Kuderera kuchangobva kuitika kwemutoro wemarariya muCôte d'Ivoire kunonyanya kukonzerwa nekushandiswa kwemambure ekuuraya zvipembenene kwenguva refu (LIN).Zvisinei, kufambira mberi uku kuri kutyisidzirwa nokusauraya zvipembenene, kuchinja kwemaitiro muvanhu veAnopheles gambiae, uye kutapurirwa kwemarariya kwasara, zvichiita kuti padiwe mamwe maturusi.Nokudaro, chinangwa chechidzidzo ichi chaiva chekuongorora kubudirira kwekushandiswa kwekubatana kweLLIN neBacillus thuringiensis (Bti) uye kuienzanisa neLLIN.
Chidzidzo ichi chakaitwa kubva munaKurume 2019 kusvika Kukadzi 2020 pamaoko maviri ekudzidza (LLIN + Bti ruoko uye LLIN chete ruoko) mudunhu reKorhogo hutano kuchamhembe kweCôte d'Ivoire.Muboka reLLIN + Bti, nzvimbo dzeAnopheles larval dzairapwa neBti mavhiki maviri ega ega kuwedzera kuLLIN.Umhutu uye huturu hwakaunganidzwa uye morphologically yakaonekwa kune genus uye marudzi vachishandisa nzira dzakajairika.Nhengo Ann.Iyo yeGambian yakaoma yakatemwa kushandisa polymerase chain reaction tekinoroji.Kubatwa nePlasmodium An.Chiitiko chemarariya muGambia uye vagari vemo vakaongororwawo.
Pakazara, Anopheles spp.Larval density yakanga yakaderera muLLIN + Bti boka richienzaniswa neLLIN chete boka 0.61 [95% CI 0.41-0.81] mhute / dive (l/dive) 3.97 [95% CI 3.56-4 .38] l/dive (RR = 6.50; 95% CI 5.81–7.29 P <0.001).Kumhanya kwese kuruma kweAn.Chiitiko cheS. gambiae bites chaiva 0.59 [95% CI 0.43-0.75] pamunhu / usiku muLLIN + Bti chete boka, zvichienzaniswa ne2.97 [95% CI 2.02-3.93] inoruma pamunhu / husiku muLLIN-chete boka (P <0.001).Anopheles gambiae sl inonyanya kuzivikanwa seAnopheles mosquito.Anopheles gambiae (ss) (95.1%; n = 293), achiteverwa neAnopheles gambiae (4.9%; n = 15).Nhamba yeropa revanhu munzvimbo yekudzidza yaiva 80.5% (n = 389).Iyo EIR yeboka reLLIN + Bti yaive 1.36 yakarumwa neutachiona pamunhu pagore (ib/p/y), nepo EIR yeboka reLLIN chete yaive 47.71 ib/p/y.Chiitiko chemarariya chakaderera zvakanyanya kubva ku291.8 ‰ (n = 765) kusvika ku111.4‰ (n = 292) muLLIN + Bti boka (P <0.001).
Kusanganiswa kweLLIN neBti kwakaderedza zvakanyanya kuitika kwemarariya.Iko kusanganiswa kweLLIN neBti inogona kunge iri nzira inovimbisa yakabatanidzwa yekutonga kunoshanda kweAn.Gambia haina malaria.
Pasinei nekufambira mberi mukutonga kwemarariya mumakumi mashoma emakore apfuura, mutoro wemarariya unoramba uri dambudziko guru muSouth Africa yeSahara [1].Sangano reWorld Health Organisation (WHO) nguva pfupi yadarika rakashuma kuti kune 249 miriyoni zviitiko zvemalaria uye inofungidzirwa kufa kwe608,000 inoenderana nemarariya pasi rose muna 2023 [2].The WHO African Region inotora 95% yematambudziko emarariya epasi rose uye 96% yekufa kwemarariya, nevakadzi vane pamuviri nevana vari pasi pemakore mashanu ekuberekwa vanonyanya kukanganiswa [2, 3].
Mambure ekuuraya zvipembenene anogara kwenguva refu (LLIN) uye kupfapfaidza kwemukati memba (IRS) vakaita basa rakakosha mukuderedza mutoro wemarariya muAfrica [4].Kuwedzerwa kwezvishandiso zvekudzivirira marariya zvakakonzera kudzikiswa kwe37% muchiitiko chemalaria uye kuderedzwa kwe60% kwekufa pakati pe2000 ne2015 [5].Nekudaro, maitiro akaonekwa kubva muna 2015 akamira zvinokatyamadza kana kutowedzera, nekufa kwemarariya kuri kuramba kwakakwira zvisingagamuchirwe, kunyanya kumaodzanyemba kweSahara Africa [3].Ongororo dzinoverengeka dzakaratidza kubuda uye kupararira kwekupokana pakati peiyo huru marariya vector Anopheles kune zvipembenene zvinoshandiswa muhutano hweveruzhinji sechipingamupinyi kune ramangwana kushanda kweLLIN uye IRS [6,7,8].Mukuwedzera, kuchinja kwevector kuruma maitiro kunze uye pakutanga kweusiku kune mutoro wekusara kwemarariya kutapukirwa uye iri kuwedzera kunetseka [9, 10].Kuganhurirwa kweLLIN neIRS mukudzora mavekita ane basa rekutapurirana kwasara ndiwo muganho mukuru wezvino kuedza kubvisa marariya [11].Mukuwedzera, kuramba kwemarariya kunotsanangurwa nemamiriro ekunze uye mabasa evanhu, izvo zvinobatsira pakusikwa kwenzvimbo yemarara [12].
Larval source management (LSM) inzvimbo yekuberekesa-yakavakirwa nzira yekudzora mavheti inovavarira kudzikisa huwandu hwenzvimbo dzekuberekesa uye huwandu hweumhutu nemapupa ari mukati mawo [13].LSM yakakurudzirwa nezvidzidzo zvakawanda seimwe nzira yakabatanidzwa yekudzivirira marariya vector [14, 15].Muchokwadi, kushanda kweLSM kunopa bhenefiti mbiri kurwisa kurumwa nemarariya vector mhando mukati nekunze [4].Pamusoro pezvo, vector control ine larvicide-based LSMs seBacillus thuringiensis israelensis (Bti) inogona kuwedzera huwandu hwesarudzo dzekudzivirira marariya.Nhoroondo, LSM yakaita basa rinokosha mukubudirira kwekutonga kwemarariya muUnited States, Brazil, Egypt, Algeria, Libya, Morocco, Tunisia neZambia [16,17,18].Kunyange zvazvo LSM yakaita basa rinokosha mukubatanidzwa kwezvipembenene mune dzimwe nyika dzakabvisa marariya, LSM haina kunyanya kubatanidzwa mumitemo yekudzivirira marariya vector uye maitiro muAfrica uye inoshandiswa chete muzvirongwa zvekudzivirira vector mune dzimwe nyika dziri pasi peSahara.nyika [14,15,16,17,18,19].Chimwe chikonzero cheizvi ndechekutenda kwakapararira kuti nzvimbo dzekuberekesa dzakawandisa uye dzakaoma kuwana, zvichiita kuti LSM idhure kwazvo kuita [4, 5, 6, 7, 8, 9, 10, 11, 13, 14].Nokudaro, World Health Organization yakakurudzira kwemakumi emakore kuti zvigadziro zvakakonzerwa nemarariya vector control zvinofanira kutarisa LLIN uye IRS [20, 21].Yakanga isati yasvika 2012 iyo World Health Organization yakakurudzira kubatanidzwa kweLSM, kunyanya kupindira kweBti, semubatsiri kuLLIN neIRS mune dzimwe nzvimbo muSouth Africa yeSahara [20].Sezvo WHO yakaita kurudziro iyi, zvidzidzo zvakawanda zvakaitwa pamusoro pekugona, kubudirira uye mari yebiolarvicides muSouth Africa yeSahara, ichiratidza kushanda kweLSM mukuderedza kusvibiswa kweAnopheles mosquito uye kubudirira kwekutapurirana kwemalaria maererano ne [22, 23].., 24].
Côte d'Ivoire iri pakati penyika gumi neshanu dzine mutoro mukuru wemarariya pasi rose [25].Kuwanda kwemarariya muCôte d'Ivoire inomiririra 3.0% yemutoro wemarariya wepasi rose, ine chiitiko chinofungidzirwa uye nhamba yezviitiko kubva pa300 kusvika pamusoro pe500 pavagari ve1000 [25].Pasinei nemwaka wakaoma wakareba kubva munaNovember kusvika muna Chivabvu, marariya inopararira gore rose kuchamhembe kweSavanna mudunhu [26].Kutapurirwa kwemarariya munharaunda ino kwakabatana nekuvapo kwenhamba huru yeasymptomatic vatakuri vePlasmodium falciparum [27].Munharaunda iyi, chirwere chemalaria chinonyanyozivikanwa ndiAnopheles gambiae (SL).Chengetedzo yenzvimbo.Anopheles gambiae mosquitoes anonyanya kuumbwa neAnopheles gambiae (SS), iyo inodzivirira zvakanyanya kumishonga inouraya zvipembenene uye naizvozvo inoisa njodzi huru yekusara kwemarariya kutapukirwa [26].Kushandiswa kweLLIN kunogona kuve nekushomeka kudzikisa kutapurira kwemarariya nekuda kwekupokana kwezvipembenene kwemavector emunharaunda uye nekudaro inoramba iri nharaunda yekunetseka kukuru.Zvidzidzo zvevatyairi vachishandisa Bti kana LLIN zvakaratidza kubudirira mukuderedza hutsi hwemosquito vector kuchamhembe kweCôte d'Ivoire.Zvisinei, hapana zvidzidzo zvekare zvakaongorora migumisiro yekudzokorora kushandiswa kweBti yakabatanidzwa neLLIN pakutapurirana kwemalaria uye chiitiko chemalaria munharaunda ino.Nokudaro, chidzidzo ichi chine chinangwa chekuongorora mhedzisiro yekushandiswa kwekubatana kweLLIN neBti pakutapurirwa kwemalaria nekuenzanisa boka reLLIN + Bti neboka reLLIN chete mumisha mina iri kuchamhembe kweCôte d'Ivoire.Zvaifungidzirwa kuti kushandisa Bti-based LSM pamusoro peLLIN kwaizowedzera kukosha nekuwedzera kuderedza kuwanda kweumhutu hwemalaria zvichienzaniswa neLLIN chete.Iyi nzira yakabatana, yakanangana nehumhutu hweAnopheles husina kukura hunotakura Bti nehumhutu hweAnopheles hwakatakura LLIN, hunogona kuve hwakakosha mukuderedza kutapurirwa kwemarariya munzvimbo dzine chirwere chemalaria chakanyanya, semisha iri kuchamhembe kweCôte d'Ivoire.Naizvozvo, mhedzisiro yeongororo iyi inogona kubatsira kusarudza kuti ingasanganisire here LSM muzvirongwa zvenyika zvekudzivirira marariya (NMCPs) munyika dziri kumaodzanyemba kweSahara.
Chidzidzo chezvino chakaitwa mumisha mina yedhipatimendi reNapieldougou (inozivikanwawo seNapier) muKorhogo sanitary zone kuchamhembe kweCôte d'Ivoire (Fig. 1).Misha iri kuongororwa: Kakologo (9° 14′ 2″ N, 5° 35′ 22″ E), Kolekakha (9° 17′ 24″ N, 5° 31′ 00″ E .), Lofinekaha (9° 17′ 31 ″).) 5° 36′ 24″ N) neNambatiurkaha (9° 18′ 36″ N, 5° 31′ 22″ E).Huwandu hweNapierledougou muna 2021 hwaifungidzirwa kuve vagari makumi matatu nerimwe, uye dunhu rine misha makumi mashanu nenhatu ine nzvimbo mbiri dzehutano [28].Mudunhu reNapyeledougou, uko marariya ndiyo inonyanya kukonzera kushanya kwekurapa, kuchipatara uye kufa, LLIN chete ndiyo inoshandiswa kudzora maAnopheles vectors [29].Misha yose mina mumapoka ezvidzidzo ese ari maviri anopihwa rubatsiro nenzvimbo imwe chete yezvehutano, ine zvinyorwa zvekiriniki zvezviitiko zvemalaria zvakaongororwa muongororo iyi.
Mepu yeCôte d'Ivoire inoratidza nzvimbo yekufunda.(Map source and software: GADM data and ArcMap 10.6.1. LLIN mambure ekuuraya zvipembenene kwenguva refu, Bti Bacillus thuringiensis israelensis
Kupararira kwemarariya pakati peNapier Health Center yakanangana nehuwandu hwevanhu yakasvika 82.0% (2038 kesi) (pre-Bti data).Mumisha mina yese, dzimba dzinoshandisa PermaNet® 2.0 LLIN chete, yakagoverwa neIvorian NMCP muna 2017, ine > 80% inowanika [25, 26, 27, 28, 30].Misha iyi ndeyedunhu reKorhogo, rinoshanda senzvimbo yekutarisa yeIvory Coast National Military Council uye inowanikwa gore rose.Mumwe nomumwe wemisha mina ine mhuri dzinenge zana uye vanenge vanhu vakafanana, uye maererano neregistry yezveutano (gwaro rinoshanda reIvorian Ministry of Health), zviitiko zvakawanda zvemarariya zvinoshumwa gore negore.Marariya inonyanya kukonzerwa nePlasmodium falciparum (P. falciparum) uye inotapuriranwa kuvanhu nePlasmodium.gambiae inotapurirwawo neAnopheles uye Anopheles nili mosquito munharaunda [28].Nzvimbo yenzvimbo An.gambiae inonyanya kuumbwa neAnopheles mosquito.gambiae ss ine nguva yakawanda ye kdr mutations (frequency range: 90.70-100%) uye ine mwero yakawanda yeace-1 alleles (frequency range: 55.56-95%) [29].
Avhareji yemvura inonaya pagore uye tembiricha inotangira pa1200 kusvika 1400 mm uye 21 kusvika 35 °C zvichiteerana, uye hunyoro hunoenderana (RH) hunofungidzirwa pa58%.Iyi nzvimbo yekudzidza ine mamiriro ekunze erudzi rweSudan ane mwaka wekuoma kwemwedzi mitanhatu (Mbudzi kusvika Kubvumbi) uye mwaka wemvura wemwedzi mitanhatu (Chivabvu kusvika Gumiguru).Dunhu iri riri kusangana nezvimwe zvinokonzerwa nekushanduka kwemamiriro ekunze, sekurasikirwa kwezvirimwa uye mwaka wakareba wekusanaya kwemvura, izvo zvinoonekwa nekuoma kwemvura (mapani, madhishi emupunga, madziva, madhamu) ayo anogona kushanda senzvimbo inogarwa nehonye dzeAnopheles. .Umhutu[26].
Chidzidzo ichi chakaitwa muboka reLLN + Bti, rinomiririrwa nemisha yeKakologo neNambatiurkaha, uye muboka reLLIN chete, rinomiririrwa nemisha yeKolekaha neLofinekaha.Munguva yeongororo iyi, vanhu mumisha yese iyi vanga vachishandisa PermaNet® 2.0 LLIN chete.
Kubudirira kweLLIN (PermaNet 2.0) pamwe chete neBti kurwisa umhutu weAnopheles uye kutapurirwa kwemalariya kwakaongororwa muyedzo yakasarudzika (RCT) nemaoko maviri ekudzidza: boka reLLIN + Bti (boka rekurapa) uye LLIN chete boka (boka rekutonga. ).Iyo LLIN + Bti sleeve inomiririrwa naKakologo naNambatiourkaha, nepo Kolékaha naLofinékaha vakagadzirwa seLLIN-chete mapendekete.Mumisha yose mina, vagari veko vari kushandisa LLIN PermaNet® 2.0 yakagamuchirwa kubva kuIvory Coast NMCP muna 2017. Zvinofungidzirwa kuti mamiriro ekushandisa PermaNet® 2.0 akafanana mumisha yakasiyana nokuti vakagamuchira network nenzira imwechete..Muboka reLLIN + Bti, nzvimbo dzeAnopheles larval dzairapwa neBti mavhiki maviri ega ega mukuwedzera kune iyo LLIN yatoshandiswa nevanhu.Nzvimbo dzekugara dzeLarval mukati memisha uye mukati memakiromita maviri kubva pakati pemusha wega wega dzakabatwa maererano nekurudziro yeWorld Health Organisation neNMCP yeCôte d'Ivoire [31].Kusiyana neizvi, boka reLLIN-chete harina kugamuchira larvicidal Bti kurapwa panguva yekudzidza.
Mvura-inoparadzirwa granular fomu yeBti (Vectobac WG, 37.4% wt; nhamba yakawanda 88-916-PG; 3000 International Toxicity Units IU/mg; Valent BioScience Corp, USA) yakashandiswa pachiyero che0.5 mg/L..Shandisa 16L yekusapfapfaidza bhegi uye pfuti yefiberglass yekupfapfaidza ine mubato uye inogadzirika muromo ine kuyerera kwe52 ml pasekondi (3.1 L/min).Kugadzirira nebulizer ine 10 L yemvura, chiyero cheBti chakaderedzwa mukusimwa ndeye 0.5 mg / L × 10 L = 5 mg.Semuenzaniso, kune imwe nzvimbo ine dhizaini yekuyerera kwemvura ye10 L, uchishandisa 10 L sprayer kurapa huwandu hwemvura, huwandu hweBti hunoda kuderedzwa ndeye 0.5 mg / L × 20 L = 10 mg.10 mg Bti yakayerwa mumunda uchishandisa chiyero chemagetsi.Uchishandisa spatula, gadzirira slurry nekuvhenganisa iyi chiyero cheBti mubhakiti yakapedza 10 L.Iyi dhizimusi yakasarudzwa mushure mekuedzwa kwemumunda kwekubudirira kweBti kurwisa akasiyana instars yeAnopheles spp.uye Culex spp.mumamiriro ezvinhu echisikigo munzvimbo yakasiyana, asi yakafanana nenharaunda yekutsvakurudza kwemazuva ano [32].Chiyero chekushandiswa kwekumiswa kwelarvicide uye nguva yekushandiswa kwenzvimbo imwe neimwe yekuberekesa yakaverengerwa zvichienderana nehuwandu hunofungidzirwa hwemvura panzvimbo yekuberekesa [33].Isa Bti uchishandisa yakagadziriswa ruoko sprayer.Nebulizers inogadziriswa uye inoedzwa panguva yekurovedza muviri uye munzvimbo dzakasiyana kuti ive nechokwadi chekuti huwandu hwakakwana hweBti hunounzwa.
Kuti riwane nguva yakanaka yekurapa nzvimbo dzekuberekesa makonye, chikwata chakaona kupfapfaidza kwemahwindo.Hwindo rekupfapfaidza inguva iyo chigadzirwa chinoshandiswa kuti chibudirire zvakanyanya: muchidzidzo ichi, hwindo rekupfapfaidza rinobva pamaawa gumi nemaviri kusvika kumasvondo maviri, zvichienderana nekushingirira kweBti.Sezviri pachena, kutorwa kweBti nemakonye panzvimbo yekuberekesa kunoda nguva kubva 7:00 kusvika 18:00.Nenzira iyi, nguva dzekunaya kwemvura zhinji dzinogona kudzivirirwa kana mvura ichireva kumira kupfapfaidza uye kutangazve zuva rinotevera kana mamiriro ekunze akabatana.Misi yekupfapfaidza uye mazuva chaiwo uye nguva zvinoenderana nemamiriro ekunze anocherechedzwa.Kuyera mabhegi ekupfapfaidza kune yaidiwa Bti application rate, tekinika yega yega inodzidziswa kutarisa nekuona uye kuseta muromo wekupfapfaidza uye kuchengetedza kudzvanywa.Calibration inopedzwa nekuona kuti chiyero chakakodzera chekurapa kweBti chinoshandiswa zvakaenzana pachikamu chimwe chete.Rapa inogara makonye masvondo maviri ega ega.Mabasa eLarvicidal anoitwa nerutsigiro rwevana vane ruzivo uye vakanyatsodzidziswa nyanzvi.Zviitwa zveLarvicidal uye vatori vechikamu vanotariswa nevatariri vane ruzivo.Kurapa kweLarvicidal kwakatanga munaKurume 2019 munguva yekupisa.Muchokwadi, chidzidzo chekare chakaratidza kuti mwaka wakaoma ndiyo nguva yakakodzera kwazvo yekupindira kwelarvicidal nekuda kwekugadzikana kwenzvimbo dzekuberekesa uye kuderera kwekuwanda kwavo [27].Kudzora makonye munguva yekusanaya kwemvura kunotarisirwa kudzivirira kukwezva kweumhutu munguva yekunaya kwemvura.Makirogiramu maviri (02) eBti anoita US$99.29 anobvumira boka rezvidzidzo rinowana kurapwa kuti ribate nzvimbo dzose.Muboka reLLIN + Bti, kupindira kwelarvicidal kwakatora gore rakazara, kubva muna March 2019 kusvika February 2020. Zvose zvezviitiko zve22 zvekugadzirisa larvicidal zvakaitika muboka reLLIN + Bti.
Zvinogona kuitika (zvakadai sekucheka, dzungu kana mhino inomhanya) zvakaongororwa kuburikidza neongororo yega yega yeBti biolarvicide nebulizers uye vagari vemumba vanotora chikamu muboka reLIN + Bti.
Ongororo yemumba yakaitwa pakati pemhuri mazana mana (dzimba mazana maviri paboka rekudzidza) kufungidzira chikamu chekushandiswa kweLLIN pakati pehuwandu.Pakuongorora mhuri, nzira yemibvunzo yehuwandu inoshandiswa.Kuwanda kwekushandiswa kweLLIN kwakakamurwa kuva mapoka matatu emakore: makore gumi nemashanu.Gwaro remibvunzo rakapedzwa rikatsanangurwa mumutauro weSenoufo weko kumukuru wemba kana mumwewo munhu mukuru ane makore 18 okukura.
Huwandu hudiki hwemhuri yakaongororwa hwakaverengerwa uchishandisa fomura yakatsanangurwa naVaughan naMorrow [34].
n ndiyo saizi yemuenzaniso, e muganho wekukanganisa, t ndiyo yekuchengetedza chinhu chinobva padanho rekuvimba, uye p chikamu chevabereki vevanhu vane hunhu hwakapihwa.Chinhu chimwe nechimwe chechikamu chine kukosha kunoenderana, saka (t) = 1.96;Huwandu hwemhuri muchiitiko ichi muongororo yaive dzimba mazana matatu nemakumi masere neina.
Kusati kwaitwa kuyedza kwazvino, marudzi akasiyana enzvimbo dzeAnopheles magonye ari muLLIN+Bti neLLIN mapoka akaonekwa, akatorwa sample, akatsanangurwa, georeferenced uye akanyorwa.Shandisa tepi kuyerwa kuyera ukuru hwenyuchi.Kuwanda kwehonye dzeumhutu dzakazoongororwa mwedzi nemwedzi gumi nemiviri panzvimbo 30 dzekuberekesa dzakasarudzwa zvisina tsarukano pamusha wega wega, kunzvimbo dzinosvika makumi matanhatu dzekuberekera paboka rezvidzidzo.Pakanga paine gumi nembiri samplings panzvimbo yekudzidza, inoenderana ne22 Bti marapiro.Chinangwa chekusarudza nzvimbo idzi makumi matatu dzekuberekera mhuka pamusha wega wega chaive chekutora nzvimbo dzakakwana dzekuunganidza makonye mumisha yose nezvikamu zvezvidzidzo kuitira kuderedza rusaruro.Makonye akaunganidzwa nekunyudzwa nechipunu chinosvika 60 ml [35].Nekuda kwekuti mamwe makireshi madiki uye asina kudzika, zvinodikanwa kushandisa bhaketi diki kunze kweiyo standard WHO bucket (350 ml).Huwandu hwe5, 10 kana 20 dive dzakagadzirwa kubva kunzvimbo dzekugara dzine denderedzwa re 10 m, zvichiteerana.Kuzivikanwa kwemorphological yezvipembenene zvakaunganidzwa (semuenzaniso Anopheles, Culex uye Aedes) kwakaitwa zvakananga mumunda [36].Mhungu dzakaunganidzwa dzakakamurwa kuita mapoka maviri zvichienderana nedanho rekukura: mapere ekutanga (matanho 1 ne2) uye ekupedzisira instar manyoka (matanho 3 ne4) [37].Makonye aiverengwa negenera uye padanho rega rega rekukura.Mushure mekuverenga, zvipembenene zveumhutu zvinodzoserwa kunzvimbo dzazvo kuberekera uye zvinowedzerwa kuhuwandu hwazvo hwepakutanga nemvura inobva mumvura inonaya.
Nzvimbo yekuberekesa yaionekwa seyakanaka kana gonye rimwe chete kana kuti pupa yemhando ipi neipi yeumhutu yaivepo.Larval density yakatemwa nekupatsanura huwandu hwemakonye emhando imwe chete nenhamba yedhivha.
Kunzvera kumwe nokumwe kwakatora mazuva maviri akatevedzana, uye mwedzi miviri yoga yoga, umhutu hwakura hwaiunganidzwa kubva mumisha gumi yaisarudzwa kubva mumusha mumwe nomumwe.Muchidzidzo chese, chikwata chega chega chetsvakurudzo chakaita ongororo dzemhuri makumi maviri pamazuva matatu akatevedzana.Umhutu hwakabatwa pachishandiswa misungo yehwindo (WT) uye pyrethrum spray traps (PSC) [38, 39].Pakutanga, dzimba dzose mumusha mumwe nomumwe dzakaverengwa.Dzimba ina mumusha mumwe nomumwe dzakabva dzasarudzwa zvisina tsarukano senzvimbo dzokuunganidzira mosikito dzavakuru.Mumba imwe neimwe yakasarudzwa zvisina tsarukano, umhutu hwaiunganidzwa kubva muimba huru yekurara.Imba yekurara yakasarudzwa ine magonhi nemahwindo uye yakagarwa husiku hwapfuura.Mimba yekurara inoramba yakavharwa usati watanga basa uye panguva yekuunganidza umhutu kudzivirira kuti umhutu husabhururuke kunze kwekamuri.A WT yakaiswa pahwindo rega rega reimba yekurara yega yega seye mosquito sampling point.Mangwana acho, mosquito dzakapinda pabasa dzichibva kudzimba dzekurara dzakaunganidzwa pakati pa06:00 na08:00 am.Unganidza umhutu kubva kunzvimbo yako yebasa uchishandisa muromo uye uchengete mukapu yepepa inoraswa yakavharwa nechidimbu chimbishi.Mosquito net.Umhutu hwakazorora mukamuri imwechete yekurara hwakatorwa pakarepo mushure mekuunganidzwa kweWT uchishandisa pyrethroid-based PSC.Mushure mekuparadzira mapepa machena pasi peimba yekurara, vhara magonhi nemahwindo uye pfapfaidza mushonga wezvipembenene (zvinoshandiswa zvinoshandiswa: 0.25% transfluthrin + 0.20% permetrin).Inenge 10 kusvika kumaminitsi e15 mushure mokupfapfaidza, bvisa mubhedha kubva muimba yekurara yakarapwa, shandisa tweezers kuti utore chero umhutu wakamhara pamashizha machena, uye uzvichengete muPetri dish yakazadzwa nemvura yakanyungudutswa yekotoni wool.Huwandu hwevanhu vakarara mudzimba dzekurara dzakasarudzwa hwakarekodhwawo.Umhutu hunenge hwaunganidzwa hunokurumidza kuendeswa kurabhoritari yepanzvimbo kuti hugadziriswe.
Murabhoritari, umhutu dzose dzakaunganidzwa dzakaonekwa morphologically kune genus uye marudzi [36].Ovaries yaAna.gambiae SL vachishandisa binocular dissecting microscope ine donhwe remvura yakasvibiswa yakaiswa pagirazi slide [35].Parity chimiro chakaongororwa kuparadzanisa vakadzi vakawanda kubva kuvakadzi vasina nulliparous zvichienderana neovarian uye tracheal morphology, pamwe nekuona chiyero chekubereka uye zera rehupenyu [35].
Indekisi yehama inotarwa nekuongorora kwakabva hupfu hweropa huchangobva kuunganidzwa.gambiae ne enzyme-yakabatana immunosorbent assay (ELISA) vachishandisa ropa kubva kuvanhu, zvipfuwo (mombe, makwai, mbudzi) uye huku [40].Entomological infestation (EIR) yakaverengerwa pachishandiswa An.Zvinofungidzirwa zvevakadzi veSL muGambia [41] Uyezve, An.Kutapukirwa nePlasmodium gambiae kwakatemwa nekuongorora musoro nechipfuva chevakadzi vakawanda vachishandisa circumsporozoite antigen ELISA (CSP ELISA) nzira [40].Pakupedzisira, kune nhengo dzaAnn.gambiae yakaonekwa nekuongorora makumbo ayo, mapapiro uye dumbu uchishandisa polymerase chain reaction (PCR) maitiro [34].
Data yekiriniki yemarariya yakawanikwa kubva kukiriniki yekubvunzana neregistry yeNapyyedugou Health Center, iyo inovhara misha mina yese inosanganisirwa muongororo iyi (kureva Kakologo, Kolekaha, Lofinekaha neNambatiurkaha).Kuongororwa kweregistry kwakanangana nemarekodhi kubva Kurume 2018 kusvika Kukadzi 2019 uye kubva Kurume 2019 kusvika Kukadzi 2020. Clinical data kubva Kurume 2018 kusvika Kukadzi 2019 inomiririra yekutanga kana pre-Bti data yekupindira, nepo data yekiriniki kubva Kurume 2019 kusvika Kukadzi 2020 inomiririra pre-Bti. data yekupindira.Data mushure mekupindira kweBti.Ruzivo rwekiriniki, zera uye musha wemurwere wega wega muLLIN + Bti uye LLIN mapoka ekudzidza akaunganidzwa mune yehutano registry.Kune murwere wega wega, ruzivo rwakadai semusha wemusha, zera, kuongororwa, uye pathology zvakanyorwa.Muzviitiko zvakaongororwa muchidzidzo ichi, marariya yakasimbiswa nekukurumidza kuongororwa kuongororwa (RDT) uye / kana marariya microscopy mushure mekutungamirirwa kweartemisinin-based combination therapy (ACT) nemupi wehutano.Zvirwere zvemarariya zvakakamurwa kuita mapoka matatu ezera (kureva makore gumi nemashanu).Chiitiko chegore negore chemarariya pavagari ve1000 chakafungidzirwa nekuparadzanisa kupararira kwemarariya pavagari ve1000 nehuwandu hwemusha.
Data yakaunganidzwa muchidzidzo ichi yakapinzwa kaviri muMicrosoft Excel dhatabhesi ichibva yapinzwa kune yakavhurika sosi software R [42] vhezheni 3.6.3 yekuongorora manhamba.Iyo ggplot2 package inoshandiswa kudhirowa zvirongwa.Generalized linear modhi inoshandisa Poisson regression yakashandiswa kuenzanisa density yelarval uye zvinoreva huwandu hwekurumwa neumhutu pamunhu pahusiku pakati pemapoka ezvidzidzo.Relevance reshiyo (RR) zviyero zvakashandiswa kuenzanisa kureba kwegonye densities uye kuruma mitengo yeCulex uye Anopheles mosquito.Gambia SL yakaiswa pakati pemapoka maviri ezvidzidzo vachishandisa LLIN + Bti boka sehwaro.Effect sizes dzakaratidzwa seasingawirirani ratios uye 95% nguva yekuvimba (95% CI).Chiyero (RR) chekuedzwa kwePoisson chakashandiswa kuenzanisa zviyero uye zviitiko zvemarariya zvisati zvaitika uye shure kwekupindira kweBti muboka rega rega rekudzidza.Chiyero chekukosha chakashandiswa chaive 5%.
Protocol yekudzidza yakatenderwa neNational Research Ethics Committee yeBazi reHutano uye Hutano Hwevanhu veCôte d'Ivoire (N/Ref: 001//MSHP/CNESVS-kp), pamwe nedunhu rehutano nehutungamiriri. of Korhogo.Asati atora mhute nevakuru, mvumo yakasainwa yakawanikwa kubva kune vatori vechikamu muongororo yemhuri, varidzi, uye/kana vagari.Mhuri uye data rekiriniki hazvizivikanwe uye zvakavanzika uye zvinongowanikwa kune vakasarudzwa vaongorori.
Nzvimbo dzekugara dzinokwana 1198 dzakashanyirwa.Pakati penzvimbo idzi dzedendere dzakaongororwa munzvimbo yekudzidza, 52.5% (n = 629) yaiva yeboka reLLIN + Bti uye 47.5% (n = 569) kune LLIN chete boka (RR = 1.10 [95% CI 0.98-1.24) ], P = 0.088).Kazhinji, nzvimbo dzekugara dzemakonye dzakaiswa mumhando gumi nembiri, pakati peiyo chikamu chikuru chenzvimbo dzemakonye yaive minda yemupunga (24.5%, n = 294), ichiteverwa nedutu remvura (21.0%, n = 252) nehari (8.3).%, n = 99), mahombekombe erwizi (8.2%, n = 100), gomba (7.2%, n = 86), gomba (7.0%, n = 84), pombi yemvura yemumusha (6.8 %, n = 81), Mahwanda akadhinda (4.8%, n = 58), machakwi (4.0%, n = 48), magaba (5.2%, n = 62), madziva (1.9%, n = 23) nematsime (0.9%, n = 11) .) .
Pakazara, huwandu hwe47,274 mosquito squito dzakaunganidzwa kubva munzvimbo yekudzidza, ine chikamu che14.4% (n = 6,796) muboka reLLIN + Bti zvichienzaniswa ne85.6% (n = 40,478) muLLIN chete boka ((RR = 5.96) [95% CI 5.80-6.11], P ≤ 0.001).Makonye aya ane marudzi matatu eumhutu, rudzi rwakanyanya kunzi Anopheles.(48.7%, n = 23,041), inoteverwa neCulex spp.(35.0%, n = 16,562) uye Aedes spp.(4.9%, n = 2340).Pupae yaisanganisira 11.3% yenhunzi dzisati dzakura (n = 5344).
Kuwanda kweavhareji yeAnopheles spp.makonye.Muchidzidzo ichi, nhamba yezvipembenene pa scoop yaiva 0.61 [95% CI 0.41-0.81] L / dip muLLIN + Bti boka uye 3.97 [95% CI 3.56-4.38] L / dive muboka reLLIN chete (kusarudza).faira 1: Mufananidzo S1).Avhareji density yeAnopheles spp.Iyo LLIN yega boka raive 6.5 nguva dzakakwirira kupfuura LLIN + Bti boka (HR = 6.49; 95% CI 5.80-7.27; P <0.001).Hapana humhutu hweAnopheles hwakaonekwa panguva yekurapwa.Mapuruguru akaunganidzwa muboka reLLIN + Bti kutanga munaJanuary, rinoenderana neramakumi maviri eBti kurapwa.Muboka reLLIN + Bti, pakave nekudzikira kukuru kwekutanga uye kunonoka nhanho density.
Kusati kwatanga kurapwa kweBti (Kurume), huwandu hwehuwandu hwekutanga instar Anopheles mosquitoes yakafungidzirwa kuva 1.28 [95% CI 0.22-2.35] L / dive muLLIN + Bti boka uye 1.37 [95% CI 0.36-2.36] l/dive muLLIN + Bti boka.l/dip./ nyudza chete ruoko rweLLIN (Fig. 2A).Mushure mekushandiswa kweBti kurapwa, chiyero chepakati chekutanga kweAnopheles mosquito muboka reLLIN + Bti kazhinji zvishoma nezvishoma yakadzikira kubva pa0.90 [95% CI 0.19–1.61] kusvika 0.10 [95% CI – 0.03–0.18] l/dip.Early instar Anopheles larval densities yakaramba yakaderera muLLIN + Bti boka.Muboka reLLIN-chete, kuchinja-chinja mukuwanda kweAnopheles spp.Early instar larvae akacherechedzwa ane huremu densities kubva 0.23 [95% CI 0.07-0.54] L/dive kusvika 2.37 [95% CI 1.77–2.98] L/dive.Pakazere, huwandu hwepakati hwemaAnopheles magonye ekutanga muboka reLLIN-chete hwakanga hwakakwira zvakanyanya pa1.90 [95% CI 1.70–2.10] L/dive, ukuwo huwandu hwemakonye ekutanga eAnopheles muboka reLLIN aive 0.38 [95% CI 0.28 –0.47]) l/dip.+ Bti boka (RR = 5.04; 95% CI 4.36-5.85; P <0.001).
Shanduko muavhareji density yeAnopheles larvae.Early (A) uye anonoka instar (B) mosquito mambure muboka rekudzidza kubva munaKurume 2019 kusvika Kukadzi 2020 mudunhu reNapier, kuchamhembe kweCôte d'Ivoire.LLIN: mambure ezvipembenene anogara kwenguva refu Bti: Bacillus thuringiensis, Israel TRT: kurapwa;
Avhareji density yeAnopheles spp.makonye.kunonoka zera muLLIN + Bti boka.Pre-treatment Bti density yaive 2.98 [95% CI 0.26-5.60] L/dip, nepo density muLLIN-yoga boka yaive 1.46 [95% CI 0.26-2.65] l / zuva Mushure meBti application, iyo density yekunonoka- instar Anopheles mhute muLLIN + Bti boka yakaderera kubva 0.22 [95% CI 0.04-0.40] kusvika 0.03 [95% CI 0.00-0.06] L/dip (Fig. 2B).Muboka reLLIN-chete, kuwanda kweanopheles ekupedzisira akawedzera kubva 0.35 [95% CI - 0.15-0.76] kusvika 2.77 [95% CI 1.13-4.40] l/dive pamwe nekumwe kusiyanisa muhuwandu hwemakonye zvichienderana nesampling date.Kuwanda kwehuwandu hwekunonoka-instar Anopheles mhute muLLIN-chete boka yaive 2.07 [95% CI 1.84-2.29] L/dive, nepfumbamwe yakakwira kupfuura 0.23 [95% CI 0.11-0.36] l/kunyudzwa muLLIN.+ Bti boka (RR = 8.80; 95% CI 7.40-10.57; P <0.001).
Avhareji density yeCulex spp.Values yaive 0.33 [95% CI 0.21-0.45] L / dip muLLIN + Bti boka uye 2.67 [95% CI 2.23-3.10] L / dip muLLIN chete boka (yakawedzerwa faira 2: Mufananidzo S2).Avhareji density yeCulex spp.Iboka reLLN roga rakanga rakakwirira kudarika boka reLLIN + Bti (HR = 8.00; 95% CI 6.90-9.34; P <0.001).
Avhareji density ye genus Culex Culex spp.Pamberi pekurapa, Bti l / dip yaiva 1.26 [95% CI 0.10-2.42] l / dip muLLIN + Bti boka uye 1.28 [95% CI 0.37-2.36] muboka reLLIN (Fig. 3A).Mushure mekushandiswa kweBti kurapwa, densities yepakutanga Culex mhute yakaderera kubva ku0.07 [95% CI - 0.001-0.] kusvika 0.25 [95% CI 0.006-0.51] L / dip.Hapana makonye eCulex akaunganidzwa kubva kunzvimbo dzemakonye dzakarapwa neBti kutanga muna Zvita.Density yekutanga Culex mhute yakaderedzwa kusvika ku0.21 [95% CI 0.14-0.28] L / dip muLLIN + Bti boka, asi yakanga yakakwirira muLLIN chete boka pa1.30 [95% CI 1.10-1.50] l / kunyudzwa.kudonha/d.Kuwanda kwezvipembenene zvekutanga zveCulex muboka reLLIN chete kwaiva 6 nguva dzakakwirira kudarika muLLIN + Bti boka (RR = 6.17; 95% CI 5.11-7.52; P <0.001).
Shanduko muavhareji density yeCulex spp.makonye.Hupenyu hwepakutanga (A) uye hupenyu hwepakutanga (B) miedzo muboka rekudzidza kubva munaKurume 2019 kusvika Kukadzi 2020 mudunhu reNapier, kuchamhembe kweCôte d'Ivoire.Inogara kwenguva refu insecticidal net LLIN, Bti Bacillus thuringiensis Israel, Trt kurapwa
Pamberi peBti kurapwa, iyo inoreva density ye late instar Culex larvae muLLIN + Bti boka uye boka reLLIN raiva 0.97 [95% CI 0.09-1.85] uye 1.60 [95% CI - 0.16-3.37] l/kunyudzwa maererano (Fig. 3B)).Zvinoreva kuwanda kweanonoka-instar Culex marudzi mushure mekutangwa kweBti kurapwa.Kuwanda muboka reLLN + Bti kwakaderera zvishoma nezvishoma uye kwaive kwakaderera pane iyo muLLIN chete boka, iro rakaramba rakakwirira zvikuru.Izvo zvinoreva density ye late instar Culex larvae yaiva 0.12 [95% CI 0.07-0.15] L / dive muLLIN + Bti boka uye 1.36 [95% CI 1.11-1.61] L / dive muboka LLIN chete.Izvo zvinoreva density ye late-instar Culex mhute yakanga yakakwirira zvikuru muLLIN-chete boka kupfuura muLLIN + Bti boka (RR = 11.19; 95% CI 8.83-14.43; P <0.001).
Pamberi peBti kurapwa, huwandu hwehuwandu hwehuputi pamadzimai hwakanga huri 0.59 [95% CI 0.24-0.94] muLLIN + Bti boka uye 0.38 [95% CI 0.13-0.63] muLLIN chete (Fig. 4).Kuwanda kwehuputi hwehuwandu hwaive 0.10 [95% CI 0.06-0.14] muLLIN + Bti boka uye 0.84 [95% CI 0.75-0.92] muLLIN chete boka.Kurapa kweBti zvakanyanya kuderedza huwandu hwepupal density muLLN + Bti boka richienzaniswa neLLIN chete boka (OR = 8.30; 95% CI 6.37-11.02; P <0.001).Muboka reLLIN + Bti, hapana pupa dzakaunganidzwa mushure meMbudzi.
Shanduko muavhareji density ye pupae.Chidzidzo ichi chakaitwa kubva munaKurume 2019 kusvika Kukadzi 2020 mudunhu reNapier kuchamhembe kweCôte d'Ivoire.Inogara kwenguva refu insecticidal net LLIN, Bti Bacillus thuringiensis Israel, Trt kurapwa
Humhutu hwakura hunosvika mazana matatu nemakumi mana nemakumi mashanu nenhanhatu hwakaunganidzwa kubva munzvimbo yeongororo.Umhutu ndewe 17 marudzi e5 genera (Anopheles, Culex, Aedes, Eretmapodites) (Tafura 1).Mune marariya vectors An.gambiae sl ndiyo yaive mhando zhinji ine chikamu che74.9% (n = 2587), ichiteverwa neAn.gambie sl.funestus (2.5%, n = 86) uye An null (0.7%, n = 24).Hupfumi hwaAna.gambiae sl muLLIN + Bti boka (10.9%, n = 375) yakanga yakaderera kupfuura muLLIN chete boka (64%, n = 2212).Hapana rugare.nli vanhu vakaiswa muLLIN chete.Zvisinei, An.gambie uye An.funestus aivepo mune ese ari maviri LLIN + Bti boka uye LLIN chete boka.
Muzvidzidzo zvinotanga pamberi peBti kushandiswa panzvimbo yekuberekesa (mwedzi ye3), iyo yose inorehwa nhamba yeumhutu hwemasikati pamunhu (b / p / n) muboka reLLIN + Bti yakafungidzirwa kuva 0.83 [95% CI 0.50-1.17] , asi muLLIN + Bti boka raive 0.72 muLLIN chete boka [95% CI 0.41-1.02] (Fig. 5).Muboka reLLIN + Bti, kukanganisa kweCulex mosquito kwakaderera uye kwakaramba kwakaderera pasinei nepamusoro pe1.95 [95% CI 1.35-2.54] bpp munaSeptember mushure mekushandiswa kwe12th Bti.Zvisinei, muboka reLLIN-chete, chiyero chekurumwa kwemhutu chakawedzera zvishoma nezvishoma chisati chasvika munaSeptember pa11.33 [95% CI 7.15-15.50] bp/n.Chiitiko chese chekurumwa kweumhutu chakanyanya kuderera muboka reLLIN + Bti zvichienzaniswa neLLIN chete boka panguva ipi zvayo panguva yekudzidza (HR = 3.66; 95% CI 3.01-4.49; P <0.001).
Kuruma kwehumhutu fauna munzvimbo yekudzidza yedunhu reNapier kuchamhembe kweCôte d'Ivoire kubva munaKurume 2019 kusvika Kukadzi 2020 LLIN mambure ekuuraya zvipembenene kwenguva refu, Bti Bacillus thuringiensis Israel, kurapwa kweTrt, kuruma b/p/husiku/munhu/ husiku
Anopheles gambiae ndiyo inonyanya kuzivikanwa nemarariya munzvimbo yeongororo.Kuruma kumhanya kweAn.Pakutanga, vakadzi veGambia vaiva ne b/p/n values e0.64 [95% CI 0.27-1.00] muLLIN + Bti boka uye 0.74 [95% CI 0.30-1.17] muboka chete LLIN (Fig. 6) .Munguva yekupindira kweBti, basa guru rekurumwa rakaonekwa munaSeptember, rinoenderana nechegumi nembiri yeBti kurapwa, nepamusoro pe1.46 [95% CI 0.87-2.05] b / p / n muLLIN + Bti boka uye a peak of 9 .65 [95% CI 0.87–2.05] w/n 5.23–14.07] LLIN boka chete.Kumhanya kwese kuruma kweAn.Chirwere chetachiona muGambia chakanga chakaderera zvikuru muboka reLLIN + Bti (0.59 [95% CI 0.43-0.75] b/p/n) kupfuura muLLIN chete boka (2.97 [95% CI 2, 02-3.93] b /p/kwete).(RR = 3.66; 95% CI 3.01-4.49; P <0.001).
Kuruma kwaAna.gambiae sl, chikwata chekutsvagisa mudunhu reNapier, kuchamhembe kweCote d'Ivoire, kubva munaKurume 2019 kusvika Kukadzi 2020 LLIN ine mushonga wemubhedha unogara kwenguva refu, Bti Bacillus thuringiensis Israel, Trt kurapwa, kuruma b/p/husiku/ munhu/usiku.
Zvose 646 amps.Gambia yakagurwa.Pakazara, chikamu chekuchengetedzwa kwenzvimbo.Parity rates muGambia yaiwanzo> 70% mukati menguva yese yekudzidza, kunze kwaChikunguru, pakashandiswa boka reLLIN chete (Yakawedzerwa faira 3: Mufananidzo S3).Nekudaro, avhareji yekubereka munzvimbo yekudzidza yaive 74.5% (n = 481).Muboka reLLIN + Bti, chiyero chekuenzanisa chakaramba chiri chepamusoro, pamusoro pe80%, kunze kweSeptember, apo chiyero chekuenzanisa chakawira ku77,5%.Zvisinei, misiyano yehuwandu hwekubereka yakaonekwa muboka reLLIN-chete, uye yakaderera inofungidzirwa kuti inoreva kuberekwa kwe64.5%.
Kubva 389 Ann.Ongororo yezvikamu zveropa zvega kubva kuGambia yakawana kuti 80.5% (n = 313) yaive yevanhu, 6.2% (n = 24) yevakadzi vakadya ropa rakasanganiswa (revanhu neremumba) uye 5.1% (n = 20) vakadya ropa. .kudya kubva kuzvipfuwo (mombe, hwai nembudzi) uye 8.2% (n = 32) yemasampuli akaongororwa akanga asina kunaka kwekudya kweropa.Muboka reLLIN + Bti, chikamu chevakadzi vaigamuchira ropa revanhu chaiva 25.7% (n = 100) chichienzaniswa ne54.8% (n = 213) muLLIN chete boka (Yakawedzerwa faira 5: Tafura S5).
Zvose 308 amps.P. gambiae yakaedzwa kuti ione nhengo dzemhando dzakaoma uye P. falciparum utachiona (Kuwedzera faira 4: Tafura S4).Mhuka mbiri "dzakabatana" dzinogara munzvimbo yefundo, dzinoti An.gambiae ss (95.1%, n = 293) uye An.coluzzii (4.9%, n = 15).Anopheles gambiae ss yakaderera zvakanyanya muboka reLLN + Bti kupfuura muLLIN chete boka (66.2%, n = 204) (RR = 2.29 [95% CI 1.78-2.97], P <0.001).Chikamu chakafanana cheAnopheles mosquitos chakawanikwa muLLIN + Bti boka (3.6%, n = 11) uye LLIN chete boka (1.3%, n = 4) (RR = 2.75 [95% CI 0.81-11 .84], P = .118).Kuwanda kwePlasmodium falciparum utachiona pakati peAn.SL muGambia yaive 11.4% (n = 35).Plasmodium falciparum chirwere chetachiona.Chirwere chetachiona muGambia chakanyanya kuderera muLLIN + Bti boka (2.9%, n = 9) kupfuura muLLIN chete boka (8.4%, n = 26) (RR = 2.89 [95% CI 1. 31-7.01) ], P = 0.006).).Kuenzaniswa neAnopheles mosquitoes, Anopheles gambiae mosquitos ndidzo dzaive nechikamu chepamusoro chechirwere chePlasmodium pa94.3% (n=32).coluzzii chete 5.7% (n = 5) (RR = 6.4 [95% CI 2.47-21.04], P <0.001).
Vanhu vanosvika zviuru zviviri nemazana mana nemakumi matatu nevashanu kubva kudzimba mazana mana vakaongororwa.Avhareji density vanhu 6.1 pamhuri.Chiyero chemuridzi weLLIN pakati pemhuri yaive 85% (n = 340), zvichienzaniswa ne15% (n = 60) kudzimba dzisina LLIN (RR = 5.67 [95% CI 4.29-7.59], P <0.001) (Kuwedzera faira 5 : Tafura S5)..Kushandiswa kweLLIN kwaiva 40.7% (n = 990) muLLIN + Bti boka rinoenzaniswa ne36.2% (n = 882) muLLIN chete boka (RR = 1.12 [95% CI 1.02-1.23], P = 0.013).Avhareji yehuwandu hwekushandisa mambure munzvimbo yekudzidza yaive 38.4% (n = 1842).Chiyero chevana vari pasi pemakore mashanu ezera vachishandisa Indaneti chakanga chakafanana mumapoka ose ekudzidza, ane mambure ekushandisa 41.2% (n = 195) muLLIN + Bti boka uye 43.2% (n = 186) muboka reLLIN chete.(HR = 1.05 [95% CI 0.85-1.29], P = 0.682).Pakati pevana vane makore 5 kusvika ku15 makore, pakanga pasina misiyano muhuwandu hwekushandisa mambure pakati pe36.3% (n = 250) muboka reLLIN + Bti uye 36.9% (n = 250) muLLIN chete boka (RR = 1. 02 [ 95% CI 1.02–1.23], P = 0.894).Zvisinei, avo vanopfuura makore gumi nemashanu vakashandisa mambure emubhedha 42.7% (n = 554) zvishoma muboka reLLIN + Bti kupfuura 33.4% (n = 439) muLLIN chete boka (RR = 1.26 [95% CI 1.11-1.43) ], P <0.001).
Zvose zvemakiriniki e2,484 zvakanyorwa paNapier Health Center pakati paMarch 2018 naFebruary 2020. Kuwanda kwechirwere chemalaria muhuwandu hwevanhu kwaiva 82.0% yezviitiko zvose zvekliniki pathology (n = 2038).Kuwanda kwegore negore kwehuwandu hwemarariya munharaunda iyi yekudzidza yaiva 479.8 ‰ uye 297.5 ‰ isati yasvika uye mushure mekurapa kweBti (Table 2).
Nguva yekutumira: Jul-01-2024