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疟疾。

Malaria.

机构信息

Department of Biochemistry, University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Boulevard, Dallas, Texas 75390-9038, USA.

Medicines for Malaria Venture, Geneva, Switzerland.

出版信息

Nat Rev Dis Primers. 2017 Aug 3;3:17050. doi: 10.1038/nrdp.2017.50.

Abstract

Malaria is caused in humans by five species of single-celled eukaryotic Plasmodium parasites (mainly Plasmodium falciparum and Plasmodium vivax) that are transmitted by the bite of Anopheles spp. mosquitoes. Malaria remains one of the most serious infectious diseases; it threatens nearly half of the world's population and led to hundreds of thousands of deaths in 2015, predominantly among children in Africa. Malaria is managed through a combination of vector control approaches (such as insecticide spraying and the use of insecticide-treated bed nets) and drugs for both treatment and prevention. The widespread use of artemisinin-based combination therapies has contributed to substantial declines in the number of malaria-related deaths; however, the emergence of drug resistance threatens to reverse this progress. Advances in our understanding of the underlying molecular basis of pathogenesis have fuelled the development of new diagnostics, drugs and insecticides. Several new combination therapies are in clinical development that have efficacy against drug-resistant parasites and the potential to be used in single-dose regimens to improve compliance. This ambitious programme to eliminate malaria also includes new approaches that could yield malaria vaccines or novel vector control strategies. However, despite these achievements, a well-coordinated global effort on multiple fronts is needed if malaria elimination is to be achieved.

摘要

疟疾是由疟原虫属的五种单细胞真核寄生虫(主要是疟原虫和疟原虫)引起的,通过按蚊属蚊子的叮咬传播。疟疾仍然是最严重的传染病之一;它威胁着世界近一半的人口,并导致 2015 年数十万人死亡,主要是非洲的儿童。疟疾的管理是通过结合病媒控制方法(如杀虫剂喷洒和使用经杀虫剂处理的蚊帐)以及治疗和预防药物来实现的。青蒿素联合疗法的广泛应用促成了与疟疾相关的死亡人数的大幅下降;然而,耐药性的出现有可能使这一进展逆转。我们对发病机制的基础分子基础的理解的进步推动了新的诊断、药物和杀虫剂的发展。有几种新的联合疗法正在临床开发中,对耐药寄生虫有效,并有可能在单剂量方案中使用,以提高依从性。消除疟疾的这一雄心勃勃的计划还包括可能产生疟疾疫苗或新型病媒控制策略的新方法。然而,尽管取得了这些成就,如果要实现消除疟疾,仍需要在多个方面进行协调一致的全球努力。

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