疟疾与妊娠：流行病学,病理生理学与控制方案的选择

妊娠期疟疾的广泛研究在不断深入，但仍存在不少问题。疟疾是引起妊娠并发症的主要外在因素，其发生率和严重性取决于多种因素。本文综述了近年来关于妊娠疟疾的研究结果、问题以及控制方法的选择。     

1950-2017年江西省疟疾时空分布特征分析

目的　探索1950–2017年江西省疟疾时空分布特征，为江西省疟疾流行因素研究和消除疟疾策略的制定提供科学依据。方法　收集1950–2017年江西省以县为单位疟疾疫情和人口数据、历史流行虫种和传播媒介等资料，建立江西省疟疾地理信息系统（GIS）数据库。利用ArcGIS 10.3软件进行江西省疟疾发病数据分析和时空展示，探讨其空间分布特征。结果　1950–2017年，江西省疟疾发病大致可分为3个阶段，分别为1950–1975年高峰期、1976–1997年持续下降期和1998–2017年低水平波动期，期间经历了疟疾发病率下降、流行区范围缩小、流行程度显著降低到无本地感染病例的过程。疟疾流行区在空间分布上经历了由南部山区向北部平原转移，最后在平原聚集、滞留、徘徊和消散的过程；疟疾流行虫种经历了间日疟、恶性疟、三日疟混合流行向单一间日疟流行，再到输入间日疟、恶性疟、三日疟和卵形疟混合流行。传播媒介经历了中华按蚊、微小按蚊、嗜人按蚊等多种按蚊分布的复合媒介地区向中华按蚊单一媒介的变化过程。结论　自2012年起江西省连续多年无本地感染疟疾病例，阻断了疟疾传播，达到了消除疟疾标准，但输入性疟疾继发本地传播的风险将长期存在。     

科技引领 技术创新|为加速消除疟疾进程提供驱动力

江苏省启动消除疟疾行动以来，在疟疾流行病学、病原生物学和媒介生物学等方面开展了系列科学研究，并建立了一些新技术和新方法，这不仅为江苏省消除疟疾提供了有力保障、有效阻断了本地疟疾传播，还为全国乃至全球消除疟疾提供借鉴和技术支持。     

海南省高疟山区乡村医生和农场卫生员疟疾专业知识调查

作为疟疾社会经济研究内容之一，对海南高疟山区３个乡镇的乡村医生和２个国营农场的卫生员的疟疾专业知识进行了调查，结果表明其疟疾专业知识水平较低，显示这是当前疟防工作的薄弱环节，加强对基层卫生人员的疟疾专业知识培训是疟防工作的迫切任务之一。本文为今后有针对性的培训提供了参考。     

全球消除疟疾行动中主要非国家行为体及行动进展

在各国政府和以WHO为代表的非国家行为体共同努力下，全球疟疾防控工作取得了巨大成就，但疟疾对人类健康仍构成严重威胁。WHO作为全球消除疟疾行动领导者，制定了《2016-2030年全球疟疾技术战略》，并通过其全球疟疾规划司执行5个重点项目，推进《2016-2030年全球疟疾技术战略》目标的实现。此外，全球基金、美国总统防治疟疾行动计划和比尔及梅琳达·盖茨基金会也是全球消除疟疾行动的主要参与者，并发挥了重要作用。本文介绍了当前参与全球消除疟疾的主要非国家行为体；建议各行为体间加强沟通协调，并与各国政府紧密合作，共同努力实现全球消除疟疾的宏伟目标。     

蚊与疟原虫相互关系Ⅱ：支持疟原虫在按蚊体内发育的因子

疟疾是一种严重危害人类健康和阻碍流行区国家经济、社会发展的寄生虫病，随着多抗药虫株的出现和媒介按蚊对杀虫剂产生抗性，疟疾的防治面临新的挑战。对按蚊与疟原虫相互关系的研究，特别是寻找按蚊支持疟原虫发育因子，弄清疟原虫在蚊体内的配子生殖和孢子生殖机制，可为疟疾防治研究提供有益线索。近年来，这方面的研究已经取得了一些进展，     

疟疾诊断研究进展简述

疟疾是一种严重危害人类健康的疾病，长期以来疟疾的诊断主要依靠厚、薄血膜涂片检查疟原虫，这种方法虽然适用，但检查速度慢，对检查技能要求高，且容易出现漏检，在检测早期阶段疟原虫种类，判定有无混合感染方面也有很大的局限性［1，2，3］。因此探索敏感、特异、快速、简便的诊断方法成为疟疾防治的重要任务之一。随着对疟疾分子生物学研究的深入、并伴随着分子生物学技术和生物化学技术的提高，为疟疾的快速、准确诊断提供了新途径。本文拟对此方面的一些进展加以综述。l核酸探针和多聚酶链反应《WR）技术应用于疟疾的诊断核酸探针…     

疟疾传播阻断疫苗的研究现状和应用前景

随着疟疾传播阻断疫苗研究的深入开展，有望将疟疾控制在孤立在地域内，阻止疟原虫再次引入无疟区，阻断抗药性和突变虫株的蔓延，减少了对疟原虫“毒力”株的暴露，近来已鉴定了系列有望的候选传播阻断疫苗分子，本文对疟疾传播阻断凤苗的研究现状和应用前景作了一概述。     

海南省高疟山区乡村医生和农场卫生员疟疾专业知识调查

作为疟疾社会经济研究内容之一，对海南高疟山区３个乡镇的乡村医生和２个国营农场的卫生员的疟疾专业知识进行了调查，结果表明其疟疾专业知识水平较低，显示这是当前疟防工作的薄弱环节，加强对基层卫生人员的疟疾专业知识培训是疟防工作的迫切任务之一。本文为今后有针对性的培训提供了参考。     

雅安市雨城区健康教育、环境治理控制疟疾试点报告

目的：为早日实现基本消灭疟疾目标，探索适合我区的疟疾防治策略。方法：于1991年在历年疟疾发病高的草坝镇、合江镇、大兴镇、香花乡、凤鸣乡、和龙乡等6个镇乡设立防治试点。在执行疟疾防治常规性措施的同时，采取健康教育，行为干预，居住环境改造等在内的综合性措施。结果：疟疾发病率由1991年的25.73/万降至2001年的0.22/万，下降99.14％。疟疾在传染病总数的比例由33.54％下降为0.46％，下降98.63％。结论：综合治理控制了雨城区疟疾的流行，达到了卫生部颁布的“基本消灭疟疾标准”，显示健康教育，行为干预，居住环境改善，对控制疟疾流行起了重要作用。     

Challenges and prospects for malaria elimination in the Southern Africa region

The burden of malaria has decreased dramatically within the past several years in parts of sub-Saharan Africa, including regions of Southern Africa. Important to effective regional malaria control in Southern Africa is the appreciation that the reductions in malaria have not been achieved uniformly, with some countries experiencing resurgence. Understanding the reasons for sustained low-level malaria transmission in the face of control efforts, why malaria control efforts have not been successful in particular epidemiological settings and the epidemiological and transmission patterns following resurgence are critical to improving further malaria control and possible elimination. The overall goal of the International Center of Excellence for Malaria Research in Southern Africa is to contribute to regional malaria control efforts that can be sustained beyond the duration of the project. This goal will be achieved through a combination of: (1) state-of-the-art research on malaria epidemiology, vector biology and the genetics of the malaria parasite in three different epidemiological settings; (2) collaborations with national malaria control programs to develop locally adapted and sustainable control strategies; and (3) training, career development and capacity building at research institutions throughout the region.     

Human behavior and malaria

Human behavior in malaria is often narrowly referred to behavior of the target populations in transmission and control of malaria. In this presentation it was discussed that such view is too narrow. A broader framework incorporating illness behavior and human behavior in malaria control bureaucracies is needed for the success of national malaria control programme. Literature under the three broad categories of human behavior in malaria is reviewed to justify future directions in human behavior research and their significance for successful malaria control.     

Challenges and prospects for malaria elimination in the Greater Mekong Subregion

Despite significant improvement in the malaria situation of the Greater Mekong Subregion (GMS), malaria control for the region continues to face a multitude of challenges. The extremely patchy malaria distribution, especially along international borders, makes disease surveillance and targeted control difficult. The vector systems are also diverse with dramatic differences in habitat ecology, biting behavior, and vectorial capacity, and there is a lack of effective transmission surveillance and control tools. Finally, in an era of heavy deployment of artemisinin-based combination therapies, the region acts as an epicenter of drug resistance, with the emergence of artemisinin resistant Plasmodium falciparum posing a threat to both regional and global malaria elimination campaigns. This problem is further exacerbated by the circulation of counterfeit and substandard artemisinin drugs. Accordingly, this Southeast Asian Malaria Research Center, consisting of a consortium of US and regional research institutions, has proposed four interlinked projects to address these most urgent problems in malaria control. The aims of these projects will help to substantially improve our understanding of malaria epidemiology, vector systems and their roles in malaria transmission, as well as the mechanisms of drug resistance in parasites. Through the training of next-generation scientists in malaria research, this program will help build up and strengthen regional research infrastructure and capacities, which are essential for sustained malaria control in this region.     

青蒿素类药物与其他药物配伍治疗疟疾的研究进展

近年来抗疟药耐药现象的出现严重影响了疟疾的防治,新药的研发和疟疾疫苗的研究离临床应用还存在一定距离,联合用药是疟疾治疗的有效途径,已成为当今疟疾防治研究的热点。本文综述了青蒿素类药物与其他药物联合治疗疟疾的研究进展。     

江苏省疟疾传播媒介控制策略与研究

疟疾曾是江苏省流行的重大传染病之一,中华按蚊和嗜人按蚊是江苏省疟疾传播的主要媒介。经过几十年的积极防治,江苏省于2019年实现了消除疟疾目标,而媒介控制策略在全省消除疟疾过程中发挥了重要作用。本文回顾了江苏省主要疟疾传播媒介中华按蚊和嗜人按蚊的历史分布和生态习性以及不同防治阶段媒介控制策略和措施,并就媒介种类鉴定、品系构建、对疟原虫易感性、对杀虫剂抗性等媒介生物学及其防控研究概况进行了阐述。     

Malaria epidemiology and control in refugee camps and complex emergencies.

Owing to the breakdown of health systems, mass population displacements, and resettlement of vulnerable refugees in camps or locations prone to vector breeding, malaria is often a major health problem during war and the aftermath of war. During the initial acute phase of the emergency, before health services become properly established, mortality rates may rise to alarming levels. Establishing good case management and effective malaria prevention are important priorities for international agencies responsible for emergency health services. The operational strategies and control methods used in peacetime must be adapted to emergency conditions, and should be regularly re-assessed as social, political and epidemiological conditions evolve. During the last decade, research on malaria in refugee camps on the Pakistan-Afghanistan and Thailand-Burma borders has led to new methods and strategies for malaria prevention and case management, and these are now being taken up by international health agencies. This experience has shown that integration of research within control programmes is an efficient and dynamic mode of working that can lead to innovation and hopefully sustainable malaria control. United Nations' humanitarian and non-governmental agencies can play a significant part in resolving the outstanding research issues in malaria control.     

Cost effectiveness of malaria surveillance and monitoring measures

The aims of the research study on cost effectiveness of malaria surveillance and monitoring measures are presented. The nature of malaria surveillance and monitoring measures and the concept of cost effectiveness are examined. Progress in cost effectiveness analysis is discussed in terms of the interactive approach to a methodology, and the constraints on data collection and analysis. The implications of the study are then considered in terms of malaria control, the development of research capability and the nature of social and economic research.     

我国疟疾疫苗研究进展及前景

研发安全有效的疟疾疫苗是当前全球疟疾防治的重要需求。以生物技术为代表的新型技术的应用,有效推动了疟疾疫苗的研发进程。30多年疟疾疫苗研发已取得了重要的成果,鉴定了一批有价值的疫苗候选抗原,其中一些已进入临床试验,一些结果令人鼓舞。我国疟疾疫苗研发同样取得可喜进展。自主研制PfCP?鄄2.9疟疾疫苗在国内率先进入临床试验,一些疟疾疫苗候选抗原也陆续进入临床前研究阶段。近年来,多种国家科技计划和国际上研究经费的投入也促进我国疟疾疫苗的研发工作。尽管研发有效疫苗以控制乃至根除疟疾是个长期目标,取得疟疾疫苗突破仍需在疟疾免疫学以及多个技术层面上解决一些关键问题,但我们正在朝着这个目标迈进。     

Macdonald模型简介及其在疟疾流行区的应用

Macdonald模型是在Ross模型的基础上提出的,进一步发展了疟疾传播动力学理论。其基本繁殖率这一重要概念中的各项参数,为疟疾的流行病学调查和制订预防、控制措施提供了依据。在20世纪80年代,应用该模型对疟疾暴发流行区进行了广泛研究。近年来,中部地区疟疾有回升趋势,应用Macdonald模型对完善预警预报系统有重要作用。     

广西壮族自治区疟疾防治研究50年成就

广西疟疾流行历史久远,危害严重,经50余年的防治,全区疟疾发病率从1954年296.7‰下降至2007年的0.016‰,95.6%的县（市）达到部颁基本消除疟疾标准,全区基本消除恶性疟。广西疟疾防治研究成绩显著,流行区范围明显缩小,疟疾危害程度显著减轻。