期刊
AMERICAN JOURNAL OF TROPICAL MEDICINE AND HYGIENE
卷 95, 期 6, 页码 133-144出版社
AMER SOC TROP MED & HYGIENE
DOI: 10.4269/ajtmh.16-0268
关键词
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资金
- U.S. Public Health Service from the U.S. National Institutes of Health [U19AI089681, D43TW007120, K24AI068903, D43TW007393]
- Strengthening the diagnosis, treatment and surveillance strategies for malaria control and elimination in the Peruvian Amazon Agency: L'Academie Belge de Recherche et d'Enseignement superieur-Commission de la Cooporation au Developpement (ARES-CCD)
- Circulo de Investigacion: Hacia la eliminacion de la malaria en el Peru, (Convenio de Financiamiento) [008-2014-FONDECY]
- Produccion-Evaluacion de antigenos candidatos a vacunas y desarrollo de pruebas diagnosticas rapidas para Plasmodium falciparum en la Amazonia peruana [178-FINCyT-IB-2013]
- FOGARTY INTERNATIONAL CENTER [D43TW007120, D43TW007393] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES [K24AI068903, U19AI089681] Funding Source: NIH RePORTER
Malaria in Peru, dominated by Plasmodium vivax, remains a public health problem. The 1990s saw newly epidemic malaria emerge, primarily in the Loreto Department in the Amazon region, including areas near to Iquitos, the capital city, but sporadic malaria transmission also occurred in the 1990s-2000s in both north-coastal Peru and the gold mining regions of southeastern Peru. Although a Global Fund-supported intervention (PAMAFRO, 2005-2010) was temporally associated with a decrease of malaria transmission, from 2012 to the present, both P.vivax and Plasmodium falciparum malaria cases have rapidly increased. The Peruvian Ministry of Health continues to provide artemesinin-based combination therapy for microscopy-confirmed cases of P.falciparum and chloroquine-primaquine for P.vivax. Malaria transmission continues in remote areas nonetheless, where the mobility of humans and parasites facilitates continued reintroduction outside of ongoing surveillance activities, which is critical to address for future malaria control and elimination efforts. Ongoing P.vivax research gaps in Peru include the following: identification of asymptomatic parasitemics, quantification of the contribution of patent and subpatent parasitemics to mosquito transmission, diagnosis of nonparasitemic hypnozoite carriers, and implementation of surveillance for potential emergence of chloroquine-and 8-aminoquinoline-resistant P.vivax. Clinical trials of tafenoquine in Peru have been promising, and glucose-6-phosphate dehydrogenase deficiency in the region has not been observed to be a limitation to its use. Larger-scale challenges for P.vivax (and malaria in general) in Peru include logistical difficulties in accessing remote riverine populations, consequences of government policy and poverty trends, and obtaining international funding for malaria control and elimination.
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