Na-Bangchang Kesara, Congpuong Kanungnit
Graduate Program in Biomedical Sciences, Faculty of Allied Health Sciences, Thammasat University, Pathumtanee, Thailand.
Tohoku J Exp Med. 2007 Feb;211(2):99-113. doi: 10.1620/tjem.211.99.
Malaria is the world's most important parasitic infection ranking among the major health and developmental challenges. Despite years of continual efforts, malaria is still one of the major causes of morbidity and mortality affecting third-world countries and still a threat to over 2 billion people, representing approximately 40% of the world's population in about 100 countries (Rollback Malaria 2005). During the "eradication era", half a century ago, malaria was eliminated or effectively suppressed in many parts of the world, particularly subtropical regions. The disease is now on the rise again since it is appearing in areas where it had disappeared. The disaster can largely be attributed to antimalarial drug resistance in most malaria endemic countries. Geographical distribution of the disease is worldwide, being found in tropical areas, throughout sub-Saharan Africa and to a lesser extent in South Africa, Southeast Asia, the Pacific Islands, India and Central and South America. Best estimates currently describe the annual global burden of malaria as 300-500 million cases and 1-2 million deaths. Over 90% of the disease burden is in sub-Saharan Africa. The malaria burden differs according to age and gender; almost all deaths occur in African children under 5 years of age (Snow et al. 2001). Pregnant women in Africa (especially primigravidae) are at high risk, and are the major adult risk group in the continent. An increasing number of imported cases of malaria have been reported particularly as a result of increasing worldwide travel to regions where there is ongoing risk of malaria transmission. Nowadays, cases of malaria acquired by international travelers from developed countries probably number 25,000 cases per year, with 10,000 of them reported annually and approximately 150 deaths per year.
疟疾是世界上最重要的寄生虫感染,位列主要的健康和发展挑战之中。尽管多年来不断努力,但疟疾仍是影响第三世界国家发病和死亡的主要原因之一,仍然威胁着超过20亿人口,约占世界100个国家总人口的40%(全球疟疾防治计划,2005年)。半个世纪前的“根除时代”,世界许多地区,特别是亚热带地区,疟疾已被消灭或得到有效控制。现在,这种疾病又开始抬头,在曾经消失的地区再度出现。这场灾难很大程度上可归因于大多数疟疾流行国家出现的抗疟药耐药性。该疾病的地理分布遍及全球,见于热带地区、撒哈拉以南非洲全境,在南非、东南亚、太平洋岛屿、印度以及中南美洲的分布范围较小。目前的最佳估计表明,全球疟疾的年负担为3亿至5亿病例以及100万至200万死亡。超过90%的疾病负担在撒哈拉以南非洲。疟疾负担因年龄和性别而异;几乎所有死亡都发生在非洲5岁以下儿童身上(斯诺等人,2001年)。非洲的孕妇(尤其是初产妇)风险很高,是该大陆主要的成年风险群体。报告的输入性疟疾病例越来越多,特别是由于前往存在疟疾传播风险地区的全球旅行增加。如今,来自发达国家的国际旅行者感染疟疾的病例每年可能有25000例,其中每年报告10000例,每年约有150人死亡。