Dev V, Sharma V P, Hojai D
National Institute of Malaria Research (ICMR), Chachal, Guwahati, 781022 Assam India.
J Parasit Dis. 2009 Dec;33(1-2):13-22. doi: 10.1007/s12639-009-0002-7. Epub 2010 Feb 27.
Malaria is major public health illness in Assam and 30-40% of the population is estimated to be at high-risk. Despite decades of attempted control interventions, malaria transmission is perennial and persistent in most parts of the state mostly transmitted by Anopheles minimus. Malaria outbreaks are returning associated with high rise in Plasmodium falciparum and attributable death cases. Therapeutic efficacy investigations for treatment of malaria revealed that chloroquine resistance was widespread for which artemisinin-based combination therapy (ACT) is being instituted in the control program. For data based on the preceding years, we briefly reviewed the available information on transmission dynamics, vector biology and control, drug policy, and discuss the challenges and opportunities for strengthening interventions for malaria control to help design situation specific strategies to check impending disease outbreaks with special reference to Assam. Under increased assistance from external agencies, we strongly advocate scaling up interventions based on mass distribution of long-lasting insecticidal nets (LLINs) for prevention and ACTs for treatment of drug-resistant malaria, and developing strong health delivery system in high-risk areas for meeting the complex emergencies and achieving transmission reduction.
疟疾是阿萨姆邦的主要公共卫生疾病，估计30%-40%的人口处于高风险状态。尽管进行了数十年的控制干预，但该邦大部分地区的疟疾传播常年持续，主要由微小按蚊传播。疟疾疫情再度出现，与恶性疟原虫感染率大幅上升及死亡病例增加有关。疟疾治疗的疗效调查显示，氯喹耐药现象普遍，因此在防控项目中采用了以青蒿素为基础的联合疗法（ACT）。基于前几年的数据，我们简要回顾了关于传播动态、媒介生物学与控制、药物政策的现有信息，并讨论加强疟疾控制干预措施的挑战与机遇，以帮助制定因地制宜的策略，特别针对阿萨姆邦，遏制即将爆发的疾病疫情。在外部机构加大援助的情况下，我们强烈主张扩大干预措施，包括大规模分发长效驱虫蚊帐（LLINs）用于预防，以及采用ACT治疗耐药性疟疾，并在高风险地区建立强大的卫生服务体系，以应对复杂的紧急情况并减少传播。
