Chen Ingrid T, Gosling Roly D
Malaria Elimination Initiative, Global Health Group, University of California, San Francisco, 50 Beale Street, Suite 1200, Box 1224, San Francisco, CA 94105, USA.
Expert Rev Clin Pharmacol. 2014 Nov;7(6):681-6. doi: 10.1586/17512433.2014.948421. Epub 2014 Aug 13.
Malaria transmission is declining worldwide, leading to a growing interest in strategies to reach elimination and eradication. Insecticide and drug resistance threaten these efforts, driving an interest in the use of gametocytocidal drugs to curb the spread of artemisinin resistance and accelerate the path to malaria elimination. Primaquine is the only marketed drug that can kill mature Plasmodium falciparum gametocytes, which can otherwise contribute to ongoing transmission for long periods of time. While primaquine has been widely used in Asia and the Americas, African countries have little experience with this drug and are reluctant to use primaquine due to a fear of hemolytic side effects. We discuss the underlying knowledge base and motivation to use primaquine as a P. falciparum transmission blocker, revealing that while primaquine implementation can benefit from further study, there remains an overall need for improved transmission-blocking drugs.
疟疾传播在全球范围内呈下降趋势，这使得人们对实现消除和根除疟疾的策略兴趣日增。杀虫剂和药物抗性对这些努力构成威胁，促使人们对使用杀配子体药物产生兴趣，以遏制青蒿素抗性的传播并加速疟疾消除进程。伯氨喹是唯一上市的能够杀死成熟恶性疟原虫配子体的药物，否则这些配子体可在很长一段时间内导致疟疾持续传播。虽然伯氨喹已在亚洲和美洲广泛使用，但非洲国家对这种药物几乎没有使用经验，并且由于担心溶血副作用而不愿使用伯氨喹。我们讨论了将伯氨喹用作恶性疟原虫传播阻断剂的基础知识和动机，结果表明，虽然伯氨喹的应用可从进一步研究中受益，但总体上仍需要改进的传播阻断药物。
