WorldWide Antimalarial Resistance Network (WWARN), UK.
Curr Opin Infect Dis. 2009 Dec;22(6):593-600. doi: 10.1097/QCO.0b013e328332c4a7.
Effective surveillance for and rapid identification of evolved antimalarial resistance ensures that all patients are treated with efficacious drugs. This review summarizes the current status and the challenges to effective surveillance, and suggests approaches for improvement.
The replacement of older drugs by artemisinin combination therapies (ACTs) as the recommended treatment for malaria has dramatically improved treatment outcomes wherever ACTs have been deployed effectively. Moreover, there has been considerable technical and organizational progress, and support for the health professionals needed to carry out this work is also increasing. As a result, the prospects for more effective surveillance of antimalarial resistance, and other vital health information are improving. However, resistance to the artemisinin component of ACTs is already suspected in Cambodia, and the current methods for tracking this resistance are not yet in place. Identification of efficient markers of ACT efficacy is a crucial challenge.
Technical advances alone are not sufficient. Detection of decreased drug efficacy is only the first step to producing accessible and useful information for decision makers. The translation of increased access to data on health outcomes into usable evidence for rational policy and planning requires a global coordination and communication effort.
有效的疟疾耐药性监测和快速鉴定可确保所有患者都使用有效药物进行治疗。本综述总结了当前的现状和面临的挑战，并提出了改进方法。
青蒿素联合疗法（ACTs）取代了旧的药物，成为疟疾的推荐治疗方法，在 ACTs 有效实施的地方，治疗效果显著改善。此外，在技术和组织方面都取得了相当大的进展，为开展这项工作提供的卫生专业人员支持也在增加。因此，更有效地监测抗疟药物耐药性和其他重要健康信息的前景正在改善。然而，柬埔寨已经怀疑 ACTs 中的青蒿素成分存在耐药性，目前还没有追踪这种耐药性的方法。确定 ACT 疗效的有效标志物是一个关键挑战。
仅靠技术进步是不够的。检测药物疗效下降只是为决策者提供可获得和有用信息的第一步。将更多关于健康结果的数据转化为合理政策和规划的有用证据，需要全球协调和沟通努力。
