Roslin Institute, University of Edinburgh, UK.
Department of Veterinary Epidemiology and Public Health, School of Veterinary Medicine, University of Surrey, UK.
Acta Trop. 2021 Apr;216:105828. doi: 10.1016/j.actatropica.2021.105828. Epub 2021 Jan 16.
Malaria is the world's deadliest parasitic disease. Great progress has been made in the fight against malaria over the past two decades, but this has recently begun to plateau, in part due to the global development of antimalarial drug resistance. The ability to track drug resistance is necessary to achieve progress in treatment, disease surveillance and epidemiology, which has prompted the development of advanced diagnostic methods. These new methods provide unprecedented access to information that can help to guide public health policies. Development of new technologies increases the potential for high throughput and reduced costs of diagnostic tests; improving the accessibility of tools to investigate the forces driving disease dynamics and, ultimately, clinical outcomes for malaria patients and public health. This literature review provides a summary of the methods currently available for the detection of antimalarial drug resistance from the examination of patients' blood samples. While no single method is perfect for every application, many of the newly developed methods give promise for more reliable and efficient characterisation of Plasmodium resistance in a range of settings. By exploiting the strengths of the tools available, we can develop a deeper understanding of the evolutionary and spatiotemporal dynamics of this disease. This will translate into more effective disease control, better-informed policy, and more timely and successful treatment for malaria patients.
疟疾是全球最致命的寄生虫病。在过去的二十年中，在抗击疟疾方面取得了巨大进展，但最近这一进展开始趋于平稳，部分原因是抗疟药物耐药性在全球范围内的发展。为了在治疗、疾病监测和流行病学方面取得进展，有必要具备跟踪耐药性的能力，这促使了先进诊断方法的发展。这些新方法提供了前所未有的信息获取途径，有助于指导公共卫生政策。新技术的发展增加了高通量和降低诊断测试成本的潜力；提高了研究疾病动态驱动力的工具的可及性，并最终提高了疟疾患者和公共卫生的临床结果。本文综述了目前可从患者血液样本检测中检测抗疟药物耐药性的方法。虽然没有一种方法适用于每种应用，但许多新开发的方法有望在各种环境中更可靠、更有效地描述疟原虫的耐药性。通过利用现有工具的优势，我们可以更深入地了解这种疾病的进化和时空动态。这将转化为更有效的疾病控制、更明智的政策以及对疟疾患者更及时和成功的治疗。
