Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Kintampo Health Research Centre, Research and Development Division, Ghana Health Service, Kintampo North Municipality, Bono East Region, Ghana.
Curr Opin Pediatr. 2024 Apr 1;36(2):164-170. doi: 10.1097/MOP.0000000000001332. Epub 2024 Jan 22.
Malaria cases and deaths decreased from 2000 to 2015 but remain increased since 2019. Several new developments and strategies could help reverse this trend. The purpose of this review is to discuss new World Health Organization (WHO) guidelines and recent research on malaria prevention in children.
Fifteen countries have now rolled out seasonal malaria chemoprophylaxis (SMC) in children at highest risk for severe malaria, and new WHO recommendations provide more flexibility for SMC implementation in terms of target age groups, geographic region, and number of cycles. Recent studies confirm that malaria burden in school aged children, and their contribution to transmission, is high. New guidelines permit expanded chemoprevention options for these children. Two vaccines have been approved for use in malaria endemic countries, RTS,S/AS01 E and R21/Matrix-M. Additionally, pyrethroid-chlorfenapyr bed nets are being deployed to combat resistant mosquitoes.
While challenges remain in malaria control towards elimination, new guidelines and recently approved vaccines offer hope. Monitoring for continued vaccine and chemoprevention effectiveness, and for possible epidemiologic shifts in severe malaria presentation and deaths as additional prevention efforts roll out will be paramount.
目的综述：从 2000 年到 2015 年，疟疾发病和死亡病例有所减少，但自 2019 年以来又有所增加。一些新的进展和策略可能有助于扭转这一趋势。本综述的目的是讨论世界卫生组织（WHO）新的指南以及最近关于儿童疟疾预防的研究。
最新发现：现在已有 15 个国家在疟疾高危儿童中开展季节性疟疾化学预防（SMC），WHO 的新建议在目标年龄组、地理区域和周期数量方面为 SMC 的实施提供了更大的灵活性。最近的研究证实，学龄儿童的疟疾负担及其对传播的贡献很高。新指南允许为这些儿童扩大化学预防选择。两种疫苗已获准在疟疾流行国家使用，即 RTS,S/AS01 E 和 R21/Matrix-M。此外，正在部署拟除虫菊酯-氯菊酯蚊帐以对抗抗药性蚊子。
总结：尽管在消除疟疾控制方面仍存在挑战，但新的指南和最近批准的疫苗带来了希望。随着更多的预防措施的实施，监测疫苗和化学预防的持续效果，以及疟疾严重程度和死亡的可能的流行病学转变，将是至关重要的。
