在泰国-缅甸边境地区的抗梅花素抗性虫疟疾
F Nosten1, F ter Kuile, T Chongsuphajaisiddhi
1Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
Lancet (London, England)
|May 11, 1991
概括
针对疟疾的梅花素,硫素和甲胺 (MSP) 组合治疗的疗效显著下降. 杆菌的抗药性已经上升,导致治疗失败,特别是在儿童中,需要放弃这种药物治疗方案.
科学领域:
- 热带医学 热带医学
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 与硫素和甲胺 (MSP) 结合的梅花素是泰国广泛用于治疗无并发多抗性型疟疾的治疗方法.
- 最初的研究显示了高效率,在20世纪80年代末的治愈率超过98%.
研究的目的:
- 为了评估MSP结合疗法对型疟疾的当前疗效.
- 评估治疗失败率的变化,并确定导致疗效下降的潜在因素.
主要方法:
- 一项前性研究在泰缅边境对395名患有型疟疾的患者进行.
- 通过28天的治愈率来评估疗效,并根据年龄组分析治疗失败情况.
- 在患有复发性感染的患者中测量了血清梅花素度.
主要成果:
- 与以前的高率相比,MSP治疗的28天治愈率大幅下降至70.8%.
- 早期治疗失败率从0.27%增加到3.7%,其中6岁以下儿童的失败率更高 (50%).
- 患有复发性感染的患者的美弗洛基因度不低于成功治疗的患者,表明耐药性,而不是药理动力学问题.
结论:
- 杆菌 (Plasmodium falciparum) 迅速发展出对梅花素的耐药性,使MSP组合无效.
- 治疗失败率高,特别是在年轻年龄组,支持停止MSP治疗的必要性.
- 由于新兴的耐药性,需要紧急重新评估该地区的疟疾治疗策略.
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