Resistant malaria spreading in South East Asia
耐葯瘧疾在東南亞蔓延
來源：BBC 翻譯：世界播
Malaria parasites resistant to key drugs have spread rapidly in South East Asia, researchers from the UK and Thailand say.
英國和泰國的研究人員表示，對關鍵藥物耐葯的瘧原蟲在東南亞迅速傳播。
The parasites have moved from Cambodia to Laos, Thailand and Vietnam, where half of patients are not being cured by first-choice drugs.
寄生蟲已經從柬埔寨轉移到寮國、泰國和越南，這些國家有一半的病人無法通過首選藥物治癒。
Researchers say the findings raise the "terrifying prospect" drug-resistance could spread to Africa.
研究人員說，這些發現增加了耐藥性瘧疾蔓延到非洲的可能性，「其前景將十分可怕」。
However, experts said the implications may not be as severe as first thought.
然而，專家表示，其影響可能不像最先想像的那麼嚴重。
What is happening?
發生了什麼？
Malaria is treated with a combination of two drugs - artemisinin and piperaquine.
瘧疾是用青蒿素和呱喹兩種藥物聯合治療的。
The drug combo was introduced in Cambodia in 2008.
這種組合藥物於2008年引入柬埔寨。
But by 2013, the first cases of the parasite mutating and developing resistance to both drugs were detected, in western parts of the country.
但到2013年，在該國西部地區發現了首例瘧原蟲變異並對這兩種藥物產生耐藥性的病例。
The latest study, published in the Lancet Infectious Diseases, analysed blood samples from patients across South East Asia.
這項發表在《柳葉刀傳染病》上的最新研究分析了東南亞各地患者的血液樣本。
Inspecting the parasite"s DNA showed resistance had spread across Cambodia and was also in Laos, Thailand and Vietnam.
對這種寄生蟲的DNA檢測顯示，這種抗藥性已經蔓延到柬埔寨各地，寮國、泰國和越南也出現了抗藥性。
It had also picked up further mutations, making it even more problematic.
檢測還發現了更多的突變，這使得問題更加嚴重。
In some regions, 80% of malaria parasites were drug resistant.
在有的地區，80%的瘧原蟲具有耐藥性。
"This strain has spread and has become worse," Dr Roberto Amato, from the Wellcome Sanger Institute, told BBC News.
來自維康桑格研究所的羅伯托·阿馬托博士在接受BBC新聞採訪時說：「這種耐藥性已經傳播開來，而且越來越嚴重。」
Does this mean the disease is becoming untreatable?
這是否意味著這種疾病變得無法治療？
No.
不。
A second study, published in the same journal, showed half of patients were not being cured with standard therapy.
發表在同一期刊上的另一項研究顯示，一半的患者無法通過標準療法治癒。
However, there are alternative drugs that can be used instead.
不過，還有其他藥物可以替代。
"With the spread and intensification of resistance, our findings highlight the urgent need to adopt alternative first-line treatments", Prof Tran Tinh Hien, from the Oxford University Clinical Research Unit, in Vietnam, said.
來自越南牛津大學臨床研究中心的Tran Tinh Hien教授說：「隨著耐藥性的擴散和加強，我們的研究結果凸顯了採用替代一線治療藥物的迫切需要。」
That could include using different drugs alongside artemisinin or using a combination of three drugs to overcome resistance.
可能包括在用青蒿素的同時使用不同的藥物，或者使用三種藥物的組合來克服耐藥性。
What"s the concern?
問題是什麼？
Huge progress has been made towards eliminating malaria. However, the development of drug resistance threatens that progress.
在消除瘧疾方面已取得巨大進展。然而，耐藥性的發展威脅到這一進展。
The other issue is if the resistance spreads further and reaches Africa, where more than nine in 10 cases of the disease are.
另一個問題是，這種耐藥性是否會進一步傳播，並蔓延到非洲。在非洲，每10個病例中就有9個是瘧疾病例。
"This highly successful resistant parasite strain is capable of invading new territories and acquiring new genetic properties, raising the terrifying prospect that it could spread to Africa, where most malaria cases occur, as resistance to chloroquine did in the 1980s, contributing to millions of deaths," Prof Olivo Miotto, from the Wellcome Sanger Institute and University of Oxford, said.
來自維康桑格研究所和牛津大學的奧利沃·米奧托教授說：「這種高度抗藥性寄生蟲菌株能夠入侵新的領土，獲得新的基因特性，這增加了它可能傳播到非洲的可能性，大多數瘧疾病例都發生在非洲，20世紀80年代對氯喹的抗藥性就導致了數百萬非洲人死亡。」。
What does this change for people living there?
對生活在那裡的人產生了什麼變化？
The findings will not change much in people"s day-to-day life in the Greater Mekong Subregion, in South East Asia.
研究結果不會對東南亞大湄公河次區域的人們的日常生活產生太大影響。
Tackling malaria is about more than just picking the right treatment after an infection.
對付瘧疾不僅僅是在感染後選擇正確的治療方法。
All the efforts around controlling the mosquitoes that spread the disease will not change.
還要注意採取各種措施來控制傳播這種疾病的蚊子。
However, the researchers say the drugs people are given after an infection should change.
不過，研究人員說，人們在感染後服用的藥物應該有所變化。
The studies also show genetic analysis of malaria parasites can help doctors keep one step ahead of emerging drug-resistance in order to give patients the right treatment.
這些研究還表明，對瘧原蟲的基因分析可以幫助醫生在出現耐藥性之前先行一步，以便為患者提供正確的治療。
Is this the whole picture?
這就是全部情況嗎？
The spread of resistance is set against the backdrop of falling cases in the region.
耐藥性的蔓延是在該地區病例不斷下降的背景下發生的。
"These parasites are scary beasts, there"s no doubt," Prof Colin Sutherland, from the London School of Hygiene and Tropical Medicine, said.
「毫無疑問，這些寄生蟲是可怕的野獸。」倫敦衛生和熱帶醫學院的科林·薩瑟蘭教授說。
"However, I wonder if these parasites are not very fit because the population as a whole is crashing."
「不過，我懷疑這些寄生蟲是不是不太適應，因為它們的種群整體正在崩潰。」
In Cambodia there were: 262,000 cases of malaria in 2008; 36,900 cases of malaria in 2018.
在柬埔寨，2008年有262,000例瘧疾病例；2018年瘧疾病例為36900例。
So, while the drug-resistant parasite has undoubtedly spread, it is not necessarily a global threat, according to Prof Sutherland.
因此，薩瑟蘭教授表示，儘管耐葯寄生蟲無疑已在傳播，但它不一定是一個全球性威脅。
"The implications are not as severe as we might think," he said.
「影響並不像我們想像的那麼嚴重。」他說。
How bad is malaria?
瘧疾有多嚴重？
There are about 219 million cases of malaria around the world each year.
全世界每年大約有2.19億瘧疾病例。
Symptoms include cycles of feeling cold and shivering followed by a high temperature with severe sweating.
癥狀包括周期性的感覺寒冷和顫抖，接著是高燒和大量出汗。
Without treatment, the parasite can lead to breathing problems and organ failure.
如果不進行治療，這種寄生蟲會導致呼吸問題和器官衰竭。
The disease kills about 435,000 people every year - most of them are children under the age of five.
這種疾病每年導致大約43.5萬人死亡，其中大多數是5歲以下的兒童。
香港九龍灣馬來街興發大廈15樓D室