Kudzikira kwemutoro wemarariya munguva pfupi yapfuura muCôte d'Ivoire kwakakonzerwa zvikuru nekushandiswa kweneti dzinouraya zvipembenene dzinogara kwenguva refu (LIN). Zvisinei, kufambira mberi uku kuri panjodzi nekuda kwekusagona kuuraya zvipembenene, shanduko muhunhu hweAnopheles gambiae populations, uye kutapurirana kwemarariya kwakasara, zvichiita kuti pave nekudiwa kwezvimwe zvishandiso. Nokudaro, chinangwa chechidzidzo ichi chaive chekuongorora kushanda kwekushandisa pamwe chete LLIN neBacillus thuringiensis (Bti) uye kuenzanisa neLLIN.
Chidzidzo ichi chakaitwa kubva munaKurume 2019 kusvika Kukadzi 2020 kuburikidza nemaoko maviri ekudzidza (LLIN + Bti arm uye LLIN only arm) munzvimbo yehutano yeKorhogo kuchamhembe kweCôte d'Ivoire. Muboka reLLIN + Bti, nzvimbo dzeAnopheles larval dzakarapwa neBti mavhiki maviri ega ega pamusoro peLLIN. Umhutu hwemakonye nehwevakuru hwakaunganidzwa uye hwakaonekwa maererano nerudzi nemarudzi uchishandisa nzira dzakajairwa. Nhengo Ann. Gambian complex yakaongororwa uchishandisa tekinoroji yepolymerase chain reaction. Kutapukirwa nePlasmodium An. Kuwanda kwemarariya muGambia nevanhu veko kwakaongororwawo.
Kazhinji, huwandu hwemakonzo eAnopheles spp. hwakanga hwakaderera muboka reLLIN + Bti zvichienzaniswa neboka reLLIN rega rega raive 0.61 [95% CI 0.41–0.81] makonzo/kunyura (l/kunyura) 3.97 [95% CI 3.56–4 .38] l/kunyura (RR = 6.50; 95% CI 5.81–7.29 P < 0.001). Kumhanya kwekurumwa kweAn. Kuwanda kwekurumwa kweS. gambiae kwaive 0.59 [95% CI 0.43–0.75] pamunhu/husiku muboka reLLIN + Bti rega, zvichienzaniswa ne2.97 [95% CI 2.02–3. 93] pamunhu/husiku muboka reLLIN chete (P < 0.001). Anopheles gambiae sl inonyanya kuzivikanwa seumhutu hweAnopheles. Anopheles gambiae (ss) (95.1%; n = 293), ichiteverwa neAnopheles gambiae (4.9%; n = 15). Nhamba yeropa revanhu munzvimbo yekuongorora yaive 80.5% (n = 389). EIR yeboka reLLIN + Bti yaive 1.36 kurumwa nehutachiona pamunhu pagore (ib/p/y), nepo EIR yeboka reLLIN chete yaive 47.71 ib/p/y. Kuwanda kwemarariya kwakadzikira zvakanyanya kubva pa291.8‰ (n = 765) kusvika pa111.4‰ (n = 292) muboka reLLIN + Bti (P < 0.001).
Kusanganiswa kweLLIN neBti kwakaderedza zvakanyanya kuwanda kwemarariya. Kusanganiswa kweLLIN neBti kungave nzira yakabatana inobatsira yekudzivirira chirwere cheAn zvinobudirira. Gambia haina marariya.
Kunyangwe paine kufambira mberi mukutonga malaria mumakumi emakore apfuura, mutoro wemalaria uchiri dambudziko guru muAfrica iri pasi peSahara [1]. Sangano reWorld Health Organization (WHO) munguva pfupi yapfuura rakashuma kuti kwaive nevanhu vanosvika mamiriyoni 249 vane malaria uye vanhu vanosvika zviuru mazana matanhatu nezvisere vakafa nemalaria pasi rose muna 2023 [2]. Dunhu reAfrica reWHO rinoita 95% yevanhu vane malaria pasi rose uye 96% yevanhu vanofa nemalaria, vakadzi vane pamuviri nevana vari pasi pemakore mashanu vachinyanya kubatwa [2, 3].
Mambure ekuuraya zvipembenene anogara kwenguva refu (LLIN) uye kupfapfaidza mumba (IRS) zvakaita basa guru mukuderedza mutoro wemarariya muAfrica [4]. Kuwedzera kwezvishandiso izvi zvekudzivirira malaria kwakaita kuti kuwanda kwemarariya kuderedzwa ne37% uye kufa kwevanhu ne60% pakati pa2000 na2015 [5]. Zvisinei, maitiro akaonekwa kubvira muna 2015 akamira zvinotyisa kana kutowedzera, nerufu rwemarariya ruchiri rwakakwira zvisingagamuchirwi, kunyanya muAfrica iri pasi peSahara [3]. Zvidzidzo zvakati wandei zvakaratidza kubuda nekupararira kwekusagona kurwisa zvipembenene pakati pevanonyanya kukonzera malaria, Anopheles, mishonga inoshandiswa muhutano hwevanhu, sechipingamupinyi pakushanda kweLLIN neIRS mune ramangwana [6,7,8]. Pamusoro pezvo, shanduko mukuita kwekurumwa nevector kunze uye munguva pfupi iri kutevera ndizvo zvinokonzera kutapurirana kwemarariya uye idambudziko riri kukura [9, 10]. Kusakwana kweLLIN neIRS mukudzora vanokonzera kutapurirana kwemarariya ndiko kudzikira kukuru kwekuedza kuri kuitwa pari zvino kubvisa malaria [11]. Pamusoro pezvo, kuramba kuripo kwemarariya kunotsanangurwa nemamiriro ekunze uye mabasa evanhu, izvo zvinobatsira pakugadzirwa kwenzvimbo dzinogara makonye [12].
Kutarisira manyuchi (LSM) inzira inoshandiswa pakudzivirira manyuchi panzvimbo yekuberekesa ine chinangwa chekuderedza huwandu hwenzvimbo dzekuberekesa uye huwandu hwemabungu eumhutu nemapupa ari mukati mawo [13]. LSM yakakurudzirwa nezvidzidzo zvakati wandei senzira yakabatanidzwa yekudzivirira malaria vector [14, 15]. Kutaura zvazviri, kushanda kweLSM kunopa mabhenefiti maviri pakurwisa kurumwa kwemarudzi emalaria vector mukati nekunze [4]. Pamusoro pezvo, kudzora manyuchi neLSM dzakavakirwa palarvicide dzakadai seBacillus thuringiensis israelensis (Bti) kunogona kuwedzera nzira dzakasiyana dzekudzivirira malaria. Kare, LSM yakaita basa guru mukubudirira kudzora malaria muUnited States, Brazil, Egypt, Algeria, Libya, Morocco, Tunisia neZambia [16,17,18]. Kunyangwe LSM yakaita basa rakakosha mukubatanidza zvipembenene mune dzimwe nyika dzakabvisa malaria, LSM haina kubatanidzwa zvakanyanya mumitemo nemaitiro ekudzivirira malaria vector muAfrica uye inoshandiswa chete muzvirongwa zvekudzivirira malaria mune dzimwe nyika dziri pasi peSahara. nyika [14,15,16,17,18,19]. Chimwe chikonzero cheizvi ipfungwa yakapararira yekuti nzvimbo dzekuberekesa dzakawandisa uye dzakaoma kuwana, zvichiita kuti LSM idhure zvikuru kuita [4, 5, 6, 7, 8, 9, 10, 11, 13, 14]. Nokudaro, World Health Organization yakakurudzira kwemakumi emakore kuti zviwanikwa zvakaunganidzwa zvekudzivirira malaria zvinofanira kutarisa paLLIN neIRS [20, 21]. Zvakanga zvisati zvaitika muna 2012 apo World Health Organisation yakakurudzira kubatanidzwa kweLSM, kunyanya Bti interventions, sekuwedzera kuLLIN neIRS mune dzimwe nzvimbo dziri kumaodzanyemba kweSahara Africa [20]. Kubva WHO yakapa kurudziro iyi, zvidzidzo zvakawanda zvekuedza zvakaitwa pamusoro pekugona, kushanda uye mutengo wemishonga yebiolarvicides muSub-Saharan Africa, zvichiratidza kushanda kweLSM mukuderedza kuwanda kweumhutu hweAnopheles uye kushanda zvakanaka kwekutapurirana kwemalaria maererano ne [22, 23]. . , 24].
Côte d'Ivoire iri pakati penyika gumi neshanu dzine dambudziko guru remarariya pasi rose [25]. Kuwanda kwemarariya muCôte d'Ivoire kunomiririra 3.0% yehuwandu hwemarariya pasi rose, nekufungidzira kuti huwandu hwevanhu vanobatwa nemarariya hunobva pa300 kusvika pamusoro pe500 pavanhu 1000 [25]. Pasinei nemwaka murefu wekusanaya kwemvura kubva muna Mbudzi kusvika Chivabvu, marariya inopararira mugore rese munzvimbo yekuchamhembe kwesavanna yenyika [26]. Kutapurirana kwemarariya munzvimbo iyi kwakabatana nekuvapo kwehuwandu hwakawanda hwevatakuri vePlasmodium falciparum vasina zviratidzo [27]. Munharaunda iyi, chirwere chemarariya chinowanzoonekwa zvikuru iAnopheles gambiae (SL). Kuchengetedzwa kwenzvimbo. Umhutu hweAnopheles gambiae hunonyanya kuumbwa neAnopheles gambiae (SS), iyo inodzivirira zvakanyanya zvipembenene uye nekudaro ine njodzi huru yekutapurirana kwemarariya yakasara [26]. Kushandiswa kweLLIN kunogona kunge kusina simba pakuderedza kutapurirana kwemarariya nekuda kwekusagona kuuraya zvipembenene kwezvipembenene zvemunharaunda uye nekudaro kuchiri chinhu chinonetsa zvikuru. Zvidzidzo zvekutanga zvekushandisa Bti kana LLIN zvakaratidza kushanda mukuderedza huwandu hwehutachiona hwemhutu kuchamhembe kweCôte d'Ivoire. Zvisinei, hapana zvidzidzo zvekare zvakaongorora kushanda kwekushandiswa kweBti pamwe chete neLLIN pakutapurirana kwemarariya uye kuwanda kwemarariya munharaunda iyi. Nokudaro, chidzidzo ichi chaive nechinangwa chekuongorora kushanda kwekushandiswa kweLLIN neBti pakutapurirana kwemarariya nekuenzanisa boka reLLIN + Bti neboka reLLIN chete mumisha mina iri kuchamhembe kweCôte d'Ivoire. Zvaifungidzirwa kuti kushandisa Bti-based LSM pamusoro peLLIN kwaizowedzera kukosha nekuderedza huwandu hwemhutu hwemalaria zvichienzaniswa neLLIN chete. Nzira iyi yakabatana, yakanangana neumhutu husina kukura hweAnopheles hunotakura Bti neumhutu hukuru hweAnopheles hunotakura LLIN, inogona kuva yakakosha mukuderedza kutapurirana kwemarariya munzvimbo dzine chirwere chemalaria chakanyanya, senge misha iri kuchamhembe kweCôte d'Ivoire. Nokudaro, mhedzisiro yechidzidzo ichi inogona kubatsira kusarudza kana kuisa LSM muzvirongwa zvekudzivirira malaria (NMCPs) munyika dziri mudunhu reSahara.
Chidzidzo ichi chakaitwa mumisha mina yedhipatimendi reNapieldougou (inozivikanwawo seNapier) munzvimbo yekuchenesa Korhogo kuchamhembe kweCôte d'Ivoire (Mufananidzo 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) uye Nambatiurkaha (9° 18′ 36″ N, 5° 31′ 22″ E). Huwandu hwevanhu vekuNapierledougou muna 2021 hwakafungidzirwa kuva vagari 31,000, uye dunhu iri rine misha 53 ine nzvimbo mbiri dzehutano [28]. Mudunhu reNapyeledougou, uko malaria iriyo inonyanya kukonzera kushanya kwechiremba, kugara muchipatara uye kufa, LLIN chete ndiyo inoshandiswa kudzora mabhakitiriya eAnopheles [29]. Misha yese mina iri mumapoka ese ekudzidza inoshumirwa nenzvimbo yehutano imwechete, ine zvinyorwa zvekiriniki zvezviitiko zvemalaria zvakaongororwa muchidzidzo ichi.
Mepu yeCôte d'Ivoire inoratidza nzvimbo yekuongorora. (Manyuko emepu nesoftware: GADM data neArcMap 10.6.1. LLIN ine zvipembenene zvinouraya zvipembenene zvinogara kwenguva refu, Bti Bacillus thuringiensis israelensis
Kuwanda kwemarariya pakati pevanhu vakatarirwa neNapier Health Center kwakasvika 82.0% (vanhu 2038) (data reBti risati rasvika). Mumisha yese mina, mhuri dzinoshandisa PermaNet® 2.0 LLIN chete, yakagoverwa neIvorian NMCP muna 2017, ne >80% yehuwandu [25, 26, 27, 28, 30]. Misha iyi ndeyedunhu reKorhogo, iro rinoshanda senzvimbo yekutarisa yeIvory Coast National Military Council uye inowanikwa gore rese. Musha wega wega une mhuri dzinosvika zana uye vanhu vanosvika vanhu vakafanana, uye zvichienderana nerejista yehutano (gwaro rinoshanda reIvorian Ministry of Health), nyaya dzinoverengeka dzemarariya dzinotaurwa gore rega rega. Marariya inonyanya kukonzerwa nePlasmodium falciparum (P. falciparum) uye inotapurirwa kuvanhu nePlasmodium. gambiae inotapurirwawo neAnopheles neAnopheles nili mosquitos munharaunda iyi [28]. Nzvimbo yemuno An. gambiae inonyanya kuve neAnopheles mosquitos. gambiae ss ine huwandu hwakawanda hwekuchinja kwe kdr (huwandu hwema frequency: 90.70–100%) uye huwandu huri pakati nepakati hwe ace-1 alleles (huwandu hwema frequency: 55.56–95%) [29].
Avhareji yemvura inonaya pagore uye tembiricha inotangira pa1200 kusvika 1400 mm uye 21 kusvika 35 °C zvichiteerana, uye hunyoro (RH) hunofungidzirwa pa58%. Nzvimbo iyi ine mamiriro ekunze akafanana neeSudan ane mwaka wekusanaya kwemvura wemwedzi mitanhatu (Mbudzi kusvika Kubvumbi) uye mwaka wekunaya kwemvura wemwedzi mitanhatu (Chivabvu kusvika Gumiguru). Dunhu iri riri kusangana nemimwe yemigumisiro yekuchinja kwemamiriro ekunze, sekurasikirwa nemiti uye mwaka wekusanaya kwemvura wakareba, unoratidzwa nekuoma kwemvura (nzvimbo dzakaderera, minda yemupunga, madziva, madziva) zvinogona kushanda senzvimbo yekugara kwehonye dzeAnopheles. Utunga[26].
Chidzidzo ichi chakaitwa muboka reLLIN + Bti, raimiririrwa nemisha yeKakologo neNambatiurkaha, uye muboka reLLIN chete, raimiririrwa nemisha yeKolekaha neLofinekaha. Munguva yekudzidza uku, vanhu mumisha yese iyi vaishandisa PermaNet® 2.0 LLIN chete.
Kushanda kweLLIN (PermaNet 2.0) pamwe chete neBti kurwisa umhutu hweAnopheles uye kutapurirana kwemalaria kwakaongororwa mukuyedzwa kwakarongwa (RCT) nemapoka maviri ekudzidza: boka reLLIN + Bti (boka rekurapa) uye boka reLLIN rega (boka rekutonga). Maoko eLLIN + Bti anomiririrwa neKakologo naNambatiourkaha, nepo Kolékaha neLofinékaha zvakagadzirwa semafudzi eLLIN chete. Mumisha yese mina, vagari vemo vari kushandisa LLIN PermaNet® 2.0 yakagamuchirwa kubva kuIvory Coast NMCP muna 2017. Zvinofungidzirwa kuti mamiriro ekushandisa PermaNet® 2.0 akafanana mumisha yakasiyana nekuti yakagamuchira network nenzira imwechete. . Muboka reLLIN + Bti, nzvimbo dzeAnopheles larval dzakarapwa neBti mavhiki maviri ega ega kuwedzera kune LLIN yatoshandiswa nevanhu. Nzvimbo dzinogara matumbu mumisha uye dziri mukati memakiromita maviri kubva pakati pemusha wega wega dzakarapwa zvichienderana nekurudziro yeWorld Health Organization neNMCP yeCôte d'Ivoire [31]. Kusiyana neizvi, boka reLLIN chete harina kurapwa neBti inouraya matumbu panguva yekudzidza.
Bti inonyungudika mumvura (Vectobac WG, 37.4% wt; lot number 88–916-PG; 3000 International Toxicity Units IU/mg; Valent BioScience Corp, USA) yakashandiswa pachiyero che0.5 mg/L. . Shandisa 16L backpack sprayer nefiberglass spray gun ine mubato nemuromo unogadziriswa une mwero wekuyerera kwe52 ml pasekondi (3.1 L/min). Kugadzira nebulizer ine 10 L yemvura, huwandu hweBti hwakanyungudika mu suspension i0.5 mg/L × 10 L = 5 mg. Semuenzaniso, kune nzvimbo ine mvura yakagadzirwa ye10 L, uchishandisa 10 L sprayer kurapa huwandu hwemvura, huwandu hweBti hunoda kunyungudika i0.5 mg/L × 20 L = 10 mg. 10 mg Bti yakayerwa mumunda uchishandisa chikero chemagetsi. Uchishandisa spatula, gadzira slurry nekusanganisa huwandu uhwu hweBti mubhaketi re10 L rakapedza. Dose iyi yakasarudzwa mushure mekuyedzwa kwemunda kwekushanda kweBti pakurwisa akasiyana-siyana eAnopheles spp. neCulex spp. mumamiriro ezvinhu echisikigo munzvimbo yakasiyana, asi yakafanana nenzvimbo yekutsvagisa kwemazuva ano [32]. Mwero wekushandiswa kwe larvicide suspension uye nguva yekushandiswa panzvimbo yega yega yekuberekesa zvakaverengerwa zvichibva pahuwandu hwemvura hunofungidzirwa panzvimbo yekuberekesa [33]. Isa Bti uchishandisa muchina wekusimbisa maoko wakagadziriswa. Nebulizers dzinoongororwa uye dzinoedzwa panguva yekurovedza muviri kwega uye munzvimbo dzakasiyana kuti ive nechokwadi chekuti huwandu hwakakodzera hweBti hwapihwa.
Kuti vawane nguva yakanakisisa yekurapa nzvimbo dzekuberekera makonye, chikwata chakaona kupfapfaidza pahwindo. Hwindo rekupfapfaidza inguva iyo mushonga unoiswa kuti uwane kushanda kwakanaka: muchidzidzo ichi, hwindo rekupfapfaidza raitangira pamaawa gumi nemaviri kusvika kumavhiki maviri, zvichienderana nekuramba kuripo kweBti. Zviri pachena kuti, kutorwa kweBti nehonye panzvimbo yekuberekera kunoda nguva kubva 7:00 kusvika 18:00. Nenzira iyi, nguva dzekunaya kwemvura yakawanda dzinogona kudzivirirwa kana mvura ichireva kumisa kupfapfaidza uye kutangazve zuva rinotevera kana mamiriro ekunze akabvumirana. Mazuva ekupfapfaidza uye mazuva chaiwo nenguva zvinoenderana nemamiriro ekunze akaonekwa. Kuti vagadzirise mapurasitiki ekupfapfaidza kumashure kuti aone chiyero chekushandiswa kweBti chinodiwa, nyanzvi yega yega inodzidziswa kuongorora nekuona uye kugadzirisa nozzle yekupfapfaidza uye kuchengetedza kumanikidzwa. Kugadzirisa kunopedzwa nekuona kuti huwandu hwakakodzera hwekurapa kweBti hunoshandiswa zvakaenzana pachikamu chimwe nechimwe. Bata nzvimbo yekugara kwehonye mavhiki maviri ega ega. Mabasa ekuuraya makonye anoitwa nerutsigiro rwenyanzvi ina dzine ruzivo uye dzakadzidziswa zvakanaka. Mabasa ekuuraya makonye nevatori vechikamu vanotariswa nevatariri vane ruzivo. Kurapa zvipembenene zvinouraya mabukira kwakatanga munaKurume 2019 munguva yemwaka wemvura. Kutaura zvazviri, ongororo yapfuura yakaratidza kuti mwaka wemvura ndiyo nguva yakakodzera yekurapa zvipembenene zvinouraya mabukira nekuda kwekugadzikana kwenzvimbo dzekuberekera uye kudzikira kwekuwanda kwazvo [27]. Kudzora zvipembenene munguva yemwaka wemvura kunotarisirwa kudzivirira kukwezva umhutu munguva yemvura. Makirogiramu maviri (02) eBti anodhura US$99.29 anobvumira boka rekudzidza riri kugamuchira kurapwa kuti rivhare nzvimbo dzese. Muboka reLLIN+Bti, zvipembenene zvinouraya mabukira zvakatora gore rose, kubva munaKurume 2019 kusvika Kukadzi 2020. Huwandu hwezviitiko makumi maviri nembiri zvekurapa zvipembenene zvakaitika muboka reLLIN+Bti.
Migumisiro inogona kuitika (yakadai sekurutsa, dzungu kana mhino inoyerera) yakaongororwa kuburikidza neongororo yega yega yeBti biolarvicide nebulizers pamwe nevagari vemumhuri vari muboka reLIN + Bti.
Ongororo yemhuri yakaitwa pakati pemhuri mazana mana (mhuri mazana maviri paboka rega rega rekudzidza) kuti vafungidzire huwandu hwekushandiswa kweLLIN pakati pevanhu. Pakuferefeta mhuri, nzira yemibvunzo yehuwandu inoshandiswa. Kuwanda kwekushandiswa kweLLIN kwakakamurwa kuita mapoka matatu ezera: makore gumi nemashanu. Mibvunzo yakazadzwa uye yakatsanangurwa mumutauro weSenoufo kumukuru wemhuri kana mumwe munhu mukuru ane makore anopfuura gumi nemasere ekuberekwa.
Hukuru hushoma hwemhuri yakaongororwa hwakaverengerwa uchishandisa fomura yakatsanangurwa naVaughan naMorrow [34].
n ihukuru hwemuenzaniso, e imuganhu wekukanganisa, t ichinhu chekuchengetedza chinobva padanho rekuvimba, uye p ihuwandu hwevabereki vevanhu vane hunhu hwakapihwa. Chinhu chimwe nechimwe chechikamu chine kukosha kwakafanana, saka (t) = 1.96; Hukuru hwemhuri hushoma mumamiriro ezvinhu aya muongororo hwaive dzimba 384.
Pamberi pekuyedza kwazvino, mhando dzakasiyana dzenzvimbo dzeAnopheles larvae mumapoka eLLIN+Bti neLLIN dzakaonekwa, dzakatorwa sampuli, dzakatsanangurwa, dzakaongororwa uye dzakanyorwa mazita. Shandisa tepi yekuyera saizi yenzvimbo yekuberekera. Kuwanda kwemhou dzeumhutu kwakazoongororwa mwedzi wega wega kwemwedzi gumi nemiviri panzvimbo makumi matatu dzakasarudzwa zvisina kurongeka dzekuberekera pamusha wega wega, kuti pave nenzvimbo makumi matanhatu dzekuberekera paboka rega rega rekudzidza. Paive nesampling gumi nembiri dzemhou panzvimbo yega yega yekudzidza, zvichienderana nekurapwa kweBti makumi maviri nembiri. Chinangwa chekusarudza nzvimbo idzi makumi matatu dzekuberekera pamusha wega wega kwaive kutora huwandu hwakakwana hwenzvimbo dzekuunganidzira mhou mumisha yese nemakamuri ekudzidza kuderedza kusarurana. Mhou dzakaunganidzwa nekunyikwa nechipunu che60 ml [35]. Nekuda kwekuti dzimwe nzvimbo dzekurima mhou diki uye dzisina kudzika, zvakakosha kushandisa bhaketi diki kunze kwebhaketi reWHO (350 ml). Huwandu hwemvura yekunyudza 5, 10 kana 20 dzakagadzirwa kubva munzvimbo dzekuberekera dzine denderedzwa remamita gumi, zvichiteerana. Kuzivikanwa kwemakonye akaunganidzwa (semuenzaniso Anopheles, Culex neAedes) kwakaitwa zvakananga mumunda [36]. Makonye akaunganidzwa akakamurwa kuita mapoka maviri zvichienderana nedanho rekukura: makonye ekutanga (danho 1 nerechipiri) uye makonye ekupedzisira (danho 3 nerechina) [37]. Makonye akaverengwa nemarudzi uye padanho rega rega rekukura. Mushure mekuverengwa, makonye anodzoserwa kunzvimbo dzawo dzekuberekera uye anozadzwa kusvika pahuwandu hwawo hwepakutanga nemvura inowedzerwa nemvura inonaya.
Nzvimbo yekuberekera yaionekwa seyakanaka kana paine gonye rimwe chete kana pupa yemhando ipi zvayo yeumhutu. Kuwanda kwemagonye kwaionekwa nekukamura huwandu hwemagonye erudzi rumwe chete nenhamba yeanonyura.
Chidzidzo chega chega chakaita kwemazuva maviri akatevedzana, uye mwedzi miviri yega yega, umhutu hukuru hwaitorwa kubva mumhuri gumi dzakasarudzwa zvisina tsarukano kubva mumusha wega wega. Mukati mekudzidza, timu yega yega yekutsvagisa yakaita ongororo dzemhuri makumi maviri mumazuva matatu akatevedzana. Umhutu hwakabatwa uchishandisa misungo yewindo (WT) uye misungo yespray yepyrethrum (PSC) [38, 39]. Pakutanga, dzimba dzese mumusha wega wega dzakaverengerwa nhamba. Dzimba ina mumusha wega wega dzakazosarudzwa zvisina tsarukano senzvimbo dzekuunganidzira umhutu hukuru. Muimba yega yega yakasarudzwa zvisina tsarukano, umhutu hwakatorwa kubva muimba huru yekurara. Makamuri ekurara akasarudzwa ane masuo nemahwindo uye aigara husiku hwapfuura. Makamuri ekurara anoramba akavharwa vasati vatanga basa uye panguva yekuunganidza umhutu kudzivirira umhutu kuti husabhururuke kubva mukamuri. WT yakaiswa muhwindo rega rega rekamuri yega yega senzvimbo yekutora umhutu. Zuva rakatevera, umhutu hwaipinda munzvimbo yebasa kubva mumakamuri ekurara hwakatorwa pakati pa06:00 na08:00 am. Unganidza umhutu kubva munzvimbo yako yebasa uchishandisa muromo uye uhuchengete mukapu yepepa inoraswa yakafukidzwa nechidimbu chisina kubikwa. Mambure eumhutu. Umhutu hwakarara muimba imwe chete yekurara hwakabatwa pakarepo mushure mekutorwa kweWT uchishandisa PSC ine pyrethroid. Mushure mekuparadzira machira machena pasi peimba yekurara, vharai magonhi nemahwindo mopfapfaidza zvipembenene (zvinoshandiswa: 0.25% transfluthrin + 0.20% permethrin). Maminetsi angangoita gumi kusvika gumi nemashanu mushure mekupfapfaidza, bvisai mubhedha muimba yekurara yakarapwa, shandisai matweezers kutora umhutu hwakawira pamachira machena, mohuchengeta mundiro yePetri yakazadzwa nedonje rakanyoroveswa mumvura. Huwandu hwevanhu vakarara husiku mumakamuri ekurara akasarudzwa hwakanyorwawo. Umhutu hwakaunganidzwa hunokurumidza kutamiswa kurabhoritari iri panzvimbo yacho kuti hugadziriswe zvakare.
Murabhoritari, umhutu hwese hwakaunganidzwa hwakaonekwa maererano nerudzi nemarudzi [36]. Mazai aAnna. gambiae SL achishandisa maikorosikopu yebinocular dissecting nedonhwe remvura yakacheneswa rakaiswa pagirazi [35]. Chimiro chehunhu hweparity chakaongororwa kuti chiparadzanise vakadzi vane mimba dzakawanda kubva kuvakadzi vasina kusununguka zvichibva pachimiro cheovarian netracheal, pamwe nekuona mwero wekubereka uye zera remuviri [35].
Nhamba yehuwandu inoonekwa nekuyedza kwakabva kudya kweropa kuchangobva kuunganidzwa. gambiae ne enzyme-linked immunosorbent assay (ELISA) uchishandisa ropa rinobva kuvanhu, zvipfuyo (mombe, makwai, mbudzi) uye huku dzinogamuchira [40]. Kubatwa nezvipembenene (EIR) kwakaverengerwa uchishandisa An. Inofungidzirwa yevakadzi vane SL muGambia [41] Pamusoro pezvo, An. Kutapukirwa nePlasmodium gambiae kwakacherechedzwa nekuongorora musoro nechipfuva chevakadzi vane mapapo akawanda vachishandisa nzira ye circumsporozoite antigen ELISA (CSP ELISA) [40]. Pakupedzisira, kune nhengo dzeAnn. gambiae dzakaonekwa nekuongorora makumbo ayo, mapapiro nedumbu vachishandisa nzira dze polymerase chain reaction (PCR) [34].
Ruzivo rwekiriniki nezvemalaria rwakawanikwa kubva kukiriniki yekubvunzana yeNapyeledugou Health Centre, iyo inofukidza misha yese mina yakabatanidzwa muchidzidzo ichi (kureva Kakologo, Kolekaha, Lofinekaha naNambatiurkaha). Ongororo yekiriniki yakatarisa pane zvakanyorwa kubva munaKurume 2018 kusvika Kukadzi 2019 uye kubva munaKurume 2019 kusvika Kukadzi 2020. Ruzivo rwekiriniki kubva munaKurume 2018 kusvika Kukadzi 2019 rwunomiririra data rekutanga kana repamberi peBti intervention, nepo ruzivo rwekiriniki kubva munaKurume 2019 kusvika Kukadzi 2020 rwunomiririra data repamberi peBti intervention. Ruzivo mushure mekupindira kweBti. Ruzivo rwekiriniki, zera nemusha wemurwere wega wega mumapoka ekudzidza eLLIN+Bti neLLIN zvakaunganidzwa mukiriniki yehutano. Kune murwere wega wega, ruzivo rwakadai sekwakabva kumusha, zera, kuongororwa, uye chirwere chakanyorwa. Muzviitiko zvakaongororwa muchidzidzo ichi, malaria yakasimbiswa nekurapwa nekukurumidza (RDT) uye/kana mamaria microscopy mushure mekupihwa artemisinin-based combination therapy (ACT) nemupi wehutano. Nyaya dzemarariya dzakakamurwa kuita mapoka matatu ezera (kureva makore gumi nemashanu). Kuwanda kwemarariya pagore pavanhu 1000 kwakafungidzirwa nekukamura kuwanda kwemarariya pavanhu 1000 zvichienderana nevanhu vemumusha.
Data rakaunganidzwa muchidzidzo ichi rakaiswa kaviri mudhatabhesi reMicrosoft Excel ndokuzopinzwa musoftware yeR [42] version 3.6.3 kuti iongororwe nenhamba. Ggglot2 package inoshandiswa kudhirowa marongero. Mamodheru akajairwa achishandisa Poisson regression akashandiswa kuenzanisa huwandu hwemakonye nenhamba yekurumwa kweumhutu pamunhu husiku pakati pemapoka ekudzidza. Kuyerwa kweRelevance ratio (RR) kwakashandiswa kuenzanisa huwandu hwemakonye nenhamba yekurumwa kweumhutu hweCulex neAnopheles. Gambia SL yakaiswa pakati pemapoka maviri ekudzidza ichishandisa boka reLLIN + Bti senzira yekutanga. Saizi dzemhedzisiro dzakaratidzwa semazinga ekusawirirana uye 95% confidence intervention (95% CI). Chiyero (RR) chePoisson test chakashandiswa kuenzanisa huwandu uye huwandu hwemarariya isati yatanga uye mushure mekupindira kweBti muboka rega rega rekudzidza. Chikamu chekukosha chakashandiswa chaive 5%.
Nzira yekudzidza iyi yakatenderwa neNational Research Ethics Committee yeMinistry of Health and Public Health yeCôte d'Ivoire (N/Ref: 001//MSHP/CNESVS-kp), pamwe nedunhu rezvehutano redunhu pamwe nehutungamiriri hweKorhogo. Vasati vatora mabundu eumhutu nevanhu vakuru, mvumo yakasainwa kubva kune vakapinda muongororo yemumba, varidzi, uye/kana vagari vemo. Ruzivo rwemhuri nerwekiriniki haruna kuzivikanwa uye rwakavanzika uye runowanikwa chete kune vaongorori vakasarudzwa.
Nzvimbo dzekuvakira matendere dzinosvika 1198 dzakashanyirwa. Panzvimbo idzi dzekuvakira matendere dzakaongororwa munzvimbo iyi, 52.5% (n = 629) dzaive dzeboka reLLIN + Bti uye 47.5% (n = 569) dzaive dzeboka reLLIN chete (RR = 1.10 [95% CI 0 .98–1.24], P = 0.088). Kazhinji, nzvimbo dzekugara makondo dzemuno dzakakamurwa kuita mhando gumi nembiri, pakati padzo chikamu chikuru chenzvimbo dzemakondo dzaive minda yemupunga (24.5%, n = 294), ichiteverwa nekuyerera kwemvura inonaya mumvura ine dutu (21.0%, n = 252) uye midziyo yevhu (8.3). %, n = 99), mahombekombe erwizi (8.2%, n = 100), dziva (7.2%, n = 86), dziva (7.0%, n = 84), pombi yemvura yemumusha (6.8 %, n = 81), prints dzemahwanda (4.8%, n = 58), madhamu (4.0%, n = 48), mapitcher (5.2%, n = 62), madziva (1.9%, n = 23) uye matsime (0.9%, n = 11). ).
Pamwe chete, hove dzeumhutu dzinosvika 47,274 dzakatorwa kubva munzvimbo yakadzidzwa, nechikamu che14.4% (n = 6,796) muboka reLLIN + Bti zvichienzaniswa ne85.6% (n = 40,478) muboka reLLIN chete ((RR = 5.96) [95% CI 5.80–6.11], P ≤ 0.001). Hove idzi dzine marudzi matatu eumhutu, mhando huru dziri Anopheles. (48.7%, n = 23,041), ichiteverwa neCulex spp. (35.0%, n = 16,562) uye Aedes spp. (4.9%, n = 2340). Pupae dzaive 11.3% yenhunzi dzisina kukura (n = 5344).
Avhareji yehuwandu hwemakonye eAnopheles spp. . Muchidzidzo ichi, huwandu hwemakonye pa scoop imwe neimwe hwaive 0.61 [95% CI 0.41–0.81] L/dip muboka reLLIN + Bti uye 3.97 [95% CI 3.56–4.38] L /dive muboka reLLIN chete (sarudzo). faira 1: Mufananidzo S1). Avhareji yehuwandu hwemakonye eAnopheles spp. Boka reLLIN rega raive rakakwira ka6.5 kupfuura boka reLLIN + Bti (HR = 6.49; 95% CI 5.80–7.27; P < 0.001). Hapana umhutu hweAnopheles hwakaonekwa panguva yekurapwa. Makonye akaunganidzwa muboka reLLIN + Bti kutanga muna Ndira, zvichienderana nekurapwa kweBti makumi maviri. Muboka reLLIN + Bti, kwaive nekuderera kukuru kwehuwandu hwemakonye pakutanga uye pakupera kwedanho.
Kusati kwatanga kurapwa kweBti (Kurume), huwandu hweumhutu hweAnopheles hwekutanga hwakafungidzirwa kuva 1.28 [95% CI 0.22–2.35] L/dive muboka reLLIN + Bti uye 1.37 [95% CI 0.36–2.36] l/dive muboka reLLIN + Bti. l/dip. /dip chete ruoko rweLLIN (Mufananidzo 2A). Mushure mekushandisa kurapwa kweBti, huwandu hweumhutu hweAnopheles hwekutanga muboka reLLIN + Bti hwakaderera zvishoma nezvishoma kubva pa0.90 [95% CI 0.19–1.61] kusvika pa0.10 [95% CI – 0.03–0.18] l/dip. Huwandu hweumhutu hweAnopheles hwekutanga hwakaramba hwakaderera muboka reLLIN + Bti. Muboka reLLIN chete, kuchinja-chinja kwekuwanda kweAnopheles spp. Makonye ekutanga akaonekwa aine huwandu hwepakati kubva pa0.23 [95% CI 0.07–0.54] L/dive kusvika pa2.37 [95% CI 1.77–2.98] L/dive. Kazhinji, huwandu hwepakati hwemakonye ekutanga eAnopheles muboka reLLIN chete hwaive hwakakwira zvakanyanya pa1.90 [95% CI 1.70–2.10] L/dive, nepo huwandu hwepakati hwemakonye ekutanga eAnopheles muboka reLLIN hwaive 0.38 [95% CI 0.28–0.47]) l/dip. + Bti group (RR = 5.04; 95% CI 4.36–5.85; P < 0.001).
Kuchinja kwehuwandu hwemakonye eAnopheles. Mambure eumhutu ekutanga (A) uye ekupedzisira (B) muboka rekudzidza kubva munaKurume 2019 kusvika Kukadzi 2020 munharaunda yeNapier, kuchamhembe kweCôte d'Ivoire. LLIN: mambure ekuuraya zvipembenene anogara kwenguva refu Bti: Bacillus thuringiensis, Israel TRT: kurapwa;
Avhareji yehuwandu hwemabukira eAnopheles spp.. makore ekuyaruka muboka reLLIN + Bti. Kuwanda kweBti isati yapihwa mushonga kwaive 2.98 [95% CI 0.26–5.60] L/dip, nepo huwandu hwemabukira eLLIN-alone hwaive 1.46 [95% CI 0.26–2.65] l/zuva Mushure mekushandisa Bti, huwandu hwemabukira eAnopheles ekupedzisira muboka reLLIN + Bti hwakaderera kubva pa0.22 [95% CI 0.04–0.40] kusvika pa0.03 [95% CI 0.00–0.06] L/dip (Mufananidzo 2B). Muboka reLLIN chete, huwandu hwemabuu eAnopheles achangoburwa hwakawedzera kubva pa0.35 [95% CI - 0.15-0.76] kusvika pa2.77 [95% CI 1.13-4.40] l/dive nekusiyana kwehuwandu hwemabuu zvichienderana nezuva rekutora sampu. Avhareji yehuwandu hwemabuu eAnopheles achangoburwa muboka reLLIN chete yaive 2.07 [95% CI 1.84–2.29] L/dive, yakapetwa kapfumbamwe pane 0.23 [95% CI 0.11–0. 36] l/immersion muLLIN. + Bti group (RR = 8.80; 95% CI 7.40–10.57; P < 0.001).
Avhareji yehuwandu hweCulex spp. Values yaiva 0.33 [95% CI 0.21–0.45] L/dip muboka reLLIN + Bti uye 2.67 [95% CI 2.23–3.10] L/dip muboka reLLIN chete (faira rekuwedzera 2: Mufananidzo S2). Avhareji yehuwandu hweCulex spp. Boka reLLIN chete raive rakakwira zvakanyanya kupfuura boka reLLIN + Bti (HR = 8.00; 95% CI 6.90–9.34; P < 0.001).
Avhareji yehuwandu hwemhando yeCulex Culex spp. Vasati varapwa, Bti l/dip yaive 1.26 [95% CI 0.10–2.42] l/dip muboka reLLIN + Bti uye 1.28 [95% CI 0.37–2.36] muboka rega reLLIN (Mufananidzo 3A). Mushure mekushandisa mushonga weBti, huwandu hwemakonye ekutanga eCulex hwakaderera kubva pa0.07 [95% CI - 0.001–0.] kusvika pa0.25 [95% CI 0.006–0.51] L/dip. Hapana makonye eCulex akatorwa kubva kunzvimbo dzinogara makonye dzakarapwa neBti kutanga muna Zvita. Kuwanda kwehonye dzeCulex dzepakutanga kwakadzikiswa kusvika pa0.21 [95% CI 0.14–0.28] L/dip muboka reLLIN + Bti, asi kwakakwira muboka reLLIN chete pa1.30 [95% CI 1.10– 1.50] l/immersion. donhwe/d. Kuwanda kwehonye dzeCulex dzekutanga muboka reLLIN chete kwakakwira ka6 kupfuura muboka reLLIN + Bti (RR = 6.17; 95% CI 5.11–7.52; P < 0.001).
Kuchinja kwehuwandu hwemakonye eCulex spp.. Kuedza kwevana vepakutanga (A) nevekutanga (B) muboka rekudzidza kubva munaKurume 2019 kusvika Kukadzi 2020 munharaunda yeNapier, kuchamhembe kweCôte d'Ivoire. Mushonga wekuuraya zvipembenene unogara kwenguva refu LLIN, Bti Bacillus thuringiensis Israel, Kurapa kweTrt
Kusati kwarapwa Bti, huwandu hwemakonye ekupedzisira eCulex muboka reLLIN + Bti neboka reLLIN hwaive 0.97 [95% CI 0.09–1.85] uye 1.60 [95% CI – 0.16–3.37] l/kunyudzwa zvinoenderana (Mufananidzo 3B) ). Huwandu hwemakonye ekupedzisira eCulex mushure mekutanga kurapwa kweBti. Huwandu hwemakonye muboka reLLIN + Bti hwakaderera zvishoma nezvishoma uye hwakanga hwakaderera pane hweboka reLLIN chete, izvo zvakaramba zvakanyanya. Huwandu hwemakonye ekupedzisira eCulex hwaive 0.12 [95% CI 0.07–0.15] L/kunyudza muboka reLLIN + Bti uye 1.36 [95% CI 1.11–1.61] L/kunyudza muboka reLLIN chete. Avhareji yehuwandu hwemakonye eCulex achangoburwa yaive yakakwira zvakanyanya muboka reLLIN chete kupfuura muboka reLLIN + Bti (RR = 11.19; 95% CI 8.83–14.43; P < 0.001).
Kusati kwarapwa Bti, huwandu hwemapupae pa ladybug hwaive 0.59 [95% CI 0.24–0.94] muboka reLLIN + Bti uye 0.38 [95% CI 0.13–0.63] muLLIN chete (Mufananidzo 4). Huwandu hwemapupae hwaive 0.10 [95% CI 0.06–0.14] muboka reLLIN + Bti uye 0.84 [95% CI 0.75–0.92] muboka reLLIN chete. Kurapwa kweBti kwakaderedza zvakanyanya huwandu hwemapupae muboka reLLIN + Bti zvichienzaniswa neboka reLLIN chete (OR = 8.30; 95% CI 6.37–11.02; P < 0.001). Muboka reLLIN + Bti, hapana mapupae akatorwa mushure meMbudzi.
Kuchinja kwehuwandu hwemapupa. Chidzidzo ichi chakaitwa kubva munaKurume 2019 kusvika Kukadzi 2020 munharaunda yeNapier kuchamhembe kweCôte d'Ivoire. Mushonga wezvipembenene unogara kwenguva refu LLIN, Bti Bacillus thuringiensis Israel, Kurapa kweTrt
Utunga hwevanhu vakuru vanosvika 3456 hwakatorwa kubva munzvimbo yaitsvakurudzwa. Utunga huri mumarudzi gumi nemanomwe emarudzi mashanu (Anopheles, Culex, Aedes, Eretmapodites) (Tafura 1). Muzvirwere zvemarariya, An. gambiae sl ndiyo yaive mhando yakawanda ine chikamu che74.9% (n = 2587), ichiteverwa neAn. gambiae sl. funestus (2.5%, n = 86) uye An null (0.7%, n = 24). Hupfumi hwaAnna. gambiae sl muboka reLLIN + Bti (10.9%, n = 375) hwaive hwakaderera pane hweboka reLLIN chete (64%, n = 2212). Hapana rugare. nli vanhu vakaiswa muboka reLLIN chete. Zvisinei, An. gambiae neAn. funestus zvaivepo muboka reLLIN + Bti neboka reLLIN chete.
Muzvidzidzo zvakatanga Bti isati yaiswa panzvimbo yekuberekesa (mwedzi mitatu), huwandu hwese hweumhutu hwehusiku pamunhu (b/p/n) muboka reLLIN + Bti hwakafungidzirwa kuva 0.83 [95% CI 0.50–1.17], nepo muboka reLLIN + Bti hwaive 0.72 muboka reLLIN chete [95% CI 0.41–1.02] (Mufananidzo 5). Muboka reLLIN + Bti, kukuvara kweumhutu hweCulex kwakaderera uye kwakaramba kuri pasi kunyangwe paine huwandu hwe1.95 [95% CI 1.35–2.54] bpp munaGunyana mushure mekushandisa Bti kechi12. Zvisinei, muboka reLLIN chete, huwandu hweumhutu hweavhareji hwakawedzera zvishoma nezvishoma usati wasvika pakakwirira munaGunyana pa11.33 [95% CI 7.15–15.50] bp/n. Kuwanda kwekurumwa kweumhutu kwaive kwakaderera zvakanyanya muboka reLLIN + Bti zvichienzaniswa neboka reLLIN rega panguva ipi zvayo panguva yekudzidza (HR = 3.66; 95% CI 3.01–4.49; P < 0.001).
Kurumwa kwemhuka dzeumhutu munzvimbo yekuongorora yedunhu reNapier kuchamhembe kweCôte d'Ivoire kubva munaKurume 2019 kusvika Kukadzi 2020 LLIN Mambure ekuuraya zvipembenene anogara kwenguva refu, Bti Bacillus thuringiensis Israel, Kurapa kweTrt, kurumwa b/p/husiku/munhu/husiku
Anopheles gambiae ndiyo inonyanya kukonzera malaria munzvimbo iyi. Kumhanya kwekurumwa kweAn. Pakutanga, vakadzi vekuGambia vaiva ne b/p/n values ye 0.64 [95% CI 0.27–1.00] muboka reLLIN + Bti uye 0.74 [95% CI 0.30–1.17] muboka reLLIN chete (Mufananidzo 6). Munguva yekupindira kweBti, chiitiko chepamusoro chekurumwa chakaonekwa munaGunyana, zvichienderana nekurapwa kweBti kwegumi nemaviri, nechikamu chepamusoro che1.46 [95% CI 0.87–2.05] b/p/n muboka reLLIN + Bti uye chikamu chepamusoro che9 .65 [95% CI 0.87–2.05] w/n 5.23–14.07] LLIN boka chete. Kumhanya kwekurumwa kweAn. Huwandu hwehutachiona muGambia hwakanga hwakaderera zvakanyanya muboka reLLIN + Bti (0.59 [95% CI 0.43–0.75] b/p/n) pane muboka reLLIN chete (2.97 [95% CI 2, 02–3.93] b/p/no). (RR = 3.66; 95% CI 3.01–4.49; P < 0.001).
Kurumidza kwaAnna kurumwa. gambiae sl, ongororo mudunhu reNapier, kuchamhembe kweCote d'Ivoire, kubva munaKurume 2019 kusvika Kukadzi 2020 LLIN ine mushonga wezvipembenene inogara kwenguva refu, Bti Bacillus thuringiensis Israel, Kurapa kweTrt, kurumwa b/p/husiku/ munhu/husiku
Huwandu hwema amps 646. Gambia yakachekwa-chekwa. Zvose, chikamu chekuchengetedzwa kwenzvimbo. Huwandu hwevana muGambia hwaiwanzova >70% munguva yese yekudzidza, kunze kwaChikunguru, apo boka reLLIN chete rakashandiswa (Faira rekuwedzera 3: Mufananidzo S3). Zvisinei, avhareji yehuwandu hwevana muchikamu chekudzidza yaive 74.5% (n = 481). Muboka reLLIN+Bti, huwandu hwevana muchikamu chakaramba huri pamusoro, pamusoro pe80%, kunze kwaGunyana, apo huwandu hwevana muchikamu chakadzikira kusvika pa77.5%. Zvisinei, misiyano yehuwandu hwevana muchikamu chakaonekwa muboka reLLIN chete, neavhareji yevana muchikamu chakaderera chiri 64.5%.
Kubva pa389 Ann. Ongororo yezvikamu zveropa zvega zvega kubva kuGambia yakawana kuti 80.5% (n = 313) yakabva kuvanhu, 6.2% (n = 24) yevakadzi vakadya ropa rakasanganiswa (revanhu nerepamba) uye 5.1% (n = 20) vakadya ropa. Chikafu chezvipfuyo (mombe, makwai nembudzi) uye 8.2% (n = 32) yemasampuli akaongororwa aive asina kunaka pakudya kweropa. Muboka reLLIN + Bti, huwandu hwevakadzi vakagamuchira ropa revanhu hwaive 25.7% (n = 100) zvichienzaniswa ne54.8% (n = 213) muboka reLLIN chete (Yakawedzerwa faira 5: Tafura S5).
Huwandu hwemaampisi 308. P. gambiae yakaedzwa kuti ione nhengo dzemhando iyi uye hutachiona hweP. falciparum (Faira rekuwedzera 4: Tafura S4). Mhando mbiri dzakabatana dziripo munzvimbo yekuongorora, dzinoti An. gambiae ss (95.1%, n = 293) uye An. coluzzii (4.9%, n = 15). Anopheles gambiae ss dzaive dzakaderera zvakanyanya muboka reLLIN + Bti pane muboka reLLIN chete (66.2%, n = 204) (RR = 2.29 [95% CI 1.78–2.97], P < 0.001). Chikamu chakafanana cheumhutu hweAnopheles chakawanikwa muboka reLLIN + Bti (3.6%, n = 11) uye boka reLLIN chete (1.3%, n = 4) (RR = 2.75 [95% CI 0.81–11 .84], P = .118). Kuwanda kwehutachiona hwePlasmodium falciparum pakati peAn. SL muGambia kwaive 11.4% (n = 35). Mwero wehutachiona hwePlasmodium falciparum. Mwero wehutachiona muGambia wakaderera zvakanyanya muboka reLLIN + Bti (2.9%, n = 9) pane muboka reLLIN chete (8.4%, n = 26) (RR = 2.89 [95% CI 1. 31–7.01], P = 0.006). ). Zvichienzaniswa neAnopheles mosquito, Anopheles gambiae mosquito dzaive nehuwandu hwakanyanya hwehutachiona hwePlasmodium pa94.3% (n=32). coluzzii chete 5.7% (n = 5) (RR = 6.4 [95% CI 2.47–21.04], P < 0.001).
Vanhu vanosvika 2,435 vanobva mumhuri 400 vakaongororwa. Avhareji yevanhu 6.1 pamhuri. Mwero wekuva muridzi weLLIN pakati pemhuri waiva 85% (n = 340), zvichienzaniswa ne15% (n = 60) kumhuri dzisina LLIN (RR = 5.67 [95% CI 4.29–7.59], P < 0.001) (Faira rekuwedzera 5: Tafura S5). . Kushandiswa kweLLIN kwaive 40.7% (n = 990) muboka reLLIN + Bti zvichienzaniswa ne36.2% (n = 882) muboka reLLIN chete (RR = 1.12 [95% CI 1.02–1.23], P = 0.013). Avhareji yekushandiswa kwese kwese munzvimbo yekutsvagurudza yaive 38.4% (n = 1842). Huwandu hwevana vari pasi pemakore mashanu ekuberekwa vanoshandisa Indaneti hwakanga hwakafanana mumapoka ese ari maviri ekudzidza, nemazinga ekushandiswa kwe41.2% (n = 195) muboka reLLIN + Bti uye 43.2% (n = 186) muboka reLLIN chete. (HR = 1.05 [95% CI 0.85–1.29], P = 0.682). Pakati pevana vane makore mashanu kusvika ku15, pakanga pasina musiyano mumazinga ekushandiswa kwekushandisa kweInternet pakati pe36.3% (n = 250) muboka reLLIN + Bti uye 36.9% (n = 250) muboka reLLIN chete (RR = 1. 02 [95% CI 1.02–1.23], P = 0.894). Zvisinei, avo vane makore anopfuura 15 ekuberekwa vakashandisa mambure emubhedha ne42.7% (n = 554) zvishoma muboka reLLIN + Bti pane 33.4% (n = 439) muboka reLLIN chete (RR = 1.26 [95% CI 1.11–1.43], P <0.001).
Vanhu vanosvika 2,484 vakanyoreswa paNapier Health Center pakati paKurume 2018 naKukadzi 2020. Kuwanda kwemalaria muvanhu vose kwaive 82.0% yezviitiko zvese zvechirwere chemalaria (n = 2038). Huwandu hwemarariya hwepagore munharaunda iyi munzvimbo iyi hwaive 479.8‰ uye 297.5‰ vasati varapwa Bti uye mushure mekurapwa (Tafura 2).
Nguva yekutumira: Chikunguru-01-2024