Laboratory of Parasitology, Department of Virology, Parasitology and Immunology, Ghent University, Merelbeke, Belgium.
Curr Opin Infect Dis. 2012 Dec;25(6):703-8. doi: 10.1097/QCO.0b013e328358993a.
With the London Declaration on neglected tropical disease (NTD), we are entering a new era of combating NTDs. However, the worldwide prospects of increased mass drug administration (MDA) treatments warrant caution on the development of anthelmintic resistance. In this review, we discuss the practical implications of MDA programs on the development of anthelmintic resistance in human soil-transmitted helminths (STH).
There is poor evidence of anthelmintic resistance in human STH. Moreover, there is presumptive evidence that the refugia in MDA programs to control human STH is currently large, suggesting that the development of anthelmintic resistance in STH will be slow or may not occur. It remains unclear whether the current MDA strategy to control STH will sufficiently delay or prevent the development of anthelmintic resistance. First, differences in efficacy across and within STH species, and seasonal transmission of STH have not yet been considered. Second, any surveillance system to monitor drug efficacy is lacking. Finally, there is still no agreed strategy on how to deal with anthelmintic resistance once it emerges.
Although anthelmintic resistance in human STH is currently of limited concern, various actions should be put in place for its delay and monitoring, and strategies should be developed in case anthelmintic resistance occurs.
随着伦敦关于被忽视热带病（NTD）宣言的发布，我们正在进入一个防治 NTD 的新时代。然而，全球范围内增加大规模药物治疗（MDA）的前景需要警惕驱虫剂耐药性的发展。在这篇综述中，我们讨论了 MDA 方案对人类土壤传播性蠕虫（STH）驱虫剂耐药性发展的实际影响。
目前在人类 STH 中几乎没有驱虫剂耐药性的证据。此外，有初步证据表明，目前 MDA 方案控制人类 STH 的避难所很大，这表明 STH 中的驱虫剂耐药性的发展将是缓慢的，或者可能不会发生。目前尚不清楚控制 STH 的当前 MDA 策略是否足以延迟或预防驱虫剂耐药性的发展。首先，尚未考虑 STH 物种之间和内部的疗效差异以及 STH 的季节性传播。其次，缺乏监测药物疗效的任何监测系统。最后，一旦出现驱虫剂耐药性，仍然没有关于如何应对的商定策略。
尽管目前人类 STH 的驱虫剂耐药性引起的关注有限，但应采取各种措施来延迟和监测，并且应该制定策略以防出现驱虫剂耐药性。
