孟加拉国消除疟疾的时代。

Bangladesh in the era of malaria elimination.

机构信息

Department of Biological Sciences, University of Notre Dame, Notre Dame, Indiana, IN, USA; Boler-Parseghian Center for Rare and Neglected Diseases, University of Notre Dame, Notre Dame, Indiana, IN, USA; Eck Institute of Global Health, University of Notre Dame, Notre Dame, Indiana, IN, USA.

Infectious Disease Division, International Center of Diarrheal Diseases, Bangladesh, (icddr, b), Dhaka, Bangladesh.

出版信息

Trends Parasitol. 2023 Sep;39(9):760-773. doi: 10.1016/j.pt.2023.06.009. Epub 2023 Jul 25.

DOI:10.1016/j.pt.2023.06.009

PMID:37500334

Abstract

Bangladesh has dramatically reduced malaria by 93% from 2008 to 2020. The strategy has been district-wise, phased elimination; however, the last districts targeted for elimination include remote, forested regions which present several challenges for prevention, detection, and treatment of malaria. These districts border Myanmar which harbors Plasmodium falciparum malaria parasites resistant to artemisinins, key drugs used in artemisinin-based combination therapies (ACTs) that have been vital for control programs. Challenges in monitoring emergence of artemisinin resistance (AR), tracking parasite reservoirs, changes in vector behavior and responses to insecticides, as well as other environmental and host factors (including the migration of Forcibly Displaced Myanmar Nationals; FDMNs) may pose added hazards in the final phase of eliminating malaria in Bangladesh.

摘要

孟加拉国在 2008 年至 2020 年间将疟疾发病率降低了 93%。其策略是分地区、分阶段消除疟疾；然而，最后几个目标消除疟疾的地区包括偏远的森林地区，这些地区给疟疾的预防、检测和治疗带来了一些挑战。这些地区与缅甸接壤，而缅甸存在对青蒿素类药物具有抗药性的恶性疟原虫寄生虫，青蒿素类药物是青蒿素类复方疗法（ACT）中的关键药物，对控制疟疾计划至关重要。在监测青蒿素耐药性（AR）的出现、追踪寄生虫库、蚊虫行为和对杀虫剂的反应变化以及其他环境和宿主因素（包括被迫流离失所的缅甸国民的迁移；FDMNs）方面的挑战，可能会给孟加拉国消除疟疾的最后阶段带来额外的危险。