Thellier Marc, Gemegah Ayawovi Arlene Jessicka, Tantaoui Ilhame
AP-HP, Centre National de Référence du Paludisme, Hôpital Pitié-Salpêtrière, 75013 Paris, France.
Sorbonne Université, Institut National de la Santé et de la Recherche Médicale (INSERM), IPLESP Institut Pierre-Louis d'Épidémiologie et de Santé Publique, 75013 Paris, France.
J Clin Med. 2024 Sep 24;13(19):5680. doi: 10.3390/jcm13195680.
This article examines the historical and ongoing efforts to fight malaria, a parasitic disease caused by species and transmitted by mosquitoes. Despite over a century of control efforts, malaria remains a major global health issue. In 2022, there were an estimated 249 million cases across 85 countries, leading to approximately 600,000 deaths. In the recently published Global Technical Strategy for Malaria 2016-2030, the World Health Organization (WHO) has prioritized malaria eradication. The main goals are to reduce malaria incidence and mortality by 90% by 2030 compared to 2015 levels. However, as of 2022, progress has been limited, with only a 2% reduction in incidence and a 6% reduction in mortality. This review traces the historical context of malaria, highlighting its ancient origins and the pivotal scientific discoveries in the late 19th century that paved the way for modern control measures. The Global Malaria Eradication Programme launched by the WHO in 1955 initially showed promise, largely due to the insecticide DDT, but ultimately failed to achieve its goals mainly due to logistical problems, vector resistance to DDT, and inadequate funding. Despite significant advances in the early 21st century, including the Roll Back Malaria initiative and increased international funding, malaria eradication remains a distant goal. Persistent challenges, such as weak healthcare systems, parasite and vector resistance to drugs and insecticides, and inadequate funding, continue to hamper global efforts. Therefore, this article underscores the need for a deeper understanding of malaria's history and recent evolution to inform future strategies for eradication.
本文探讨了抗击疟疾的历史及当前所做的努力。疟疾是一种由疟原虫引起、通过蚊子传播的寄生虫病。尽管经过了一个多世纪的防控努力,疟疾仍然是一个重大的全球健康问题。2022年,85个国家估计有2.49亿疟疾病例,导致约60万人死亡。在最近发布的《2016 - 2030年全球疟疾技术战略》中,世界卫生组织(WHO)已将消除疟疾列为优先事项。主要目标是到2030年将疟疾发病率和死亡率相较于2015年的水平降低90%。然而,截至2022年,进展有限,发病率仅降低了2%,死亡率降低了6%。这篇综述追溯了疟疾的历史背景,强调了其古老起源以及19世纪后期为现代防控措施奠定基础的关键科学发现。WHO于1955年发起的全球疟疾根除计划最初显示出了希望,这在很大程度上归功于杀虫剂滴滴涕(DDT),但最终未能实现目标,主要原因是后勤问题、病媒对DDT产生抗药性以及资金不足。尽管在21世纪初取得了重大进展,包括“击退疟疾”倡议和国际资金增加,但消除疟疾仍然是一个遥远的目标。诸如医疗保健系统薄弱、寄生虫和病媒对药物和杀虫剂产生抗药性以及资金不足等持续存在的挑战,继续阻碍着全球的努力。因此,本文强调有必要更深入地了解疟疾的历史和近期演变,以为未来的根除战略提供信息。