Oladipo Habeebullah Jayeola, Tajudeen Yusuf Amuda, Oladunjoye Iyiola Olatunji, Yusuff Sodiq Inaolaji, Yusuf Rashidat Onyinoyi, Oluwaseyi Egbewande Muyiwa, AbdulBasit Muili Opeyemi, Adebisi Yusuff Adebayo, El-Sherbini Mona Said
Faculty of Pharmaceutical Sciences, University of Ilorin, P.M.B. 1515, Ilorin, 240003, Nigeria.
Department of Microbiology, Faculty of Life Sciences, University of Ilorin, P.M.B. 1515, Ilorin, 240003, Nigeria.
Ann Med Surg (Lond). 2022 Aug 18;81:104366. doi: 10.1016/j.amsu.2022.104366. eCollection 2022 Sep.
The ever-increasing cases and mortality due to malaria remains one of the most important public health threats, especially in sub-Saharan Africa-where this burden is considerably high. In 2020, sub-Saharan Africa accounted for about 95% of all cases and 96% of all malaria deaths with about 80% of these deaths reported in children under the age of 5. This review, adopting a public health focus, aimed to understand the challenges of malaria control in sub-Saharan Africa despite ongoing public health interventions. Our review highlights two important findings. First, the increasing resistance of malaria parasites to artemisinin-based combination therapy (ACT) and its partner drugs coupled with increased vector resistance to pyrethroids and insecticides is reversing the progress of public health interventions in keeping malaria under control. Second, the wanning for the efficacy of the WHO-approved vaccine i.e. RTS,S from 60 to 70% following 18 months of observation, and its short-term availability remains an impediment to achieving the WHO target of producing malaria vaccines with more than 75% efficacy by 2030. Our findings underline the need to reassess research priorities with a focus on vaccine production in sub-Saharan Africa. Furthermore, African governments and policymakers must be committed to invest both the political and financial capital in vaccine production and distribution.
疟疾导致的病例数和死亡率不断上升，仍然是最重要的公共卫生威胁之一，尤其是在撒哈拉以南非洲地区，那里的负担相当沉重。2020年，撒哈拉以南非洲地区约占所有疟疾病例的95%和所有疟疾死亡病例的96%，其中约80%的死亡病例报告发生在5岁以下儿童中。本综述以公共卫生为重点，旨在了解尽管有持续的公共卫生干预措施，但撒哈拉以南非洲地区疟疾控制面临的挑战。我们的综述突出了两项重要发现。第一，疟原虫对以青蒿素为基础的联合疗法（ACT）及其配套药物的耐药性不断增加，再加上病媒对拟除虫菊酯和杀虫剂的耐药性增强，正在扭转公共卫生干预措施在控制疟疾方面取得的进展。第二，世界卫生组织批准的疫苗即RTS,S在观察18个月后的效力从60%降至70%，其短期供应仍然是实现世界卫生组织到2030年生产效力超过75%的疟疾疫苗目标的一个障碍。我们的研究结果强调需要重新评估研究重点，重点是撒哈拉以南非洲地区的疫苗生产。此外，非洲各国政府和政策制定者必须致力于在疫苗生产和分发方面投入政治和财政资本。
