Mishonga yezvipembenene inoita basa guru mukurima kumaruwa, asi kushandiswa kwayo zvakanyanya kana kusashandiswa zvakanaka kunogona kukanganisa mitemo yekudzora marariya; Chidzidzo ichi chakaitwa pakati pevarimi kumaodzanyemba kweCôte d'Ivoire kuti vaone kuti ndeipi mishonga yezvipembenene inoshandiswa nevarimi veko uye kuti izvi zvine chekuita sei nemaonero evarimi nezvemarariya. Kunzwisisa kushandiswa kwemishonga yezvipembenene kunogona kubatsira kugadzira mapurogiramu ekuzivisa vanhu nezvekudzivirira umhutu nekushandiswa kwemishonga yezvipembenene.
Ongororo iyi yakaitwa pakati pemhuri 1,399 mumisha gumi. Varimi vakaongororwa nezvedzidzo yavo, maitiro ekurima (semuenzaniso, kugadzira zvirimwa, kushandisa mishonga inouraya zvipembenene), maonero avo nezvemalaria, uye nzira dzakasiyana-siyana dzekudzora umhutu hwemhuri dzavanoshandisa. Mamiriro ehupfumi hwemhuri (SES) emhuri yega yega anoongororwa zvichibva pane zvimwe zvinhu zvemhuri zvakatarwa. Hukama hwehuwandu pakati pezvinhu zvakasiyana-siyana hunoverengwa, zvichiratidza zvinhu zvakakosha zvinokonzera njodzi.
Dzidzo yevarimi yakabatana zvikuru nemamiriro avo ehupfumi (p < 0.0001). Mhuri zhinji (88.82%) dzaitenda kuti umhutu ndihwo hunokonzera malaria uye ruzivo rwemalaria rwakabatana zvakanaka nedanho redzidzo yepamusoro (OR = 2.04; 95% CI: 1.35, 3.10). Kushandiswa kwemakemikari mumba kwakabatana zvakanyanya nemamiriro ehupfumi hwemhuri, danho redzidzo, kushandiswa kwemambure emubhedha akarapwa zvipembenene uye mishonga yekurima inouraya zvipembenene (p < 0.0001). Varimi vakawanikwa vachishandisa mishonga yekuuraya zvipembenene inouraya zvipembenene inouraya zvipembenene mumba uye vanoshandisa mishonga iyi yekuuraya zvipembenene kuchengetedza zvirimwa.
Chidzidzo chedu chinoratidza kuti dzidzo ichiri chinhu chikuru chinopesvedzera ruzivo rwevarimi nezvekushandiswa kwemishonga inouraya zvipembenene uye kudzora malaria. Tinokurudzira kuti kutaurirana kwakanangana nekubudirira kwedzidzo, kusanganisira mamiriro ehupfumi, kuwanikwa, uye kuwanikwa kwemishonga inodzorwa, zvifungisiswe pakugadzira nzira dzekutarisira mishonga inouraya zvipembenene uye nzira dzekutarisira zvirwere zvinotapukira munharaunda.
Kurima ndiko kwainyanya kukonzera hupfumi hwenyika zhinji dzeWest Africa. Muna 2018 na2019, Côte d'Ivoire ndiyo yaive nyika inotungamira mukugadzira cocoa ne cashew nuts uye iri yechitatu mukugadzira kofi muAfrica [1], ine mabasa ekurima nezvigadzirwa zvaiita 22% yeGDP [2]. Sevaridzi veminda mizhinji yekurima, varidzi vadiki vari kumaruwa ndivo vanonyanya kubatsira mukusimudzira hupfumi hwechikamu ichi [3]. Nyika ine mukana mukuru wekurima, ine mahekita mamiriyoni gumi nemanomwe eminda yekurima uye mwaka yakasiyana-siyana zvichikurudzira kusiyanisa zvirimwa uye kurimwa kwekofi, cocoa, cashew nzungu, rabha, donje, mayam, palm, cassava, mupunga nemiriwo [2]. Kurima kwakasimba kunobatsira mukupararira kwezvipembenene, kunyanya kuburikidza nekuwedzera kushandiswa kwemishonga yekuuraya zvipembenene [4], kunyanya pakati pevarimi vekumaruwa, kuchengetedza zvirimwa nekuwedzera goho rezvirimwa [5], uye kudzora umhutu [6]. Zvisinei, kushandiswa zvisina kunaka kwemishonga yekuuraya zvipembenene ndeimwe yezvikonzero zvikuru zvekusagona kuuraya zvipembenene muzvirwere zvinopararira, kunyanya munzvimbo dzekurima uko umhutu nezvipembenene zvinogona kumanikidzwa nemishonga yekuuraya zvipembenene yakafanana [7,8,9,10]. Kushandiswa kwemishonga yekuuraya zvipembenene kunogona kukonzera kusvibiswa kunokanganisa nzira dzekudzora zvipembenene nenharaunda uye nekudaro kunoda kutariswa [11, 12, 13, 14, 15].
Kushandiswa kwemishonga inouraya zvipembenene nevarimi kwakambodzidzwa kare [5, 16]. Dzidzo yakaratidzwa kuva chinhu chakakosha pakushandiswa kwemishonga inouraya zvipembenene nemazvo [17, 18], kunyange hazvo kushandiswa kwemishonga inouraya zvipembenene nevarimi kuchiwanzokonzerwa neruzivo rwezvakaitika kana kurudziro kubva kuvatengesi [5, 19, 20]. Zvipingamupinyi zvemari ndeimwe yemipingamupinyi inowanzo kanganisa kuwanikwa kwemishonga inouraya zvipembenene kana mishonga inouraya zvipembenene, zvichiita kuti varimi vatenge zvigadzirwa zvisiri pamutemo kana zvekare, izvo zvinowanzova zvakachipa pane zvigadzirwa zvepamutemo [21, 22]. Maitiro akafanana anoonekwa mune dzimwe nyika dzeWest Africa, uko mari shoma iri chikonzero chekutenga nekushandisa mishonga inouraya zvipembenene isina kukodzera [23, 24].
MuCôte d'Ivoire, mishonga yezvipembenene inoshandiswa zvakanyanya pazvirimwa [25, 26], izvo zvinokanganisa nzira dzekurima uye huwandu hwevanhu vanokonzera malaria [27, 28, 29, 30]. Zvidzidzo munzvimbo dzine malaria zvakaratidza hukama pakati pemamiriro ehupfumi nemaonero emalaria nenjodzi dzehutachiona, uye kushandiswa kwemambure emubhedha ane mushonga wezvipembenene (ITN) [31,32,33,34,35,36,37]. Pasinei nezvidzidzo izvi, kuedza kugadzira mitemo chaiyo yekudzora umhutu kunokanganiswa nekushaikwa kweruzivo nezvekushandiswa kwemishonga yezvipembenene munzvimbo dzekumaruwa uye zvinhu zvinobatsira pakushandiswa kwemishonga yezvipembenene nemazvo. Chidzidzo ichi chakaongorora zvitendero zvemalaria uye nzira dzekudzora umhutu pakati pemhuri dzekurima muAbeauville, kuchamhembe kweCôte d'Ivoire.
Chidzidzo ichi chakaitwa mumisha gumi muAbeauville department kumaodzanyemba kweCôte d'Ivoire (Mufananidzo 1). Agbowell Province ine vagari 292,109 munzvimbo ine 3,850 square kilometers uye ndiyo dunhu rine vanhu vakawanda mudunhu reAnyebi-Tiasa [38]. Ine mamiriro ekunze ekupisa ane mwaka miviri yemvura (Kubvumbi kusvika Chikunguru naGumiguru kusvika Mbudzi) [39, 40]. Kurima ndicho chiitiko chikuru munharaunda iyi uye chinoitwa nevarimi vadiki nemakambani makuru ekurima. These 10 locations include Aboude Boa Vincent (323,729.62 E, 651,821.62 N), Aboude Kuassikro (326,413.09 E, 651,573.06 N), Aboude Mandek (326,413.09 E , 601N7 Abude) (330633.05E, 652372.90N), Amengbeu (348477.76E, 664971.70N), Damojiang (374,039.75 E, 661,579.59 N), Casigue 1 (363,1477.76N), Love 671. (351,545.32 E., 642.06 2.37 N), Ofa (350 924.31 E, 654 607.17 N), Ofonbo (338 578.5) 1 E, 657 302.17 kuchamhembe kwelatitude) uye Uji (363,990.74 kumabvazuva kwelongitude, 648,587.44 kuchamhembe kwelatitude).
Chidzidzo ichi chakaitwa pakati paNyamavhuvhu 2018 naKurume 2019 nekutora chikamu kwemhuri dzevarimi. Huwandu hwevagari vemumusha wega wega hwakatorwa kubva kubazi rebasa remunharaunda, uye vanhu 1,500 vakasarudzwa zvisina kurongeka kubva pane runyorwa urwu. Vatori vechikamu vakatorwa vaimiririra pakati pe6% ne16% yevanhu vemumusha. Mhuri dzaibatanidzwa muchidzidzo ichi dzaive mhuri dzevarimi dzakabvuma kutora chikamu. Ongororo yekutanga yakaitwa pakati pevarimi makumi maviri kuti vaongorore kana mimwe mibvunzo yaifanira kunyorwa patsva. Mibvunzo yacho yakazopedzwa nevaunganidzi vedata vakadzidziswa uye vanobhadharwa mumusha wega wega, mumwe wavo akatorwa kubva mumusha wega wega. Sarudzo iyi yakaita kuti musha wega wega uve nemuunganidzi wedata mumwe chete aiziva nharaunda uye aitaura mutauro wemuno. Mumhuri yega yega, kubvunzurudzwa kwechiso nechiso kwakaitwa nemusoro wemhuri (baba kana amai) kana, kana mukuru wemhuri asipo, mumwe mukuru ane makore anopfuura 18 ekuberekwa. Mibvunzo iyi yaive nemibvunzo makumi matatu nematanhatu yakakamurwa kuita zvikamu zvitatu: (1) Huwandu hwevanhu uye magariro evanhu nehupfumi hwemhuri (2) Maitiro ekurima nekushandisa mishonga yekuuraya zvipembenene (3) Ruzivo nezvemalaria nekushandiswa kwemishonga yekuuraya zvipembenene mukudzivirira umhutu [ona Annex 1].
Mishonga yekuuraya zvipembenene yakataurwa nevarimi yakarongwa nemazita ekutengeserana uye yakarongwa nezvikamu zvinoshanda uye mapoka emakemikari vachishandisa Ivory Coast Phytosanitary Index [41]. Mamiriro ehupfumi hwemhuri yega yega akaongororwa nekuverenga index yemidziyo [42]. Midziyo yemhuri yakashandurwa kuita dichotomous variables [43]. Negative factor ratings inobatanidzwa ne lower socioeconomic status (SES), nepo positive factor ratings inobatanidzwa ne higher SES. Asset scores inopfupikiswa kuti ibudise total score yemhuri yega yega [35]. Zvichibva pa total score, mhuri dzakakamurwa kuita 5 quintiles ye socioeconomic status, kubva kune varombo kusvika kune vapfumi [ona Additional file 4].
Kuti uone kana shanduko yakasiyana zvakanyanya nemagariro evanhu, musha, kana nhanho yedzidzo yemisoro yemhuri, bvunzo ye chi-square kana bvunzo chaiyo yaFisher inogona kushandiswa, sezvakakodzera. Mamodheru ekugadzirisa mafambiro emagetsi akaiswa nematanho anotevera ekugadzirisa: nhanho yedzidzo, mamiriro ehupfumi hwevanhu (ese akachinjwa kuita ma "dichotomous variables"), musha (akabatanidzwa se "categorical variables"), ruzivo rwakanyanya nezve malaria nekushandiswa kwemishonga inouraya zvipembenene mukurima, uye kushandiswa kwemishonga inouraya zvipembenene mumba (inobuda kuburikidza ne aerosol). kana coil); nhanho yedzidzo, mamiriro ehupfumi hwevanhu nemusha, zvichikonzera ruzivo rwakanyanya nezve malaria. Muenzaniso wekugadzirisa mafambiro emagetsi wakaitwa uchishandisa R package lme4 (Glmer function). Ongororo dzehuwandu dzakaitwa muR 4.1.3 (https://www.r-project.org) uye Stata 16.0 (StataCorp, College Station, TX).
Pavanhu 1,500 vakabvunzurudzwa, 101 havana kunyorwa nekuti mibvunzo haina kuzadzikiswa. Chikamu chikuru chemhuri dzakabvunzurudzwa chaive muGrande Maury (18.87%) uye chakaderera muOuanghi (2.29%). Mhuri 1,399 dzakabvunzurudzwa dziri muongororo iyi dzinomirira vanhu 9,023. Sezvakaratidzwa muTafura 1, 91.71% yemisoro yemhuri varume uye 8.29% vakadzi.
Vanenge 8.86% vemisoro yemhuri vaibva kunyika dziri pedyo dzakadai seBenin, Mali, Burkina Faso neGhana. Madzinza anonyanya kumiririrwa ndiAbi (60.26%), Malinke (10.01%), Krobu (5.29%) naBaulai (4.72%). Sezvinotarisirwa kubva mumuenzaniso wevarimi, kurima ndiko chete kunopa mari kune varimi vazhinji (89.35%), necocoa ichinyanya kurimwa mumhuri dzemuenzaniso; Muriwo, zvirimwa zvekudya, mupunga, rabha nemaplantain zvinorimwawo panzvimbo diki yevhu. Vasara vemisoro yemhuri ndevemabhizinesi, vanyori vemifananidzo nevabati vehove (Tafura 1). Pfupiso yehunhu hwemhuri nemusha inoratidzwa mufaira rekuwedzera [ona faira rekuwedzera 3].
Chikamu chedzidzo hachina kusiyana nekuda kwehunhu hwevakadzi nevarume (p = 0.4672). Vazhinji vevakabvunzwa vaiva nedzidzo yepuraimari (40.80%), ichiteverwa nedzidzo yesekondari (33.41%) uye kusagona kuverenga nekunyora (17.97%). 4.64% chete ndivo vakapinda yunivhesiti (Tafura 1). Pavakadzi 116 vakabvunzwa, vanopfuura 75% vaiva nedzidzo yepuraimari, uye vamwe vese vakanga vasati vamboenda kuchikoro. Dzidzo yevarimi inosiyana zvakanyanya mumisha (bvunzo chaiyo yaFisher, p < 0.0001), uye dzidzo yevatungamiriri vedzimba ine hukama hwakanaka nemamiriro avo ehupfumi (bvunzo chaiyo yaFisher, p < 0.0001). Kutaura zvazviri, mazinga epamusoro ehupfumi anowanzova varimi vakadzidza zvakanyanya, uye zvakasiyana, mazinga epasi ehupfumi anosanganisira varimi vasina kudzidza; Zvichibva pazvinhu zvese, mhuri dzakakamurwa kuita mazinga mashanu ehupfumi: kubva kune varombo (Q1) kusvika kune vakapfuma (Q5) [ona faira rekuwedzera 4].
Kune mutsauko mukuru muhukama hwemhuri dzevapfumi vakasiyana (p < 0.0001): 83.62% vane mukwanyina mumwe chete, 16.38% vane barika (kusvika kuvarume vatatu). Hapana mutsauko wakakosha wakawanikwa pakati peboka repfuma nehuwandu hwevakaroorana.
Ruzhinji rwevanhu vakapindura (88.82%) vaidavira kuti umhutu ndihwo humwe hwezvikonzero zvemarariya. 1.65% chete ndivo vakapindura kuti havazivi chinokonzera marariya. Zvimwe zvikonzero zvakaonekwa zvinosanganisira kunwa mvura yakasviba, kupiswa nezuva, kudya kusina kunaka uye kuneta (Tafura 2). Padanho remusha muGrande Maury, mhuri zhinji dzaiona kunwa mvura yakasviba sechikonzero chikuru chemarariya (musiyano wehuwandu pakati pemisha, p < 0.0001). Zviratidzo zvikuru zviviri zvemarariya kupisa muviri kwakanyanya (78.38%) uye kutsvuka kwemaziso (72.07%). Varimi vakataurawo nezvekurutsa, kupererwa neropa uye kusviba kweganda (ona Tafura 2 pazasi).
Pakati penzira dzekudzivirira malaria, vakapindura vakataura nezvekushandiswa kwemishonga yechivanhu; zvisinei, kana vachirwara, mishonga yekurapa malaria yemishonga neyechivanhu yaionekwa senzira dzinoshanda (80.01%), nesarudzo dzine chekuita nemamiriro ehupfumi hwevanhu. Hukama hwakakosha (p < 0.0001). ): Varimi vane mamiriro ehupfumi epamusoro vanonyanya kufarira uye vaigona kutenga mishonga yekurapa, varimi vane mamiriro ehupfumi epasi vanonyanya kufarira mishonga yemishonga yechivanhu; Inenge hafu yemhuri inoshandisa avhareji inopfuura 30,000 XOF pagore pakurapa malaria (zvine chekuita neSES; p < 0.0001). Zvichibva pakufungidzira kwemari yakananga kwakaitwa nevanopa mazano, mhuri dzine mamiriro ehupfumi epasi dzaive ne mukana wekushandisa XOF 30,000 (inenge US$50) yakawanda pakurapa malaria kupfuura mhuri dzine mamiriro ehupfumi epamusoro. Pamusoro pezvo, ruzhinji rwevakapindura vaidavira kuti vana (49.11%) ndivo vanogona kubatwa nemalaria kupfuura vakuru (6.55%) (Tafura 2), nemaonero aya akajairika pakati pemhuri dziri mu quintile yevarombo (p < 0.01).
Pakurumwa neumhutu, ruzhinji rwevatori vechikamu (85.20%) vakashuma kuti vakashandisa mambure emubhedha akagadziriswa zvipembenene, ayo vakagamuchira zvakanyanya panguva yekugoverwa kwenyika muna 2017. Vakuru nevana vakashumwa kuti vakarara pasi pemambure eumhutu akagadziriswa zvipembenene mu90.99% yemhuri. Kushandiswa kwemambure emubhedha akagadziriswa zvipembenene mudzimba kwaive pamusoro pe70% mumisha yese kunze kwemusha weGessigye, uko 40% chete yemhuri dzakashuma kuti dzakashandisa mambure akagadziriswa zvipembenene. Avhareji yehuwandu hwemambure emubhedha akagadziriswa zvipembenene emhuri yaive nehukama hwakakura uye hwakanaka nehukuru hwemhuri (Pearson's correlation coefficient r = 0.41, p < 0.0001). Zvakabuda zvedu zvakaratidzawo kuti mhuri dzine vana vari pasi pegore rimwe chete dzaive nemukana wekushandisa mambure akagadziriswa zvipembenene kumba zvichienzaniswa nemhuri dzisina vana kana nevana vakuru (odds ratio (OR) = 2.08, 95% CI : 1.25–3.47).
Pamusoro pekushandisa mambure emubhedha akagadziriswa mishonga yezvipembenene, varimi vakabvunzwawo nezvedzimwe nzira dzekudzivirira umhutu mudzimba dzavo uye pazvigadzirwa zvekurima zvinoshandiswa kudzora zvipembenene zvezvirimwa. 36.24% chete yevatori vechikamu vakataura nezvekupfapfaidza mishonga yezvipembenene mudzimba dzavo (hukama hwakakosha uye hwakanaka neSES p < 0.0001). Zvishandiso zvemakemikari zvakataurwa zvakabva kumakambani mapfumbamwe ekutengeserana uye zvakanyanya kuendeswa kumisika yemuno uye kune vamwe vatengesi muchimiro chefumigating coils (16.10%) uye zvipembenene zvinopfapfaidza (83.90%). Kugona kwevarimi kudoma mazita ezvipembenene zvinopfapfaidzwa mudzimba dzavo kwakawedzera nedzidzo yavo (12.43%; p < 0.05). Zvigadzirwa zvemakemikari zvakashandiswa pakutanga zvakatengwa mumagaba uye zvakasanganiswa nemasprayers vasati vashandisa, nehuwandu hukuru hunowanzoitirwa zvirimwa (78.84%) (Tafura 2). Musha weAmangbeu une huwandu hwakaderera hwevarimi vanoshandisa mishonga yezvipembenene mudzimba dzavo (0.93%) uye zvirimwa (16.67%).
Huwandu hwakanyanya hwezvinhu zvinouraya zvipembenene (zvinopfapfaidzwa kana kuti zvinomonereka) zvakatorwa pamhuri imwe neimwe hwaive 3, uye SES yaive yakabatana zvakanaka nehuwandu hwezvigadzirwa zvakashandiswa (Fisher's exact test p < 0.0001, zvisinei mune dzimwe nguva zvigadzirwa izvi zvakawanikwa zvine zvakafanana); zvinhu zvinoshanda pasi pemazita akasiyana ekutengeserana. Tafura 2 inoratidza kuwanda kwekushandiswa kwemishonga yezvipembenene vhiki nevhiki pakati pevarimi zvichienderana nemamiriro avo ehupfumi.
Mishonga yePyrethroids ndiyo inonyanya kumiririrwa mumhuri (48.74%) uye mishonga yekurima (54.74%) yezvipembenene. Zvigadzirwa zvinogadzirwa kubva mumishonga yezvipembenene yega yega kana pamwe chete nemimwe mishonga yezvipembenene. Musanganiswa wemishonga yezvipembenene yemumba unowanzoitwa nevarimi ndeye carbamates, organophosphates uye pyrethroids, nepo neonicotinoids nepyrethroids zvakajairika pakati pemishonga yezvipembenene yekurima (Appendix 5). Mufananidzo 2 unoratidza huwandu hwemhuri dzakasiyana dzemishonga yezvipembenene inoshandiswa nevarimi, iyo yose yakarongwa seClass II (ngozi iri pakati nepakati) kana Class III (ngozi diki) zvichienderana neWorld Health Organization yekupatsanura mishonga yezvipembenene [44]. Pane imwe nguva, zvakazoonekwa kuti nyika yaishandisa mushonga wezvipembenene wedeltamethrin, wakagadzirirwa kurima.
Panyaya yezvinhu zvinoshanda, propoxur nedeltamethrin ndizvo zvinonyanya kushandiswa mudzimba nemumunda, zvichiteerana. Faira rekuwedzera 5 rine ruzivo rwakadzama nezvezvigadzirwa zvemakemikari zvinoshandiswa nevarimi kumba uye pazvirimwa zvavo.
Varimi vakataura nezvedzimwe nzira dzekudzivirira umhutu, dzinosanganisira mafeni emashizha (pêpê mumutauro weAbbey wemuno), kupisa mashizha, kuchenesa nzvimbo yacho, kubvisa mvura yakamira, kushandisa mishonga inodzinga umhutu, kana kungoshandisa machira kudzinga umhutu.
Zvinhu zvine chekuita neruzivo rwevarimi nezvemalaria uye kupfapfaidza zvipembenene mumba (kuongorora logistic regression).
Data rakaratidza hukama hwakakosha pakati pekushandiswa kwemishonga inouraya zvipembenene mudzimba nezvinhu zvishanu zvinofanotaura: nhanho yedzidzo, SES, ruzivo rweumhutu sechikonzero chikuru chemalaria, kushandiswa kweITN, uye kushandiswa kwemishonga inouraya zvipembenene mukurima. Mufananidzo 3 unoratidza maOR akasiyana echinhu chimwe nechimwe chinofanotaura. Pakarongwa nemusha, zvese zvinofanotaura zvakaratidza hukama hwakanaka nekushandiswa kwemishonga inouraya zvipembenene mumhuri (kunze kwekuziva zvikonzero zvikuru zvemalaria, izvo zvaive zvakabatana nekushandiswa kwemishonga inouraya zvipembenene (OR = 0.07, 95% CI: 0.03, 0.13) . )) (Mufananidzo 3). Pakati pezvinhu izvi zvinofanotaura zvakanaka, chimwe chinonakidza ndechekushandiswa kwemishonga inouraya zvipembenene mukurima. Varimi vaishandisa mishonga inouraya zvipembenene pazvirimwa vaive ne188% mukana wekushandisa mishonga inouraya zvipembenene kumba (95% CI: 1.12, 8.26). Zvisinei, mhuri dzine ruzivo rwakanyanya nezvekupararira kwemalaria dzaive nekashoma kekushandisa mishonga inouraya zvipembenene mudzimba. Vanhu vane dzidzo yepamusoro vaiziva kuti umhutu ndihwo hunonyanya kukonzera malaria (OR = 2.04; 95% CI: 1.35, 3.10), asi pakanga pasina hukama hwehuwandu neSES yakakwira (OR = 1.51; 95% CI: 0.93, 2.46).
Sekureva kwemukuru wemba, huwandu hweumhutu hunowanda munguva yemvura uye husiku ndiyo nguva inonyanya kurumwa neumhutu (85.79%). Varimi pavakabvunzwa nezvemaonero avo pamusoro pekukanganisa kwekupfapfaidza zvipembenene pahuwandu hweumhutu hunotakura malaria, 86.59% vakasimbisa kuti umhutu hunoita sehuri kuramba mishonga yezvipembenene. Kusakwanisa kushandisa mishonga yemakemikari yakakwana nekuda kwekushaikwa kwayo kunoonekwa sechikonzero chikuru chekusashanda zvakanaka kana kushandiswa zvisina kunaka kwemishonga, izvo zvinoonekwa sezvimwe zvikonzero. Kunyanya, yekupedzisira iyi yakabatana nekudzikira kwedzidzo (p < 0.01), kunyangwe paidzora SES (p < 0.0001). 12.41% chete yevakapindura vakaona kusagadzikana kweumhutu sechimwe chezvikonzero zvinogona kukonzera kusagadzikana kwemishonga yezvipembenene.
Paiva nehukama hwakanaka pakati pekushandiswa kwemishonga inouraya zvipembenene kumba uye maonero ekuti mushonga unouraya zvipembenene haushandiswe nemishonga inouraya zvipembenene (p < 0.0001): mishumo yekuti mushonga unouraya zvipembenene haushandiswe nemishonga inouraya zvipembenene yakavakirwa pakushandiswa kwemishonga inouraya zvipembenene kumba nevarimi katatu kusvika kana pasvondo (90.34%). Pamusoro pekuwanda kwemishonga inouraya zvipembenene inoshandiswa yakabatanawo nemaonero evarimi ekuti mushonga unouraya zvipembenene haushandiswe nemishonga inouraya zvipembenene (p < 0.0001).
Chidzidzo ichi chakatarisa pamaonero evarimi nezvekushandiswa kwemarariya nemishonga inouraya zvipembenene. Zvakabuda muongororo iyi zvinoratidza kuti dzidzo nemamiriro ehupfumi hwevanhu zvinoita basa guru mutsika dzemaitiro neruzivo nezvemarariya. Kunyangwe vatungamiriri vemhuri vazhinji vaipinda chikoro chepuraimari, semamwe marudzi, huwandu hwevarimi vasina kudzidza hwakakura [35, 45]. Chiitiko ichi chinogona kutsanangurwa nekuti kunyangwe varimi vazhinji vakatanga kuwana dzidzo, vazhinji vavo vanofanira kusiya chikoro kuti vatsigire mhuri dzavo kuburikidza nemabasa ekurima [26]. Asi, chiitiko ichi chinoratidza kuti hukama huripo pakati pemamiriro ehupfumi hwevanhu nedzidzo hwakakosha pakutsanangura hukama huripo pakati pemamiriro ehupfumi hwevanhu uye kugona kuita zvinoenderana neruzivo.
Munzvimbo dzakawanda dzine malaria, vatori vechikamu vanoziva zvikonzero nezviratidzo zvemalaria [33,46,47,48,49]. Zvinogamuchirwa kuti vana vanogona kubatwa nemalaria [31, 34]. Kuziva uku kunogona kunge kwakabatana nekubatwa kwevana uye kuoma kwezviratidzo zvemalaria [50, 51].
Vatori vechikamu vakataura kuti vakashandisa avhareji yemadhora zviuru makumi matatu ($30,000), tisingasanganisire zvekufambisa nezvimwe zvinhu.
Kuenzanisa mamiriro ehupfumi hwevarimi kunoratidza kuti varimi vane mamiriro ehupfumi epasi vanopedza mari yakawanda kupfuura varimi vakapfuma. Izvi zvinogona kunge zvichikonzerwa nekuti mhuri dzine mamiriro ehupfumi epasi dzinoona kuti mitengo yakakwira (nekuda kwekurema kwavo mumari yemhuri) kana nekuda kwezvibatsiro zvinowanikwa mumabasa ehurumende neakazvimirira (sezvinoita mhuri dzakapfuma). ): Nekuda kwekuwanikwa kweinishuwarenzi yehutano, mari yekurapa malaria (zvichienderana nemitengo yese) inogona kunge yakaderera zvakanyanya pane mitengo yemhuri dzisingabatsirwe neinishuwarenzi [52]. Kutaura zvazviri, zvakashumwa kuti mhuri dzakapfuma dzinonyanya kushandisa mishonga yekurapa mishonga yekurapa zvichienzaniswa nemhuri dzine urombo.
Kunyange zvazvo varimi vazhinji vachiona umhutu sechinokonzera malaria, vashoma chete ndivo vanoshandisa mishonga inouraya zvipembenene (kuburikidza nekupfapfaidza nefumigation) mudzimba dzavo, zvakafanana nezvakawanikwa muCameroon neEquatorial Guinea [48, 53]. Kusava nehanya neumhutu zvichienzaniswa nezvipembenene zvezvirimwa kunokonzerwa nekukosha kwemari yezvirimwa. Kuderedza mitengo, nzira dzinodhura zvishoma dzakadai sekupisa mashizha kumba kana kungodzinga umhutu nemaoko dzinofarirwa. Chepfu inoonekwa inogonawo kuva chikonzero: kunhuhwirira kwezvimwe zvigadzirwa zvemakemikari uye kusagadzikana mushure mekushandisa kunoita kuti vamwe vashandisi vasashandise [54]. Kushandiswa kwakanyanya kwemishonga inouraya zvipembenene mudzimba (85.20% yemhuri dzakataurwa kuti dzinoishandisa) kunoitawo kuti kushandiswa kushoma kwemishonga inouraya umhutu kushandiswe. Kuvapo kwemishonga inouraya zvipembenene mudzimba kwakabatanawo zvakanyanya nekuvapo kwevana vari pasi pegore rimwe chete, zvichida nekuda kwerutsigiro rwekiriniki yemadzimai ane pamuviri anogamuchira mishonga inouraya zvipembenene panguva yekubvunzana nachiremba nezvekusununguka [6].
Mishonga yePyrethroids ndiyo mishonga mikuru inoshandiswa mumambure emubhedha ane mushonga wezvipembenene [55] uye inoshandiswa nevarimi kudzora zvipembenene neumhutu, zvichikonzera kushushikana pamusoro pekuwedzera kwekusagona kuuraya zvipembenene [55, 56, 57,58,59]. Izvi zvinogona kutsanangura kudzikira kwekunzwa kweumhutu kumishonga yezvipembenene kunoonekwa nevarimi.
Kukura kwehupfumi hwenyika hakuna kubatana neruzivo rwakanyanya nezvemalaria nehumhutu sechikonzero chayo. Kusiyana nezvakawanikwa kare naOuattara nevamwe vake muna 2011, vanhu vakapfuma vanowanzo kwanisa kuziva zviri nani zvinokonzera malaria nekuti vane mukana wekuwana ruzivo kuburikidza neterevhizheni neredhiyo [35]. Ongororo yedu inoratidza kuti huwandu hwedzidzo yepamusoro hunoratidza kunzwisisa kuri nani kwemalaria. Izvi zvinosimbisa kuti dzidzo inoramba iri chinhu chakakosha paruzivo rwevarimi nezvemalaria. Chikonzero nei mamiriro ehupfumi hwenyika asina simba rakawanda ndechekuti misha inowanzo goverana terevhizheni neredhiyo. Zvisinei, mamiriro ehupfumi hwenyika anofanira kufungwa nezvawo pakushandisa ruzivo nezvenzira dzekudzivirira malaria dzemumba.
Kukwirira kwehupfumi hwenyika nedzidzo yepamusoro kwakabatana zvakanaka nekushandiswa kwemishonga inouraya zvipembenene mudzimba (spray kana spray). Zvinoshamisa kuti, kugona kwevarimi kuziva umhutu sechikonzero chikuru chemalaria kwakakanganisa modhi iyi. Izvi zvakaratidza kuti zvaibatanidzwa zvakanaka nekushandiswa kwemishonga inouraya zvipembenene pazvakaiswa mumapoka evanhu vese, asi zvakabatanidzwa zvisina kunaka nekushandiswa kwemishonga inouraya zvipembenene pazvakaiswa mumapoka nemisha. Mhedzisiro iyi inoratidza kukosha kwepesvedzero yekudya vanhu pamaitiro evanhu uye kudiwa kwekuisa migumisiro isina kurongeka muongororo. Chidzidzo chedu chinoratidza kekutanga kuti varimi vane ruzivo rwekushandisa mishonga inouraya zvipembenene mukurima vane mukana wekushandisa mishonga inouraya zvipembenene nema coils kupfuura vamwe senzira dzekudzivirira malaria.
Zvichidzokorora zvidzidzo zvekare pamusoro pesimba remamiriro ehupfumi hwevanhu pamaonero evarimi nezvemishonga inouraya zvipembenene [16, 60, 61, 62, 63], mhuri dzakapfuma dzakashuma kusiyana kwakanyanya uye kushandiswa kwemishonga inouraya zvipembenene kakawanda. Vakapindura vaidavira kuti kupfapfaidza mishonga yakawanda yezvipembenene ndiyo nzira yakanakisisa yekudzivirira kukura kwekusagona kurwisa umhutu, izvo zvinoenderana nezvinonetsa zvakaratidzwa kune dzimwe nzvimbo [64]. Saka, zvigadzirwa zvemumba zvinoshandiswa nevarimi zvine makemikari akafanana pasi pemazita akasiyana ekutengeserana, zvinoreva kuti varimi vanofanira kukoshesa ruzivo rwehunyanzvi rwechigadzirwa uye zvinhu zvachinoshanda. Kunofanirawo kutariswa pakuziva kwevatengesi, sezvo vari ivo vamwe vevanonyanya kutaurwa nevatengi vemishonga inouraya zvipembenene [17, 24, 65, 66, 67].
Kuti zvive nemigumisiro yakanaka pakushandiswa kwemishonga inouraya zvipembenene munharaunda dzekumaruwa, mitemo uye nzira dzinofanirwa kupindira dzinofanira kutarisa pakuvandudza nzira dzekutaurirana, tichifunga nezvemazinga edzidzo uye maitiro ehunhu maererano netsika nemagariro, pamwe nekupa mishonga inouraya zvipembenene yakachengeteka. Vanhu vachatenga zvichienderana nemutengo (mari yavanokwanisa kutenga) uye mhando yechigadzirwa. Kana mhando yavapo pamutengo unokwanisika, kuda kuchinja maitiro pakutenga zvigadzirwa zvakanaka kunotarisirwa kuwedzera zvakanyanya. Dzidzisai varimi nezvekutsiva mishonga inouraya zvipembenene kuti vabvise cheni dzekudzivirira zvipembenene, vachijekesa kuti kuchinja hakurevi kuchinja muchiratidzo chechigadzirwa; (sezvo mhando dzakasiyana dzine chinhu chimwe chete chinoshanda), asi kusiyana kwezvinhu zvinoshanda. Dzidzo iyi inogonawo kutsigirwa nekunyorwa zviri nani kwechigadzirwa kuburikidza nemifananidzo iri nyore uye yakajeka.
Sezvo mishonga yezvipembenene ichishandiswa zvakanyanya nevarimi vekumaruwa muAbbotville Province, kunzwisisa kusaziva kwevarimi uye mafungiro avo pamusoro pekushandiswa kwemishonga yezvipembenene munharaunda kunoita sekunge chinhu chakakosha pakugadzira zvirongwa zvekuzivisa vanhu zvinobudirira. Chidzidzo chedu chinosimbisa kuti dzidzo ichiri chinhu chikuru pakushandiswa kwemishonga yezvipembenene nemazvo uye ruzivo nezvemarariya. Mamiriro ehupfumi hwemhuri akatorwawo sechishandiso chakakosha chekufunga nezvacho. Kuwedzera kune mamiriro ehupfumi hwemhuri uye nhanho yedzidzo yemusoro wemhuri, zvimwe zvinhu zvakaita seruzivo nezvemarariya, kushandiswa kwemishonga yezvipembenene kudzora zvipembenene, uye maonero ekudzivirira umhutu kumishonga yezvipembenene zvinopesvedzera mafungiro evarimi pamusoro pekushandiswa kwemishonga yezvipembenene.
Nzira dzinoenderana nemhinduro dzakadai semibvunzo dzinogona kurangarira uye kusarurana kwevanhu. Zviri nyore kushandisa hunhu hwemhuri kuongorora mamiriro ehupfumi hwevanhu, kunyange zvazvo matanho aya angave akanangana nenguva nenzvimbo yavakagadzira uye angasaratidza zvakafanana chokwadi chemazuva ano chezvinhu zvakakosha mutsika, zvichiita kuti kuenzanisa pakati pezvidzidzo kuve kwakaoma. Zvechokwadi, panogona kuve nekuchinja kukuru mukuva nenhengo dzemhuri dzisingazotungamirire kudzikira kwehurombo hwezvinhu.
Vamwe varimi havayeuki mazita ezvigadzirwa zvemishonga inouraya zvipembenene, saka huwandu hwemishonga inoshandiswa nevarimi hunogona kuderedzwa kana kuwedzeredzwa. Chidzidzo chedu hachina kufunga nezvemaonero evarimi nezvekupfapfaidza mishonga inouraya zvipembenene uye maonero avo pamusoro pemigumisiro yezviito zvavo pahutano hwavo nenharaunda. Vatengesi havanawo kubatanidzwa muchidzidzo ichi. Pfungwa dzese dziri mbiri dzinogona kuongororwa muzvidzidzo zveramangwana.
Dataseti dzakashandiswa uye/kana dzakaongororwa panguva yekudzidza kuri kuitwa dziripo kubva kumunyori anoenderana nadzo kana zvikakumbirwa zvine musoro.
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