Roe Merryn S, O'Flaherty Katherine, Fowkes Freya J I
Disease Elimination Program, Burnet Institute, Melbourne, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Disease Elimination Program, Burnet Institute, Melbourne, Australia.
Trends Parasitol. 2022 May;38(5):356-364. doi: 10.1016/j.pt.2022.02.005. Epub 2022 Mar 4.
A large body of evidence demonstrates that Plasmodium falciparum infections are chronic in malaria endemic areas; however, the notion of spontaneous clearance in the absence of antimalarial drug treatment is rarely discussed. In this opinion article, we review and reinterpret data to postulate that spontaneous clearance of P. falciparum infections occurs frequently, has been demonstrated in a range of transmission settings, and confirmed by the most sensitive malaria diagnostic techniques. We also discuss factors which may influence the likelihood, measurement, and conclusions of spontaneous clearance. A greater understanding of the phenomenon of spontaneous clearance will advance our knowledge of malaria epidemiology, transmission potential of malaria parasites, as well as inform interventions for malaria control and elimination.
大量证据表明，在疟疾流行地区，恶性疟原虫感染呈慢性状态；然而，在不进行抗疟药物治疗的情况下自发清除感染这一概念却很少被讨论。在这篇观点文章中，我们回顾并重新解读数据，以假定恶性疟原虫感染的自发清除经常发生，已在一系列传播环境中得到证实，并通过最敏感的疟疾诊断技术得到确认。我们还讨论了可能影响自发清除的可能性、测量方法及结论的因素。对自发清除现象的更深入理解将推进我们对疟疾流行病学、疟原虫传播潜力的认识，并为疟疾控制和消除干预措施提供参考。
