性联合疗法，以防止耐药性的发展，并实现对寄生虫的相加和协同杀灭。
