マラリアの制御と撲滅

Malaria is one of the leading causes of death worldwide. According to the World Health Organization’s (WHO’s) world malaria report for 2018, there were 228 million cases and 405,000 deaths worldwide.Background The efficient allocation of financial resources for malaria control using appropriate combinations of interventions requires accurate information on the geographic distribution of malaria risk. An evidence-based description of the global range of Plasmodium falciparum malaria and its endemicity has not been assembled in almost 40 y. This paper aims to define the global geographic distribution of P. falciparum malaria in 2007 and to provide a preliminary description of its transmission intensity within this range. Methods and Findings The global spatial distribution of P. falciparum malaria was generated using nationally reported case-incidence data, medical intelligence, and biological rules of transmission exclusion, using temperature and aridity limits informed by the bionomics of dominant Anopheles vector species.

During the last decade, substantial progress has been made in controlling malaria worldwide through the large-scale implementation of effective malaria interventions. The magnitude of this progress has led some malaria-endemic countries, even those with historically high burdens of malaria, to consider the possibility of malaria elimination. Malaria elimination is defined as the reduction to zero of the incidence of infection caused by a specified malaria parasite in a defined geographical area as a result of deliberate efforts. Significant progress has been achieved in malaria control worldwide over the past decade. Increased financial support for malaria programs has enabled impressive reductions in transmission in many endemic regions. These successes have stimulated renewed discussion of how, when, and where malaria can be eliminated.

The World Health Organization Global Malaria Programme, in keeping with its mandate to set evidence-informed policies for malaria control, has convened the Malaria Policy Advisory Committee as a mechanism to increase the timeliness, transparency, independence and relevance of its recommendations to World Health Organization member states in relation to malaria control and elimination.As a result, there is a growing need for the malaria policy setting process to rapidly review increasing amounts of evidence.

The objectives of this study are to describe the malaria situation in Ghana and give a brief account of how mathematical modelling techniques could support a more informed malaria control effort in the Ghanaian context. A review is carried out of some mathematical models investigating the dynamics of malaria transmission in subSaharan African countries, including Ghana. Collaboration between malaria control experts and modellers will allow for more appropriate mathematical models to be developed. A core set of intervention and treatment options are recommended by the World Health Organization for use against falciparum malaria.

Control, elimination, and eradication of malaria are one of the world’s greatest public health challenges, especially in Sub-Saharan Africa.The expectation of producing an effectivevaccine has been on for 40 years, but the recent breakthrough announcement of a malaria vaccine showing some level of protection among infants and children 3-4 years post vaccination seems like an excellent starting point. The globally accepted strategy for the control of malaria rely on chemotherapy, but unfortunately the overreliance on chemotherapy without proper control of drug usage and diagnosis has encouraged the selection of drug-resistant parasites, significantly contributing to the problem. Therefore, the prospects of malaria eradication rest heavily on integrated approaches that would include chemotherapy, vector control, and manipulation of environmental and ecological characteristics, and vaccination.