Kuisamushonga wezvipembeneneMambure emahwindo (ITNs) ari pamahwindo akavhurika, mahwindo, uye maburi emadziro mudzimba dzisina simba inhanho inogona kushandiswa mukudzivirira malaria.kudzivirira umhutukubva mukupinda mumba, zvichipa migumisiro inouraya uye isingauraye pazvirwere zvemalaria uye zvingangoderedza kutapurirana kwemalaria. Nokudaro, takaita ongororo yezvirwere mumhuri dzekuTanzania kuti tiongorore kushanda kwemishonga yekudzivirira zvipembenene (ITNs) mukudzivirira kubva kuhutachiona hwemalaria nezvirwere zvinopararira mumba.
MuCharinze District, Tanzania, mhuri 421 dzakaiswa mumapoka maviri zvisina tsarukano. Kubva muna Chikumi kusvika muna Chikunguru 2021, mambure eumhutu ane deltamethrin ne synergist akaiswa pamahwindo, mahwindo, uye mumadziro muboka rimwe, nepo rimwe boka risina kuiswa. Mushure mekuiswa, pakupera kwemwaka wemvura wakareba (Chikumi/Chikunguru 2022, mhedzisiro yekutanga) uye mwaka wemvura mupfupi (Ndira/Kukadzi 2022, mhedzisiro yechipiri), nhengo dzese dzemhuri dzaitora chikamu (vane makore ≥ mwedzi mitanhatu) vakaongororwa hutachiona hwemalaria nehuwandu hwePCR. Mhedzisiro yechipiri yaisanganisira huwandu hweumhutu pahumwe husiku (Chikumi/Chikunguru 2022), maitiro asina kunaka mwedzi mumwe mushure mekuiswa kwembure (Nyamavhuvhu 2021), uye chemobioavailability uye residues gore rimwe mushure mekushandiswa kwembure (Chikumi/Chikunguru 2022). Pakupera kwekuyedzwa, boka rekutonga rakawanawo mambure eumhutu.
Chidzidzo ichi hachina kukwanisa kuwana mhedziso nekuda kwekusakwana kwesampuro nekuda kwekurambwa kwevamwe vagari kuti vatore chikamu. Kuedzwa kukuru kwakarongwa kwakaitwa nemapoka akasiyana-siyana, kunyanya kusanganisira kuiswa kwezvidzitiro zvemahwindo zvakarapwa nemushonga wezvipembenene unogara kwenguva refu, kunodiwa kuti kupindira uku kuongororeke.
Ruzivo rwekupararira kwemarariya rwakaongororwa pachishandiswa nzira yekutevera protocol, zvichireva kuti vanhu vakafamba mukati memavhiki maviri ongororo isati yaitwa kana kuti vakatora mishonga yekurwisa marariya vakabviswa muongororo iyi.
Nekuti huwandu hweumhutu hwakabatwa panguva yekuongorora hwaive hushoma, modhi isina kugadziriswa ye binomial regression yehuwandu hweumhutu hwakabatwa husiku hwega hwega nemusungo wega wega ndiyo yakashandiswa kuona huwandu hweumhutu huri mukamuri.
Pamhuri mazana mana nemakumi mashanu dzakasarudzwa mumisha mipfumbamwe yese, pfumbamwe dzakabviswa nekuti dzakanga dzisina matenga akavhurika kana mahwindo vasati vaita sarudzo. Muna Chivabvu 2021, mhuri mazana mana nemakumi mana nerimwe dzakaitwa sarudzo dzakarongwa nemisha: mhuri mazana maviri nemakumi maviri nerimwe dzakaiswa muboka revanofema mweya (IVS), uye dzimwe 220 dzakasara dzakaiswa muboka revanofema mweya. Pakupedzisira, mhuri mazana maviri nemasere dzakapedza kuisa IVS, nepo 195 dzakaramba dziri muboka revanofema mweya (Mufananidzo 3).
Dzimwe ongororo dzinoratidza kuti ITS inogona kushanda zvakanyanya mukudzivirira malaria mumapoka ezera, dzimba, kana kana ikashandiswa nemambure eumhutu. Kuwanikwa kwezvinhu zvekudzivirira malaria, kunyanya mambure eumhutu, kwakataurwa kuti kwakaderera, kunyanya pakati pevana vezera rekuenda kuchikoro.[46] Kuwanikwa kushoma kwemambure mumhuri kunoita kuti kushandiswa kwemambure kushoma mumhuri, uye vana vezera rekuenda kuchikoro vanowanzoregeredzwa, nokudaro zvichiva chikonzero chekutapurirana kwemalaria nguva dzose.[16, 47, 48] Tanzania iri kuita zvirongwa zvekugovera, kusanganisira chirongwa chemambure echikoro, kuti iwedzere kuwanikwa kwemambure eumhutu kuvana vezera rekuenda kuchikoro.[14, 49] Zvichienderana nehuwandu hwakaderera hwekuwanikwa kwemambure (50%) panguva yeongororo uye chokwadi chekuti boka iri rinogona kusangana nematambudziko ekuwana mambure, ITS ingave yakapa dziviriro kuboka iri, nokudaro ichizadza mukaha wekudzivirira mukushandiswa kwemambure. Zvivako zvedzimba zvakabatanidzwa kare nekuwedzera kutapurirana kwemalaria; semuenzaniso, mitswe iri mumadziro evhu nemakomba ari mudenga rekare zvinoita kuti umhutu upinde.[8] Zvisinei, hapana humbowo hunotsigira izvi; Kuongororwa kwemapoka ekudzidza zvichienderana nerudzi rwemadziro, rudzi rwedenga, uye kushandiswa kwekare kweITN hakuna kuratidza musiyano uripo pakati peboka rekutonga neboka reITN.
Kunyangwe mhuri dzinoshandisa nzira yekudzora umhutu mumba (ITS) dzaive neumhutu hushoma hweAnopheles hwakabatwa pamusungo wega wega pahusiku, mutsauko wacho waiva mudiki zvichienzaniswa nedzimba dzisina ITS. Kubatwa kwakaderera mumhuri dzinoshandisa ITS kungave kuri nekuda kwekushanda kwayo kurwisa mhando dzeumhutu dzinodya nekurara mumba (semuenzaniso, Anopheles gambiae [50]) asi inogona kunge isingashande zvakanyanya kurwisa mhando dzeumhutu dzine mukana wekushanda panze (semuenzaniso, Anopheles africanus). Uyezve, maITS aripo anogona kunge asina huwandu hwakakwana uye hwakaringana hwepyrethroids nePBO uye, nekudaro, anogona kunge asina kushanda zvakakwana kurwisa Anopheles gambiae inodzivirira pyrethroid, sezvakaratidzwa muchikamu chekudzidza [Odufuwa, chiri kuuya]. Mhedzisiro iyi inogona kunge iri nekuda kwesimba risina kukwana rehuwandu. Kuti uone mutsauko we10% pakati peboka reITS neboka rekutonga rine simba re80% rehuwandu, mhuri mazana mashanu dzaidiwa paboka rega rega. Zvakatoipisisa ndezvokuti, chidzidzo ichi chakaitika panguva imwe chete nemamiriro ekunze asina kujairika muTanzania gore iroro, nekukwira kwekupisa uye kuderera kwemvura inonaya [51], izvo zvaigona kunge zvakakanganisa kuvapo uye kupona kweumhutu hweAnopheles [52] uye zvaigona kunge zvakaita kuti huwandu hweumhutu hwese huderere panguva yekudzidza. Kusiyana neizvi, pakanga pasina musiyano mukuru muhuwandu hwezuva nezuva hweCulex pipiens pallens mudzimba dzine ITS zvichienzaniswa nedzimba dzisina iyo. Sezvambotaurwa kare [Odufuwa, iri kuuya], chiitiko ichi chingave chakakonzerwa netekinoroji chaiyo yekuwedzera pyrethroids nePBO kuITS, iyo inoderedza simba rayo rekuuraya zvipembenene paCulex pipiens. Uyezve, kusiyana neumhutu hweAnopheles, Culex pipiens inogona kupinda muzvivakwa nepamasuo, sezvakawanikwa muongororo yeKenya [24] uye ongororo yezvipembenene muTanzania [53]. Kuisa masuo echidzitiro kunogona kunge kusiri kushanda uye kuchawedzera njodzi yekusangana nemishonga yezvipembenene nevanhu vanogaramo. Umhutu hweAnopheles hunonyanya kupinda nemudenga remvura [54], uye kupindira kukuru kunogona kukanganisa huwandu hweumhutu, sezvinoratidzwa nemuenzaniso zvichibva padata reSFS [Odufuwa, rinotevera].
Kukanganisa kwakataurwa nenyanzvi dzezvekurapa nevatori vechikamu kwaienderana nekukanganisa kwaizivikanwa pakubatwa nechirwere chepyrethroid [55]. Zvinonyanya kukosha kuti, kushushikana kwakawanda kwakataurwa kwakapera mukati memaawa makumi manomwe nemaviri mushure mekubatwa nechirwere ichi, sezvo vanhu vashoma chete (6%) vemhuri vakatsvaga rubatsiro rwechiremba, uye vese vakatora rubatsiro rwekurapa mahara. Kuwanda kwekuhotsira kwakaonekwa pakati penyanzvi gumi nenhatu (65%) kwakabatana nekukundikana kushandisa masiki akapihwa, zvichiratidza kusagadzikana uye hukama hunogona kunge hwakaita neCOVID-19. Zvidzidzo zveramangwana zvinogona kufunga nezvekuda kupfeka masiki.
MuCharinze District, hapana musiyano wakakosha wakaonekwa muhuwandu hwemarariya kana huwandu hweumhutu huri mumba pakati pemhuri dzine uye dzisina mahwindo ane zvipembenene (ITS). Izvi zvingangove zvichikonzerwa nekugadzirwa kwechidzidzo, hunhu hwezvipembenene nemarara, uye kubuda kwevakawanda muzvirwere. Pasinei nekushaikwa kwemusiyano wakakosha, kudzikira kwehuwandu hwezvipembenene mumhuri kwakaonekwa munguva yemvura yakareba, kunyanya pakati pevana vezera rechikoro. Huwandu hweumhutu hweAnopheles huri mumba hwakadererawo, zvichiratidza kuti panofanira kuenderera mberi nekudzidza. Nokudaro, kuti pave nechokwadi chekuti vatori vechikamu vanoramba vachitora chikamu, dhizaini yakarongwa isina kurongeka, pamwe nekubatanidzwa kwenharaunda uye kusvika kune vamwe, inokurudzirwa.
Nguva yekutumira: Mbudzi-21-2025