Made in Europe: will artemisinin resistance emerge in French Guiana?

Malaria Journal

Opinion

Mathieu Nacher¹  Bernard Carme²  Félix Djossou³  Magalie Demar-Pierre³  François Nosten⁴  Philippe J Guérin⁵ 

[1] Centre d’Investigation Clinique Epidémiologie Clinique AntillesGuyane, Cayenne General Hospital, CIC-EC CIE 802, Cayenne, French Guiana;Equipe EPaT EA3593 Epidémiologie des Parasitoses et Mycoses Tropicales, Universite Antilles Guyane, Martinique, Antilles;Centre d’Investigation Clinique Epidémiologie Clinique AntillesGuyane, Cayenne General Hospital, CIC-EC CIE 802, Cayenne, French Guiana;Equipe EPaT EA3593 Epidémiologie des Parasitoses et Mycoses Tropicales, Universite Antilles Guyane, Martinique, Antilles;Centre Hospitalier de Cayenne, Laboratoire Hospitalo Universitaire de Parasitologie Mycologie, French Guiana, France;Equipe EPaT EA3593 Epidémiologie des Parasitoses et Mycoses Tropicales, Universite Antilles Guyane, Martinique, Antilles;Unité des Maladies Infectieuses et Tropicales, Centre Hospitalier de Cayenne, French Guiana, France;Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Bangkok, Thailand;World Wide Antimalarial Resistance Network (WWARN) and Nuffield Department ofClinical Medicine, University of Oxford, Old Road, OX3 7LJ, Oxford, UK;

关键词: Malaria;    Rapid Diagnostic Test;    Malaria Elimination;    Primaquine;    Infectious Disease Specialist;   

DOI  :  10.1186/1475-2875-12-152

 received in 2013-01-15, accepted in 2013-04-29,  发布年份 2013

来源: Springer

【 摘 要 】

Resistance to artemisinin casts a shadow on the fight against malaria. Theimportance of illegal gold miners and of malaria in isolated regions of FrenchGuiana constitutes a threat that endangers the fight against malaria in theAmazon. The hurdles of French laws and the remoteness of the territory fromFrance make it impossible for the system to adapt to the problem of totalinaccessibility of an important part of the malaria problem. Transmission ishigh in these areas and gold miners self-medicate with erratic regimens ofartemisinin combinations, thus creating perfect conditions for the emergence ofresistance. What needs to be done is being done, but within the limits ofnational law, with some results. However, facing the same difficult problem,Suriname shows more flexibility and is doing much better than French Guianadespite having lower resources. Local authorities in French Guiana cannotoverrule the laws that block appropriate malaria care from reaching a third ofmalaria-exposed persons. Thus the health authorities in France should takeimmediate calibrated legislative and financial measures to avoid a predictabledisaster.

【 授权许可】

CC BY   
© Nacher et al.; licensee BioMed Central Ltd. 2013