Mahidol Oxford Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok10400, Thailand.
Nat Rev Microbiol. 2010 Apr;8(4):272-80. doi: 10.1038/nrmicro2331. Epub 2010 Mar 8.
Artemisinin combination therapies are the first-line treatments for uncomplicated Plasmodium falciparum malaria in most malaria-endemic countries. Recently, partial artemisinin-resistant P. falciparum malaria has emerged on the Cambodia-Thailand border. Exposure of the parasite population to artemisinin monotherapies in subtherapeutic doses for over 30 years, and the availability of substandard artemisinins, have probably been the main driving force in the selection of the resistant phenotype in the region. A multifaceted containment programme has recently been launched, including early diagnosis and appropriate treatment, decreasing drug pressure, optimising vector control, targeting the mobile population, strengthening management and surveillance systems, and operational research. Mathematical modelling can be a useful tool to evaluate possible strategies for containment.
青蒿素联合疗法是大多数疟疾流行国家治疗无并发症恶性疟原虫疟疾的一线药物。最近，柬埔寨-泰国边境地区出现了部分青蒿素耐药恶性疟原虫。三十多年来，寄生虫种群暴露在亚治疗剂量的青蒿素单一疗法中，以及不合格青蒿素的供应，可能是该地区耐药表型选择的主要驱动力。最近启动了一项多方面的遏制计划，包括早期诊断和适当治疗、降低药物压力、优化病媒控制、针对流动人口、加强管理和监测系统以及开展业务研究。数学建模可以成为评估遏制策略的有用工具。
