儿童无并发症疟疾的治疗：比较以青蒿素为基础的联合疗法。
Treating uncomplicated malaria in children: comparing artemisinin-based combination therapies.
机构信息
Uganda Malaria Surveillance Project, Kampala, Uganda.
出版信息
Curr Opin Pediatr. 2010 Dec;22(6):798-803. doi: 10.1097/MOP.0b013e32833fac44.
PURPOSE OF REVIEW
In response to increased resistance to conventional drugs, the WHO is promoting artemisinin-based combination therapy (ACT) for treating uncomplicated malaria. The objective of this report is to review the available evidence on the efficacy and effectiveness, acceptability, and deployment of ACT in resource-limited settings with a focus on sub-Saharan Africa.
RECENT FINDINGS
ACTs are very effective in the treatment of uncomplicated Plasmodium falciparum malaria in children. ACTs are relatively safe and tolerable with no reported resistance in sub-Saharan Africa despite indications of delayed clearance of infections in south-east Asia. The major challenges to the widespread use of ACT include its high cost, availability, and inefficient delivery due to, among other things, weak healthcare systems.
SUMMARY
ACTs are an essential tool in the fight to control and eliminate malaria. They are currently the most effective drugs against P. falciparum malaria. They should be deployed through programs that address availability, cost, adherence, and quality assurance. Initiatives including home-based management of malaria, improving public sector procurement and supply chains, and reducing private sector pricing should make ACTs more accessible for sub-Saharan African children who bear the brunt of the burden of malarial disease.
目的综述：为应对抗药性增加，世卫组织提倡采用青蒿素类复方疗法（ACT）治疗疟疾。本文旨在对 ACT 在资源有限环境下的疗效、有效性、可接受性和部署情况进行综述，重点关注撒哈拉以南非洲地区。
最近发现：ACT 对儿童的无并发症恶性疟原虫感染非常有效。ACT 相对安全，在撒哈拉以南非洲地区尚未出现耐药性报道，尽管有迹象表明在东南亚地区感染清除速度较慢。ACT 在广泛使用上面临的主要挑战包括高成本、可及性和低效的提供，这归因于医疗体系薄弱等多种因素。
总结：ACT 是疟疾防治的重要工具。ACT 是目前治疗恶性疟原虫感染最有效的药物。应通过确保药物供应、药物成本、药物可及性和质量保证等措施来推广 ACT。包括家庭管理疟疾、改善公共部门采购和供应链、降低私人部门价格等举措，都应致力于让 ACT 能惠及在疟疾疾病负担中首当其冲的撒哈拉以南非洲儿童。
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