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Dzidzo uye magariro ehupfumi zvinhu zvakakosha zvinopesvedzera ruzivo rwevarimi nezvekushandisa mushonga wezvipembenene uye marariya kumaodzanyemba kweCôte d'Ivoire BMC Public Health.

Mishonga yezvipembenene inoita basa guru mukurima kwekumaruwa, asi kuwandisa kana kushandisa zvisizvo kunogona kukanganisa marariya vector control policy;Ongororo iyi yakaitwa pakati penharaunda dzinorima kumaodzanyemba kweCôte d'Ivoire kuti paonekwe kuti ndeipi mishonga inouraya zvipembenene inoshandiswa nevarimi veko uye kuti izvi zvinoenderana sei nemaonero evarimi nezvemarariya.Kunzwisisa kushandiswa kwemishonga yezvipembenene kunogona kubatsira kugadzira zvirongwa zvekuzivisa nezvekudzivirira umhutu uye kushandisa mishonga yezvipembenene.
Ongororo iyi yakaitwa mudzimba 1 399 mumisha gumi.Varimi vakaongororwa nezvedzidzo yavo, kurima (semuenzaniso, kurima mbesa, kushandisa mishonga yezvipembenene), maonero emarariya, uye nzira dzakasiyana-siyana dzekudzivirira mosquito dzemumba dzavanoshandisa.Mamiriro ezvehupfumi hwemagariro (SES) emhuri yega yega anoongororwa zvichibva pane zvakafanotemerwa midziyo yemumba.Huwandu hwehukama pakati pezvakasiyana-siyana zvinoverengerwa, zvichiratidza zvakakosha zvengozi.
Chiyero chedzidzo yevarimi chakabatana zvakanyanya nemamiriro avo emagariro nehupfumi (p <0.0001).Mhuri zhinji (88.82%) dzaitenda kuti humhutu ndihwo hunonyanya kukonzera marariya uye ruzivo rwemalaria rwaienderana nedanho redzidzo yepamusoro (OR = 2.04; 95% CI: 1.35, 3.10).Kushandiswa kwemakemikari emumba kwaibatanidzwa zvakanyanya nemamiriro ehupfumi hwemagariro emhuri, mwero wedzidzo, kushandiswa kwemambure akaiswa mishonga yezvipembenene nemishonga yekurima (p <0.0001).Varimi vakaonekwa kuti vanoshandisa mishonga yepyrethroid mumba uye vanoshandisa mishonga iyi kuchengetedza zvirimwa.
Ongororo yedu inoratidza kuti danho redzidzo rinoramba riri chinhu chikuru chiri kukurudzira kuti varimi vazive nezvekushandisa mishonga yekuuraya zvipembenene pamwe nekurwisa marariya.Isu tinokurudzira kuti kufambiswa kwemashoko kwakavandudzwa kunanga kuwaniswa kwedzidzo, kusanganisira mamiriro ezvehupfumi, kuwanikwa, uye kuwanikwa kwezvigadzirwa zvemakemikari zvinodzorwa zvitariswe pakugadzira manejimendi emishonga yezvipembenene uye kupindira kwezvirwere zvinotapukirwa nenharaunda munharaunda.
Zvekurima ndiyo inofambisa hupfumi hwenyika zhinji dzeWest Africa.Muna 2018 na2019, Côte d'Ivoire yaive iri kutungamira pasi rose kugadzira koko uye cashew nzungu uye yechitatu pakukura mugadziri wekofi muAfrica [1], iine mabasa ekurima uye zvigadzirwa zvinoverengera 22% yechigadzirwa chepamba (GDP) [2] .Sevaridzi veminda mizhinji yekurima, varimi vadiki kumaruwa ndivo vanonyanya kubatsira mukusimudzira hupfumi hwechikamu [3].Nyika ine hunyanzvi hwekurima hwakakura, ine mahekita 17 miriyoni eminda yekurima uye misiyano yemwaka inokurudzira zvirimwa zvakasiyana-siyana uye kurimwa kwekofi, koko, nzungu, rabha, donje, mayam, muchindwe, mufarinya, mupunga nemiriwo [2].Kurima kwakanyanya kunobatsira mukupararira kwezvipembenene, kunyanya kuburikidza nekuwedzera kwekushandisa kwemishonga yekuuraya zvipembenene [4], kunyanya pakati pevarimi vekumaruwa, kuchengetedza zvirimwa uye kuwedzera goho rezvirimwa [5], uye kudzora umhutu [6].Zvisinei, kushandiswa kusina kukodzera kwemishonga yezvipembenene ndeimwe yezvikonzero zvikuru zvekudzivirira zvipembenene muzvirwere zvezvirwere, kunyanya munzvimbo dzekurima umo umhutu uye zvipembenene zvezvirimwa zvingave zviri pasi pekusarudzwa kwekumanikidzwa kubva kune zvipembenene zvakafanana [7,8,9,10].Kushandiswa kwepesticide kunogona kukonzera kusvibiswa kunokanganisa mazano ekudzora vector uye zvakatipoteredza uye naizvozvo zvinoda kutarisirwa [11, 12, 13, 14, 15].
Kushandiswa kwepesticide nevarimi kwakadzidzwa munguva yakapfuura [5, 16].Nhamba yedzidzo yakaratidzwa kuva chinhu chinokosha pakushandiswa kwakarurama kwemishonga yezvipembenene [17, 18], kunyange zvazvo kushandiswa kwepesticide nevarimi kunowanzopesvedzerwa neruzivo rwemagetsi kana mazano kubva kune vatengesi [5, 19, 20].Zvipingamupinyi zvemari ndechimwe chezvipingamupinyi zvinonyanya kutadzisa kuwana mishonga yezvipembenene kana mishonga yezvipembenene, zvichiita kuti varimi vatenge zvisiri pamutemo kana zvisingachashandi, izvo zvinowanzodhura zvishoma pane zvigadzirwa zvepamutemo [21, 22].Maitiro akafanana anoonekwa mune dzimwe nyika dzeWest Africa, uko mari shoma ndiyo chikonzero chekutenga nekushandisa mishonga yezvipembenene zvisina kufanira [23, 24].
MuCôte d'Ivoire, mishonga inouraya zvipembenene inoshandiswa zvakanyanya pazvirimwa [25,26], iyo inokanganisa maitiro ekurima uye marariya vector populations [27, 28, 29, 30].Zvidzidzo munzvimbo dzine marariya dzakaratidza kushamwaridzana pakati pehutano hwemagariro evanhu uye maonero emarariya uye njodzi dzehutachiona, uye kushandiswa kwemambure emubhedha ane mishonga yezvipembenene (ITN) [31,32,33,34,35,36,37].Zvisinei nezvidzidzo izvi, kuedza kwekugadzira mitemo yekudzivirira umhutu kunokanganiswa nekushaikwa kweruzivo rwekushandiswa kwemishonga yezvipembenene kumaruwa uye zvikonzero zvinoita kuti kushandiswa kwemishonga yezvipembenene kwakanaka.Ongororo iyi yakaongorora zvinotendwa nemarariya uye nzira dzekudzora mosquito pakati pedzimba dzekurima muAbeauville, kumaodzanyemba kweCôte d'Ivoire.
Chidzidzo chacho chakaitwa mumisha gumi mudhipatimendi reAbeauville kumaodzanyemba kweCôte d'Ivoire (Mufananidzo 1).Dunhu reAgbowell rine vagari ve292,109 munzvimbo ye3,850 square kilometers uye ndiro dunhu rine vanhu vakawanda mudunhu reAnyebi-Tiasa [38].Iine mamiriro ekunze anopisa ane mwaka miviri yekunaya kwemvura (Kubvumbi kusvika Chikunguru naGumiguru kusvika Mbudzi) [39, 40].Zvekurima ndiro basa guru mudunhu iri uye rinoitwa nevarimi vadiki nemakambani makuru ezvekurima.Izvi 10 nzvimbo dzinosanganisira 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 , .3035N 651N 651) 372.90N), Amengbeu (348477.76E, 664971.70 N) ), Ofonbo (338 578.5) 1 E, 657 302.17 north latitude) uye Uji (363,990.74 east longitude, 648,587.44 north latitude).
Ongororo iyi yakaitwa pakati paNyamavhuvhu 2018 naKurume 2019 paine varimi vedzimba.Huwandu hwevagari vemumusha wega wega hwakawanikwa kubva kudhipatimendi rebasa renzvimbo, uye vanhu 1,500 vakasarudzwa kubva pane iyi runyorwa.Vatori vechikamu vakatorwa vakamiririra pakati pe6% ne16% yevagari vemumusha.Mhuri dzakabatanidzwa muchidzidzo idzo mhuri dzevarimi dzakabvuma kutora chikamu.Ongororo yekutanga yakaitwa pakati pevarimi makumi maviri kuti vaone kana paine mimwe mibvunzo inoda kunyorwa patsva.Mapepa emibvunzo akazopedzwa nevaunganidzi vedata vakadzidziswa uye vaibhadharwa mumusha wega wega, mumwe chete wavo akatorwa kubva mumusha wacho.Sarudzo iyi yakaita kuti musha wega wega uve nemuunganidzi data mumwe chete aiziva nezvezvakatipoteredza uye aitaura mutauro weko.Mumhuri imwe neimwe, bvunzurudzo yaiitwa chiso nechiso nomusoro wemba (baba kana kuti amai) kana kuti, kana mukuru wemba akanga asipo, mumwe mukuru anopfuura makore 18 okukura.Gwaro remibvunzo raive nemibvunzo 36 yakakamurwa kuita zvikamu zvitatu: (1) Kuwanda kwevanhu uye magariro nehupfumi hwemhuri (2) Miitiro yekurima nekushandiswa kwemishonga yezvipembenene (3) Kuziva nezvemarariya uye kushandiswa kwemishonga yekuuraya mosquito [ona Annex 1] .
Mishonga yezvipembenene inotaurwa nevarimi yakanyorwa nemazita ekutengeserana uye yakarongedzwa neanoshanda zvinosanganisa uye mapoka emakemikari achishandisa Ivory Coast Phytosanitary Index [41].Mamiriro ehupfumi hwemhuri yega yega akaongororwa nekuverenga index yeasset [42].Zvinhu zvemumba zvakashandurwa kuita dichotomous variables [43].Negative factor ratings inobatanidzwa neiyo yakaderera socioeconomic status (SES), nepo positive factor ratings inobatanidzwa nepamusoro SES.Zvibodzwa zveasset zvinopfupikiswa kuti zvibudise zvibodzwa zvemhuri yega yega [35].Zvichienderana nezvibodzwa zvakazara, dzimba dzakakamurwa kuita mashanu quintiles emamiriro ehupfumi nehupfumi, kubva kuvarombo kusvika kune vakapfuma [ona Kuwedzera faira 4].
Kuti uone kana shanduko ichisiyana zvakanyanya nemamiriro ehupfumi nemagariro, musha, kana nhanho yedzidzo yevakuru vedzimba, bvunzo ye-chi-square kana bvunzo chaiyo yaFisher inogona kushandiswa, sezvakakodzera.Logistic regression modhi dzaive dzakagadzirwa neanotevera anofanota kusiyanisa: nhanho yedzidzo, mamiriro ehupfumi hwemagariro (ese akashandurwa kuita dichotomous variables), musha (waisanganisirwa sezvikamu zvakasiyana), ruzivo rwepamusoro nezvemarariya nekushandiswa kwemishonga yezvipembenene mukurima, uye kushandiswa kwemishonga yezvipembenene mudzimba (zvinobuda. kuburikidza neaerosol).kana coil);danho redzidzo, magariro nehupfumi uye musha, zvichikonzera kuziva kwakanyanya nezvemarariya.Irogistic yakasanganiswa regression modhi yakaitwa uchishandisa iyo R package lme4 (Glmer basa).Kuongorora kwenhamba kwakaitwa muR 4.1.3 (https://www.r-project.org) uye Stata 16.0 (StataCorp, College Station, TX).
Pamabvunzurudzo e1,500 akaitwa, 101 haana kuverengerwa pakuongorora nekuti mubvunzo wemibvunzo hauna kupera.Chikamu chepamusoro chemhuri dzakaongororwa chaive muGrande Maury (18.87%) uye yakaderera muOuanghi (2.29%).Mhuri dze1,399 dzakaongororwa dzakabatanidzwa mukuongorora dzinomiririra huwandu hwevanhu ve9,023.Sezvinoratidzwa muTable 1, 91.71% yevakuru vedzimba varume uye 8.29% vanhukadzi.
Vanosvika 8.86% yevakuru vedzimba vakabva kunyika dzakavakidzana dzakaita seBenin, Mali, Burkina Faso neGhana.Marudzi anonyanya kumiririrwa ndiAbi (60.26%), Malinke (10.01%), Krobu (5.29%) uye Baulai (4.72%).Sezvinotarisirwa kubva kumuenzaniso wevarimi, kurima ndiko chete kunopa mari kune vazhinji vevarimi (89.35%), necocoa inorimwa kakawanda mudzimba dzemuenzaniso;Miriwo, zvirimwa zvekudya, mupunga, rabha uye plantain zvinorimwawo panzvimbo diki yevhu.Vakuru vedzimba vakasara ndevemabhizinesi, maartist uye vabati vehove (Tafura 1).Pfupiso yemaitiro emumba nemusha inoratidzwa muSupplementary file [ona Kuwedzera faira 3].
Chikamu chedzidzo hachina kusiyana nehukadzi (p = 0.4672).Vazhinji vevakabvunzwa vaive nedzidzo yepuraimari (40,80%), ichiteverwa neyesekondari (33,41%) nekusagona kuverenga nekunyora (17,97%).Chete 4.64% vakapinda yunivhesiti (Tafura 1).Pavakadzi 116 vakaongororwa, vanopfuura makumi manomwe neshanu muzana vaive neinenge dzidzo yepuraimari, uye vamwe vese vaive vasina kumboenda kuchikoro.Chiyero chedzidzo yevarimi chinosiyana zvakanyanya mumisha (Fisher's exact test, p <0.0001), uye mwero wedzidzo wevakuru vedzimba unofambirana zvakanyanya nemamiriro avo emagariro nehupfumi (Fisher's exact test, p <0.0001).Muchokwadi, mamiriro epamusoro emamiriro ehupfumi hwemagariro anowanzo sanganisira varimi vakadzidza, uye ukuwo, mamiriro akaderera emagariro nehupfumi quintiles anosanganisira varimi vasingagoni kuverenga nekunyora;Zvichienderana nehupfumi hwese, dzimba dzemuenzaniso dzakakamurwa kuita mashanu ehupfumi quintiles: kubva kuvarombo (Q1) kusvika kune vakapfuma (Q5) [ona Kuwedzera faira 4].
Pane misiyano yakakura muwanano yevakuru vedzimba dzemakirasi akasiyana ehupfumi (p <0.0001): 83.62% vane murume mumwe chete, 16.38% vane barika (kusvika kune vatatu vakaroora).Hapana misiyano yakakosha yakawanikwa pakati pekirasi yehupfumi nehuwandu hwevakaroorana.
Ruzhinji rwevakabvunzwa (88.82%) vaitenda kuti umhutu chimwe chezvikonzero zvinokonzera marariya.1.65% chete ndivo vakapindura kuti havazive chinokonzera marariya.Zvimwe zvikonzero zvinozivikanwa zvinosanganisira kunwa mvura yakasviba, kuvhenekwa nezuva, kusadya zvakanaka uye kuneta (Table 2).Padanho remumusha muGrande Maury, ruzhinji rwemhuri dzakaona kunwa mvura yakasviba sechikonzero chikuru chemarariya (musiyano wenhamba pakati pemisha, p <0.0001).Zviratidzo zvikuru zviviri zvemalaria kupisa kwemuviri (78.38%) uye kutsvuka kwemaziso (72.07%).Varimi vakataurawo nezvekurutsa, kupererwa neropa uye kuoma (ona Table 2 pazasi).
Panzira dzekudzivirira marariya, vakabvunzwa vakataura nezvekushandiswa kwemishonga yechivanhu;zvisinei, pakurwara, kurapwa kwemarariya kwechivanhu uye kwechinyakare kwaionekwa sesarudzo dzinogoneka (80.01%), nezvaidiwa zvine chekuita nemagariro nehupfumi.Yakakosha kuwirirana (p <0.0001).): Varimi vane chinzvimbo chepamusoro chezvemagariro evanhu uye vanokwanisa kurapwa nemishonga, varimi vane mamiriro ezvehupfumi akaderera vaifarira mishonga yechivanhu;Inenge hafu yemhuri inopedza paavhareji inodarika 30,000 XOF pagore pakurapa marariya (zvisina hukama neSES; p <0.0001).Zvichienderana nefungidziro yemitengo yakadzikira, mhuri dzine mamiriro ehupfumi hwemagariro akadzikira vangangoshandisa XOF 30,000 (inenge US$50) yakawanda mukurapa marariya pane dzimba dzine chinzvimbo chepamusoro-soro chemagariro nehupfumi.Pamusoro pezvo, ruzhinji rwevakabvunzwa vaidavira kuti vana (49.11%) vanobatwa nemarariya zvakanyanya kupfuura vakuru (6.55%) (Tafura 2), nemaonero aya ari kuwanda pakati pemhuri dzine urombo zvikuru (p <0.01) .
Pakurumwa neumhutu, ruzhinji rwevatori vechikamu (85.20%) vakashuma vachishandisa mambure ane mishonga yekuuraya zvipembenene, ayo ainyanya kugamuchira panguva yekugoverwa kwenyika muna 2017.Vanhu vakuru nevana vanonzi vairara pasi pemambure eumhutu ane mishonga inouraya zvipembenene mudzimba dzinosvika zvikamu makumi mapfumbamwe nemazana mapfumbamwe nepfumbamwe kubva muzana.Kuwanda kwekushandiswa kwemumbure kwemambure ane mishonga yezvipembenene kwakadarika 70% mumisha yese kunze kwemusha weGessigye, uko chete 40% yedzimba dzakashuma kushandisa mambure ane mishonga yezvipembenene.Avhareji yenhamba yemambure emubhedha ane mishonga yezvipembenene ane mhuri ainyatsoenderana nekukura kwemba (Pearson's correlation coefficient r = 0.41, p <0.0001).Zvakabuda zvedu zvakaratidzawo kuti dzimba dzine vana vari pasi pegore 1 dzaiwanzoshandisa mambure ane mushonga wezvipembenene pamusha kana zvichienzaniswa nedzimba dzisina vana kana dzine vana vakura (odd ratio (OR) = 2.08, 95% CI : 1.25–3.47 ).
Pamusoro pekushandisa mambure ane mishonga yezvipembenene, varimi vakabvunzwawo nezvedzimwe nzira dzekudzivirira umhutu mudzimba dzavo uye nezvezvigadzirwa zvekurima zvinoshandiswa kurwisa tumbuyu.Chete 36.24% yevatori vechikamu vakataura kupfapfaidza mishonga yezvipembenene mudzimba dzavo (yakakosha uye yakanaka kuwirirana neSES p <0.0001).Mishonga yemakemikari yakashumwa yaibva kumhando pfumbamwe dzekutengesa uye yainyanya kupihwa kumisika yemuno uye vamwe vatengesi semakoiri ekufusa (16.10%) uye maspray emishonga yezvipembenene (83.90%).Kugona kwevarimi kudoma mazita emishonga yakapfapfaidzwa mudzimba kwakawedzera nedzidzo yavo (12.43%; p <0.05).Zvigadzirwa zveagrochemical zvakashandiswa zvakatanga kutengwa mumagaba uye zvakanyungudutswa mumasprayers zvisati zvashandiswa, nechikamu chikuru chinowanzoitirwa zvirimwa (78.84%) (Tafura 2).Musha weAmangbeu une chikamu chakaderera chevarimi vanoshandisa mishonga mudzimba (0.93%) nezvirimwa (16,67%).
Nhamba yepamusoro yemishonga yezvipembenene (sprays kana makoiri) yainzi pamhuri imwe neimwe yaiva 3, uye SES yakanga yakanyatsoenderana nehuwandu hwezvigadzirwa zvakashandiswa (Fisher's exact test p <0.0001, zvisinei mune dzimwe nguva zvigadzirwa izvi zvakawanikwa zviine zvakafanana);zvinoshanda zvinosanganisa pasi pemazita akasiyana ekutengeserana.Tafura 2 inoratidza kuwanda kwesvondo kwekushandiswa kwemishonga yezvipembenene pakati pevarimi zvinoenderana nemagariro avo nemagariro.
Pyrethroids ndiyo inonyanya kumiririrwa mhuri yemakemikari mumhuri (48.74%) uye yekurima (54.74%) yekupfapfaidza zvipembenene.Zvigadzirwa zvinogadzirwa kubva kumushonga wega wega kana kusanganiswa nemimwe mishonga yezvipembenene.Misanganiswa yakajairika yezvipembenene zvemumba ndeye carbamates, organophosphates uye pyrethroids, nepo neonicotinoids uye pyrethroids zvakajairika pakati pezvipembenene zvekurima (Appendix 5).Mufananidzo 2 unoratidza chikamu chemhuri dzakasiyana dzemishonga yezvipembenene inoshandiswa nevarimi, iyo yose inorongwa seClass II (moderate hazard) kana Class III (njodzi shoma) maererano neWorld Health Organization kupatsanurwa kwemishonga yezvipembenene [44].Pane imwe nguva, zvakazoitika kuti nyika yaishandisa mushonga wezvipembenene deltamethrin, wakanangana nekurima.
Panyaya yezvishandiso zvinoshandiswa, propoxur uye deltamethrin ndizvo zvinonyanya kushandiswa zvigadzirwa zvemukati uye mumunda, zvichiteerana.Yekuwedzera faira 5 ine ruzivo rwakadzama pamusoro pezvigadzirwa zvemakemikari anoshandiswa nevarimi kumba uye pazvirimwa zvavo.
Varimi vakataura dzimwe nzira dzekudzivirira mosquito dzinosanganisira mafeni emashizha (pêpê mumutauro weAbbey weko), kupisa mashizha, kuchenesa nzvimbo, kubvisa mvura yakamira, kushandisa mishonga inodzinga umhutu, kana kungoshandisa machira kudzinga umhutu.
Zvinhu zvine chekuita neruzivo rwevarimi nezvemalaria nekupfapfaidza tumbuyu mukati meimba (logistic regression analysis).
Data yakaratidza kushamwaridzana kwakakosha pakati pekushandiswa kwezvipembenene zvemumba uye zvishanu zvinofanotaura: nhanho yedzidzo, SES, ruzivo rweumhutu sechikonzero chikuru chemarariya, kushandiswa kweITN, uye kushandiswa kwemishonga yeagrochemical.Mufananidzo 3 unoratidza maOR akasiyana ega ega ega ega ega ega.Pavakaiswa mumusha, vose vanofanotaura vakaratidza kushamwaridzana kwakanaka nekushandiswa kwemishonga yezvipembenene mudzimba (kunze kweruzivo rwezvikonzero zvikuru zvemarariya, iyo yakabatanidzwa nekushandiswa kwemishonga yezvipembenene (OR = 0.07, 95% CI: 0.03, 0.13) . )) (Mufananidzo 3).Pakati peizvi zvinofanotaura zvakanaka, chinonakidza kushandiswa kwemishonga yezvipembenene mukurima.Varimi vakashandisa mishonga yezvipembenene pazvirimwa vaive nechikamu che188% chekushandisa mishonga kumba (95% CI: 1.12, 8.26).Zvakadaro, mhuri dzine ruzivo rwepamusoro pamusoro pekutapurirwa kwemalaria hadzina mukana wekushandisa mishonga mudzimba.Vanhu vane dzidzo yepamusoro ndivo vainyanya kuziva kuti umhutu ndihwo hunokonzera marariya (OR = 2.04; 95% CI: 1.35, 3.10), asi pakanga pasina kushamwaridzana kwenhamba neSES yakakwirira (OR = 1.51; 95% CI : 0.93, 2.46).
Sekutaura kwemukuru wemba, humhutu hunowedzera munguva yekunaya kwemvura uye husiku ndiyo nguva inonyanyorumwa neumhutu (85.79%).Varimi pavakabvunzwa nezvemaonero avanoita kupfapfaidza tumbuyu muhumhutu hunokonzerwa nemalaria, chikamu che86.59% chakatsinhira kuti humhutu hunenge huchikura kurwisa zvipembenene.Kusakwanisa kushandisa zvigadzirwa zvemakemikari zvakakwana nekuda kwekusavapo kwavo kunoonekwa sechikonzero chikuru chekusashanda kana kushandiswa zvisina kunaka kwezvigadzirwa, izvo zvinoonekwa sezvimwe zvinogadzirisa zvinhu.Kunyanya, iyo yekupedzisira yaibatanidzwa neiyo yakaderera mamiriro edzidzo (p <0.01), kunyangwe pakudzora SES (p <0.0001).Chete 12.41% yevakabvunzwa vakafunga kuramba Umhutu sechimwe chezvikonzero zvinokonzeresa kurwisa zvipembenene.
Paiva nehukama hwakanaka pakati pehuwandu hwekushandiswa kwezvipembenene kumba uye maonero ekudzivirira mosquito kune mishonga yezvipembenene (p <0.0001): mishumo yekurwisana neumhutu kune mishonga inouraya yainyanya kuenderana nekushandiswa kwezvipembenene kumba nevarimi 3-4 nguva a. vhiki (90.34%) .Pamusoro pehuwandu, huwandu hwemishonga yakashandiswa hwaienderanawo nemaonero evarimi ekuramba mishonga yezvipembenene (p <0.0001).
Ongororo iyi yakanangana nemaonero evarimi pamusoro pemalaria nekushandiswa kwemishonga yezvipembenene.Mhedzisiro yedu inoratidza kuti dzidzo uye mamiriro ezvehupfumi anoita basa rakakosha mukuzvibata uye ruzivo nezve marariya.Kunyange zvazvo misoro yemhuri yakawanda yakapinda chikoro chepuraimari, sekune dzimwe nzvimbo, chikamu chevarimi vasina kudzidza chakakosha [35, 45].Chiitiko ichi chinogona kutsanangurwa nekuti kunyangwe varimi vazhinji vakatanga kuwana dzidzo, vazhinji vacho vanotofanira kusiira chikoro panzira kuti vararamise mhuri dzavo kuburikidza nekurima [26].Asi, chiitiko ichi chinoratidza kuti hukama huri pakati pemamiriro ehupfumi hwevanhu uye dzidzo inokosha pakutsanangura hukama huri pakati pehutano hwemagariro evanhu uye kukwanisa kuita maererano nemashoko.
Munzvimbo dzakawanda dzine marariya, vatori vechikamu vanoziva zvikonzero uye zviratidzo zvemarariya [33,46,47,48,49].Zvinowanzogamuchirwa kuti vana vanobatwa nemarariya [31, 34].Kuzivikanwa uku kunogona kunge kwakabatana nekunetseka kwevana uye kuoma kwezviratidzo zvemalaria [50, 51].
Vatori vechikamu vakashuma kushandisa avhareji yemadhora makumi matatu ezviuru, kusasanganisa zvekufambisa uye zvimwe zvinhu.
Kuenzaniswa kwemamiriro ehupfumi hwevarimi kunoratidza kuti varimi vane hutsika hwehupfumi hwemagariro vanopedza mari yakawanda kupfuura varimi vakapfuma.Izvi zvinogona kunge zvichikonzerwa nekuti mhuri dzine mamiriro ehupfumi hwemagariro akadzikira dzinoona kuti mitengo yakakwira (nekuda kwehuremu hwadzo hukuru mumari yemumba yese) kana nekuda kwemabhenefiti ane chekuita nemabasa ehurumende neakazvimirira (sezvinoita mhuri dzakapfuma).): Nekuda kwekuvapo kweinishuwarenzi yehutano, mari yekurapa marariya (inoenderana nemutengo wakazara) inogona kunge yakaderera zvakanyanya pane mutengo wemhuri dzisingabatsirwe neinishuwarenzi [52].Muchokwadi, zvakashumwa kuti dzimba dzakapfuma dzakanyanya kushandisa marapirwo ekurapa zvichienzaniswa nedzimba dzevarombo.
Kunyange zvazvo varimi vakawanda vachifunga kuti umhutu ndiyo inonyanya kukonzera marariya, vashomanana chete vanoshandisa mishonga yezvipembenene (kuburikidza nekupfapfaidza uye fumigation) mudzimba dzavo, zvakafanana nezvakawanikwa muCameroon neEquatorial Guinea [48, 53].Kushaikwa kwehany’a neumhutu kana tichienzanisa netwumbuyu twegoho kunokonzerwa nekukosha kwezvirimwa munyaya dzeupfumi.Kuti udzikise mari, nzira dzakachipa dzakadai sekupisa mashizha kumba kana kungodzinga umhutu nemaoko dzinosarudzwa.Inofungidzirwa chepfu inogonawo kuva chikonzero: kunhuwa kwezvimwe zvigadzirwa zvemakemikari uye kusagadzikana mushure mekushandisa kunoita kuti vamwe vashandisi vadzivise kushandiswa kwavo [54].Kushandiswa kwakanyanya kwemishonga yezvipembenene mudzimba (85.20% yedzimba dzinonzi dzaishandisa) kunobatsirawo kuti pasanyanya kushandiswa mishonga inouraya umhutu.Kuvapo kwemambure ane mishonga yekuuraya zvipembenene mumhuri kunobatanidzawo zvakasimba nekuvapo kwevana vari pasi pegore rekuberekwa, zvichida nekuda kwerutsigiro rwekiriniki yevakadzi vane pamuviri vanowana mambure ane mishonga yezvipembenene panguva yekukurukurirana kwevakadzi [6].
Pyrethroids ndiyo mishonga inouraya zvipembenene inoshandiswa mumambure akaiswa mishonga yezvipembenene [55] uye anoshandiswa nevarimi kudzora tupukanana neumhutu, zvichimutsa kunetseka pamusoro pekuwedzera kwekudzivirira kwezvipembenene [55, 56, 57,58,59].Mamiriro ezvinhu aya anogona kutsanangura kudzikira kwekunzwa kweumhutu kune mishonga inouraya zvipembenene inocherechedzwa nevarimi.
Hunhu hwepamusoro hwehupfumi hwevanhu hwakanga husina kubatana neruzivo rwuri nani rwemarariya uye umhutu sechikonzero chayo.Kusiyana nezvakawanikwa kare naOuattara nevamwe vaaishanda navo muna 2011, vanhu vakapfuma vanowanzokwanisa kuziva zvikonzero zvemarariya nekuti vanowana ruzivo nyore kuburikidza neterevhizheni neredhiyo [35].Ongororo yedu inoratidza kuti mwero wedzidzo yepamusoro unofanotaura kunzwisisa kuri nani kwemarariya.Ongororo iyi inotsinhira kuti dzidzo inoramba iri chinhu chikuru cheruzivo rwevarimi nezve malaria.Chikonzero icho chimiro chemagariro nehupfumi chine zvachinoita ndechekuti misha inowanzogovana terevhizheni neredhiyo.Nekudaro, magariro ehupfumi anofanirwa kuverengerwa kana uchishandisa ruzivo nezve epamba ekudzivirira marariya.
Mamiriro epamusoro ezvemagariro evanhu uye nhanho yedzidzo yepamusoro zvakabatanidzwa nekushandiswa kwemishonga yezvipembenene mudzimba (spray kana kupfapfaidza).Sezvineiwo, kugona kwevarimi kuona umhutu sehonzeri huru yemarariya kwakakanganisa muenzaniso uyu.Ichi chinofanotaura chaive chakabatana nekushandiswa kwemishonga yezvipembenene kana yakaunganidzwa muhuwandu hwese, asi zvakashata zvine chekuita nekushandiswa kwemishonga kana yakaunganidzwa nemusha.Ichi chigumisiro chinoratidza kukosha kwekukanganiswa kwekudya kwevanhu pakuita kwevanhu uye kudiwa kwekubatanidza migumisiro isingatarisirwi mukuongorora.Ongororo yedu inoratidza kekutanga kuti varimi vane ruzivo rwekushandisa mishonga mukurima vane mukana mukuru pane vamwe kushandisa mishonga yekupfapfaidza nekoiri senzira dzemukati dzekurwisa malaria.
Kudzokorora zvidzidzo zvekare pamusoro pesimba rehutano hwemagariro evanhu pamusoro pemafungiro evarimi pamusoro pemishonga yekuuraya zvipembenene [16, 60, 61, 62, 63], mhuri dzakapfuma dzakashuma kusiyana kwepamusoro uye kuwanda kwekushandiswa kwepesticide.Vakapindura vaidavira kuti kupfapfaidza mishonga yakawanda yezvipembenene ndiyo nzira yakanakisisa yekudzivisa kukura kwekudzivirira muumhutu, izvo zvinopindirana nezvinetso zvinoratidzwa kune imwe nzvimbo [64].Nekudaro, zvigadzirwa zvemumba zvinoshandiswa nevarimi zvine chimiro chakafanana chemakemikari pasi pemazita akasiyana ekutengesa, izvo zvinoreva kuti varimi vanofanirwa kukoshesa ruzivo rwehunyanzvi hwechigadzirwa uye zvinoshandiswa zvinoshanda.Kuchenjerera kunofanirawo kubhadharwa kune kuziva kwevashambadziri, sezvo vari imwe yenzvimbo huru dzevanotenga mishonga yezvipembenene [17, 24, 65, 66, 67].
Kuti tive nemigumisiro yakanaka pakushandiswa kwemishonga yezvipembenene munharaunda dzekumaruwa, mitemo uye kupindira kunofanira kutarisa pakuvandudza mazano ekukurukurirana, tichifunga nezvemazinga ezvidzidzo uye maitiro ehutsika mumamiriro ekugadzirisa tsika uye nharaunda, pamwe nekupa mishonga yakachengeteka.Vanhu vanozotenga zvichienderana nemutengo (imarii yavanogona kutenga) uye mhando yechigadzirwa.Kana mhando yave kuwanikwa nemutengo unokwanisika, kudiwa kwekuchinja kwemaitiro mukutenga zvigadzirwa zvakanaka kunotarisirwa kuwedzera zvakanyanya.Dzidzisai varimi nezvekuchinjanisa mishonga yezvipembenene kuti mudambure cheni dzekurwisa zvipembenene, muchiratidza pachena kuti kutsinhanisa hakurevi shanduko yemhando yechigadzirwa;(sezvo mabhureki akasiyana aine musanganiswa unoshanda wakafanana), asi mutsauko wezvinhu zvinoshanda.Dzidzo iyi inogona zvakare kutsigirwa nekunyorwa kwechigadzirwa kuri nani kuburikidza nemifananidzo iri nyore, yakajeka.
Sezvo mishonga yezvipembenene ichishandiswa zvakanyanya nevarimi vekumaruwa muProvince yeAbbotville, kunzwisisa mikaha yeruzivo rwevarimi pamusoro pekushandiswa kwemishonga yezvipembenene munzvimbo inoratidzika sechinhu chinodiwa pakugadzira zvirongwa zvinobudirira zvekuzivisa.Ongororo yedu inotsinhira kuti dzidzo inoramba iri chinhu chikuru mukushandiswa nemazvo kwemishonga yezvipembenene uye ruzivo nezvemarariya.Mamiriro emhuri yemagariro nehupfumi aionekwawo sechishandiso chakakosha chekufunga nezvacho.Kuwedzera pamamiriro akaita upfumi hwenyika uye dzidzo yomukuru wemba, zvimwe zvinhu zvakadai seruzivo nezvemarariya, kushandiswa kwemishonga yezvipembenene kurwisa tumbuyu, uye maonero ekusaita umhutu nemishonga inouraya zvipembenene zvinokanganisa mafungiro evarimi nezvekushandisa mishonga yezvipembenene.
Nzira dzinoenderana nevanopindura dzakaita semibvunzo yemibvunzo inoenderana nekurangarira uye nerusaruro rwekudiwa kwevanhu.Zviri nyore kushandisa hunhu hwemumba kuongorora mamiriro emagariro nehupfumi, kunyangwe matanho aya angave akanangana nenguva uye mamiriro ejografia maakatangwa uye anogona kunge asingaratidzi zvakafanana chokwadi chemazuva ano chezvakakosha zvetsika, zvichiita kuti kuenzanisa pakati pezvidzidzo kuve kwakaoma. .Zvamazvirokwazvo, pangava nechinjo huru mukuva varidzi vemhuri vezvikamu zveindekisi izvo zvisingazoiti hazvo kutungamirira kukuderera kwourombo hwokunyama.
Vamwe varimi havayeuke mazita emishonga yezvipembenene, saka huwandu hwemishonga inoshandiswa nevarimi inogona kushomeka kana kuwedzererwa.Ongororo yedu yanga isingatarise mafungiro evarimi panyaya yekupfapfaidza zvipembenene nemaonero avanoita mhedzisiro yezviito zvavo pautano hwavo pamwe nenharaunda.Vatengesi havanawo kubatanidzwa muchidzidzo.Mapoinzi ese ari maviri anogona kuongororwa muzvidzidzo zvinotevera.
Iwo ma dataset akashandiswa uye/kana akaongororwa panguva yechidzidzo chazvino anowanikwa kubva kumunyori anowirirana nechikumbiro chine musoro.
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