Eliminating malaria--all of them.

摘要

In 1952, Lowell Coggeshall wrote "The greatest misconceptions about the treatment of malaria, especially in the past, have arisen from the fact that too many considered it a single disease. Malaria is not a disease-it is a variety of diseases." In The Lancet's Series, four papers detail the lofty goal of elimination for the broad spectrum of clinical manifestations, species, and stages of plasmodia that are responsible forthese many diseases (table). Do we have the tools to manage them all?For treatment, malaria workers have focused on asexual blood stages of Plasmodium faldparum to the exclusion of the many other malarias. Surveys of available therapies show the extraordinary dominance of P faldparum and this stage of parasite. Acute P faldparum malaria might be treated with 12 or more therapies; half as many are in clinical development. However, the only treatment for the asexual liver stages and the sexual blood stages of all species is primaquine, which is an imperfect therapy.