Vestergaard Lasse S, Ringwald Pascal
Department of Epidemiology, Statens Serum Institut, Artillerivej 5, Copenhagen, Denmark.
Am J Trop Med Hyg. 2007 Dec;77(6 Suppl):153-9.
Reduced sensitivity of Plasmodium falciparum to formerly recommended cheap and well-known antimalarial drugs places an increasing burden on malaria control programs and national health systems in endemic countries. The high costs of the new artemisinin-based combination treatments underline the use of rational and updated malaria treatment policies, but defining and updating such policies requires a sufficient volume of high-quality drug-resistance data collected at national and regional levels. Three main tools are used for drug resistance monitoring, including therapeutic efficacy tests, in vitro tests, and analyses of molecular markers. Data obtained with the therapeutic efficacy test conducted according to the standard protocol of the World Health Organization are most useful for updating national treatment policies, while the in vitro test and molecular markers can provide important additional information about changing patterns of resistance. However, some of the tests are technically demanding, and thus there is a need for more resources for training and capacity building in endemic countries to be able to adequately respond to the challenge of drug resistance.
恶性疟原虫对先前推荐的廉价且知名抗疟药物的敏感性降低，给疟疾流行国家的疟疾控制项目和国家卫生系统带来了日益沉重的负担。新型青蒿素联合疗法的高昂成本凸显了合理且与时俱进的疟疾治疗政策的重要性，但制定和更新此类政策需要在国家和地区层面收集足够数量的高质量耐药性数据。耐药性监测主要使用三种工具，包括治疗效果测试、体外测试和分子标记分析。按照世界卫生组织标准方案进行的治疗效果测试所获得的数据，对于更新国家治疗政策最为有用，而体外测试和分子标记可以提供有关耐药性变化模式的重要补充信息。然而，其中一些测试技术要求较高，因此疟疾流行国家需要更多资源用于培训和能力建设，以便能够充分应对耐药性挑战。
