监测间歇性预防疗法治疗疟疾中的抗叶酸耐药性。
Monitoring antifolate resistance in intermittent preventive therapy for malaria.
机构信息
Howard Hughes Medical Institute/Center for Vaccine Development, University of Maryland School of Medicine, 685 West Baltimore Street, HSF1-480, Baltimore, MD 21201, USA; WorldWide Antimalarial Resistance Network (WWARN) Molecular Module(*).
出版信息
Trends Parasitol. 2013 Oct;29(10):497-504. doi: 10.1016/j.pt.2013.07.008. Epub 2013 Aug 12.
Abstract
Mutations in the Plasmodium falciparum genes Pfdhfr and Pfdhps have rendered sulfadoxine-pyrimethamine (SP) ineffective for malaria treatment in most regions of the world. Yet, SP is efficacious as intermittent preventive therapy in pregnant women (IPTp) and infants (IPTi) and as seasonal malaria control in children (SMC). SP-IPTp is being widely implemented in sub-Saharan Africa. SP-IPTi is recommended where the prevalence of SP-resistant malaria parasites is low, whereas SMC is recommended for areas of intense seasonal malaria transmission. The continuing success of these interventions depends largely on the prevalence of Pfdhfr and Pfdhps resistance mutations in the target population. Here we review the relationship between resistance mutations and SP-IPT within target populations in the context of monitoring and informing implementation of this intervention.
摘要
疟原虫 falciparum 基因 Pfdhfr 和 Pfdhps 的突变使磺胺多辛-乙胺嘧啶（SP）在世界大多数地区对疟疾治疗无效。然而，SP 作为孕妇（IPTp）和婴儿（IPTi）的间歇性预防治疗以及儿童季节性疟疾控制（SMC）仍然有效。SP-IPTp 在撒哈拉以南非洲地区得到广泛实施。在 SP 耐药疟原虫流行率低的地方推荐使用 SP-IPTi，而 SMC 则推荐用于疟疾季节性传播强度高的地区。这些干预措施的持续成功在很大程度上取决于目标人群中 Pfdhfr 和 Pfdhps 耐药突变的流行率。在这里，我们回顾了在监测和告知这种干预措施的实施过程中，目标人群中耐药突变与 SP-IPT 之间的关系。
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