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Malaria.
The Lancet ( IF 98.4 ) Pub Date : 2018-04-21 , DOI: 10.1016/s0140-6736(18)30324-6 Elizabeth A Ashley 1 , Aung Pyae Phyo 2 , Charles J Woodrow 3
The Lancet ( IF 98.4 ) Pub Date : 2018-04-21 , DOI: 10.1016/s0140-6736(18)30324-6 Elizabeth A Ashley 1 , Aung Pyae Phyo 2 , Charles J Woodrow 3
Affiliation
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Following unsuccessful eradication attempts there was a resurgence of malaria towards the end of the 20th century. Renewed control efforts using a range of improved tools, such as long-lasting insecticide-treated bednets and artemisinin-based combination therapies, have more than halved the global burden of disease, but it remains high with 445 000 deaths and more than 200 million cases in 2016. Pitfalls in individual patient management are delayed diagnosis and overzealous fluid resuscitation in severe malaria. Even in the absence of drug resistance, parasite recurrence can occur, owing to high parasite densities, low host immunity, or suboptimal drug concentrations. Malaria elimination is firmly back as a mainstream policy but resistance to the artemisinin derivatives, their partner drugs, and insecticides present major challenges. Vaccine development continues on several fronts but none of the candidates developed to date have been shown to provide long-lasting benefits at a population level. Increased resources and unprecedented levels of regional cooperation and societal commitment will be needed if further substantial inroads into the malaria burden are to be made.
中文翻译：
疟疾。
在根除失败的尝试之后，疟疾在 20 世纪末卷土重来。使用一系列改进工具（例如长效杀虫剂处理的蚊帐和基于青蒿素的联合疗法）重新进行的控制工作已将全球疾病负担减少了一半以上，但仍然很高，有 445 000 人死亡和 2 亿多病例在 2016 年。 个体患者管理的陷阱是严重疟疾的延迟诊断和过度热心的液体复苏。即使没有耐药性，由于寄生虫密度高、宿主免疫力低或药物浓度不理想，也可能发生寄生虫复发。消除疟疾已成为主流政策，但对青蒿素衍生物、其伙伴药物和杀虫剂的耐药性提出了重大挑战。疫苗开发在几个方面继续进行，但迄今为止开发的候选疫苗均未显示出在人群水平上提供长期益处。如果要进一步实质性地减轻疟疾负担，就需要增加资源和空前水平的区域合作和社会承诺。
更新日期：2018-04-20
中文翻译：
疟疾。
在根除失败的尝试之后，疟疾在 20 世纪末卷土重来。使用一系列改进工具（例如长效杀虫剂处理的蚊帐和基于青蒿素的联合疗法）重新进行的控制工作已将全球疾病负担减少了一半以上，但仍然很高，有 445 000 人死亡和 2 亿多病例在 2016 年。 个体患者管理的陷阱是严重疟疾的延迟诊断和过度热心的液体复苏。即使没有耐药性，由于寄生虫密度高、宿主免疫力低或药物浓度不理想，也可能发生寄生虫复发。消除疟疾已成为主流政策，但对青蒿素衍生物、其伙伴药物和杀虫剂的耐药性提出了重大挑战。疫苗开发在几个方面继续进行，但迄今为止开发的候选疫苗均未显示出在人群水平上提供长期益处。如果要进一步实质性地减轻疟疾负担，就需要增加资源和空前水平的区域合作和社会承诺。
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