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疫苗能成为消除疟疾的“灵丹妙药”吗?现实情况不容乐观。

Is vaccine the magic bullet for malaria elimination? A reality check.

机构信息

KEMRI-Wellcome Trust Research Programme, P.O. BOX 230, Kilifi, Kenya.

出版信息

Malar J. 2010 Dec 13;9 Suppl 3:S1. doi: 10.1186/1475-2875-9-S3-S1.

Abstract

Malaria remains a major health burden especially for the developing countries. Despite concerted efforts at using the current control tools, such as bed nets, anti malarial drugs and vector control measures, the disease is accountable for close to a million deaths annually. Vaccines have been proposed as a necessary addition to the armamentarium that could work towards elimination and eventual eradication of malaria in view of their historical significance in combating infectious diseases. However, because malaria vaccines would work differently depending on the targeted parasite stage, this review addresses the potential impact various malaria vaccine types could have on transmission. Further, because of the wide variation in the epidemiology of malaria across the endemic regions, this paper proposes that the ideal approach to malaria control ought to be tailor-made depending on the specific context. Finally, it suggests that although it is highly desirable to anticipate and aim for malaria elimination and eventual eradication, many affected regions should prioritize reduction of mortality and morbidity before aspiring for elimination.

摘要

疟疾仍然是一个主要的健康负担,特别是对发展中国家而言。尽管人们一直在努力使用现有的控制工具,如蚊帐、抗疟药物和病媒控制措施,但这种疾病每年仍导致近 100 万人死亡。鉴于疫苗在防治传染病方面的历史意义,疫苗被提议作为一种必要的补充手段,可以用于消除和最终根除疟疾。然而,由于疟疾疫苗的作用方式因针对的寄生虫阶段而异,因此本综述探讨了各种疟疾疫苗类型对传播可能产生的潜在影响。此外,由于疟疾在流行地区的流行病学存在广泛差异,本文提出,疟疾控制的理想方法应该根据具体情况量身定制。最后,它表明,尽管人们非常希望预测和追求消除和最终根除疟疾,但许多受影响地区在追求消除之前,应该优先考虑降低死亡率和发病率。

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