Kuwanda kwezviitiko zvevana vane makore 6 kusvika kumakore gumi kwaiva 2.7 pa100 munhu-mwedzi munharaunda ye IRS uye 6.8 pa100 yemunhu-mwedzi munzvimbo yekutonga. Zvakadaro, pakanga pasina mutsauko unokosha mukuitika kwemalaria pakati penzvimbo mbiri idzi mukati memwedzi miviri yekutanga (Chikunguru-Nyamavhuvhu) uye mushure memwaka wekunaya kwemvura (Zvita-Kukadzi) (ona Mufananidzo 4).
Kaplan-Meier kupona curves yevana vane makore 1 kusvika 10 makore munzvimbo yekudzidza mushure memwedzi misere yekutevera.
Ichi chidzidzo chakaenzanisa kuwanda kwemarariya uye kuitika mumatunhu maviri vachishandisa nzira dzakabatanidzwa dzekudzivirira marariya kuongorora kuwedzera kweiyo IRS. Dhata yakaunganidzwa mumatunhu maviri kuburikidza neaviri-sectional ongororo uye 9-mwedzi passive kesi-yekutsvaga ongororo kumakiriniki ehutano. Mibairo kubva kuongororo dzakachinjika-chikamu pakutanga nekupera kwemwaka wekuparadzira marariya dzakaratidza kuti malaria parasitaemia yaive yakadzikira mudunhu reIRS (LLTID+IRS) pane mudunhu rekutonga (LLTIN chete). Sezvo matunhu maviri aya achifananidzwa maererano nechirwere chemalaria uye kupindira, mutsauko uyu unogona kutsanangurwa nehuwandu hwakawedzerwa hweIRS mudunhu reIRS. Muchokwadi, ese mambure ekuuraya zvipembenene anogara kwenguva refu uye IRS anozivikanwa kudzikisa zvakanyanya mutoro wemalaria kana akashandiswa ega. Nokudaro, zvidzidzo zvakawanda [7, 21, 23, 24, 25] zvinofanotaura kuti kusanganiswa kwavo kuchaguma nekuderedza kukuru kwemutoro wemarariya pane imwe chete. Zvisinei neIRS, Plasmodium parasitaemia inowedzera kubva pakutanga kusvika pakupera kwemwaka wekunaya kwemvura munzvimbo dzine utachiona hwemarariya mumwaka, uye izvi zvinotarisirwa kuti zvichanyanya kupera kwemwaka wekunaya kwemvura. Zvisinei, kuwedzera munharaunda ye IRS (53.0%) yakanga yakaderera zvikuru kupfuura iyo munzvimbo yekutonga (220.0%). Makore mapfumbamwe ekutevedzana kweIRS mishandirapamwe pasina mubvunzo akabatsira kudzikisira kana kudzvanya nhongonya dzekutapurirana kwehutachiona munzvimbo dzeIRS. Uyezve, pakanga pasina misiyano mumutsara we gametophyte pakati penzvimbo mbiri pakutanga. Pakupera kwemwaka wekunaya kwemvura, yaive yakakwira zvakanyanya munzvimbo yekutonga (11.5%) pane iyo IRS saiti (3.2%). Ongororo iyi inotsanangura kuderera kwemarariya parasitemia mudunhu reIRS, sezvo indekisi yegametocyte iri inogona kukonzera utachiona hwemosquito hunokonzera kutapurirwa marariya .
Zvigumisiro zvekugadzirisa kugadziriswa kwekuongorora kunoratidza njodzi chaiyo inosangana nehutachiona hwemarariya munzvimbo yekutonga uye inoratidza kuti kushamwaridzana pakati pefivha uye parasitemia kunowedzera uye kuti anemia inokanganisa.
Sezvakaita parasitaemia, chiitiko chemalaria pakati pevana vane makore 0-10 makore aive akaderera zvakanyanya muIRS pane munzvimbo dzekutonga. Mapoka ekutapurirana echinyakare akaonekwa munzvimbo mbiri idzi, asi aive akaderera zvakanyanya muIRS pane munzvimbo yekutonga (Mufananidzo 3). Muchokwadi, nepo mishonga yezvipembenene ichigara kweanoda kusvika makore matatu muLLINs, inogara kusvika kumwedzi mitanhatu muIRS. Naizvozvo, mishandirapamwe ye IRS inoitwa gore rega rega kuvhara kukwirira kwekutapurirana. Sezvinoratidzwa neKaplan-Meier survival curves (Mufananidzo 4), vana vanogara munzvimbo dzeIRS vaive nezviitiko zvishoma zvekiriniki zvemarariya pane avo vari munzvimbo dzekutonga. Izvi zvinopindirana nezvimwe zvidzidzo zvakashuma kuderedzwa kukuru kwechiitiko chemalaria apo IRS yakawedzerwa inosanganiswa nemamwe mapindiro. Nekudaro, nguva shoma yedziviriro kubva kune zvakasara mhedzisiro yeIRS inoratidza kuti zano iri ringangoda kuvandudzwa nekushandisa mishonga inouraya zvipembenene kwenguva refu kana kuwedzera kuwanda kwegore kwekushandisa.
Misiyano yekupararira kweanemia pakati peIRS nenzvimbo dzekutonga, pakati pemapoka emazera akasiyana uye pakati pevatori vechikamu vane fivha uye vasina fivha inogona kushanda sechiratidzo chisina kunanga chechirongwa chinoshandiswa.
Ichi chidzidzo chinoratidza kuti pirimiphos-methyl IRS inogona kuderedza zvakanyanya kuwanda uye kuitika kwemarariya muvana vari pasi pemakore gumi munharaunda yeKoulikoro inodzivirira pyrethroid, uye kuti vana vanogara munzvimbo dze IRS vanowanzoita marariya uye kuramba vasina marariya. kureba mudunhu. Zvidzidzo zvakaratidza kuti pirimiphos-methyl insecticide yakakodzera yekudzivirira marariya munzvimbo dzinogara pyrethroids.
Nguva yekutumira: Zvita-09-2024