Visceral leishmaniasis (VL), inozivikanwa sekala-azar muIndian subcontinent, chirwere chinopararira chinokonzerwa neflagellated protozoan Leishmania chinogona kuuraya kana chikasarapwa nekukasika. Sandfly Phlebotomus argentipes ndiyo yega yakasimbiswa kuti inokonzera VL muSoutheast Asia, uko inodzorwa neindoor residual spraying (IRS), mushonga wezvipembenene wakagadzirwa. Kushandiswa kweDDT muzvirongwa zvekudzora VL kwakonzera kukura kwekusagona kudzivirira zvipembenene mujecha, saka DDT yakatsiviwa nemushonga wezvipembenene alpha-cypermethrin. Zvisinei, alpha-cypermethrin inoshanda zvakafanana neDDT, saka njodzi yekusagona kudzivirira zvipembenene mujecha inowedzera kana paine kushushikana kunokonzerwa nekusangana nemushonga uyu kakawanda. Muchidzidzo ichi, takaongorora kusagona kudzivirira zvipembenene mujecha uye vana vazvo veF1 tichishandisa CDC bottle bioassay.
Takaunganidza umhutu kubva kumisha gumi mudunhu reMuzaffarpur kuBihar, India. Misha misere yakaramba ichishandisa simba rakawanda.cypermethrinpakushandisa mushonga wekupfapfaidza mumba, mumwe musha wakarega kushandisa mushonga we cypermethrin une simba guru pakupfapfaidza mumba, uye mumwe musha hauna kumbobvira washandisa mushonga we cypermethrin une simba guru pakupfapfaidza mumba. Umhutu hwakaunganidzwa hwakaiswa pamushonga wakafa kwenguva yakatarwa (3 μg/ml kwemaminitsi makumi mana), uye huwandu hwehutachiona nerufu zvakaonekwa maawa makumi maviri nemana mushure mekubatwa nawo.
Huwandu hweumhutu hwemusango hwakaurayiwa hwakabva pa91.19% kusvika pa99.47%, uye hwezvizvarwa zvavo zveF1 hwakabva pa91.70% kusvika pa98.89%. Maawa makumi maviri nemana mushure mekusangana nechirwere ichi, huwandu hweumhutu hwemusango hwakabva pa89.34% kusvika pa98.93%, uye hwechizvarwa chavo cheF1 hwakabva pa90.16% kusvika pa98.33%.
Zvakabuda muchidzidzo ichi zvinoratidza kuti kusagona kurwisa P. argentipes kunogona kuitika, zvichiratidza kuti panofanira kuramba pachitariswa uye kungwarira kuti pave nekudzora kana kuparadzwa kwaitwa.
Visceral leishmaniasis (VL), inozivikanwa sekala-azar muIndian subcontinent, chirwere chinokonzerwa neflagellated protozoan Leishmania uye chinotapuriranwa nekurumwa nesand flies dzechikadzi dzine utachiona (Diptera: Myrmecophaga). Sand flies ndidzo chete dzinozivikanwa kuti dzinobata VL muSoutheast Asia. India yava pedyo nekuzadzisa chinangwa chekubvisa VL. Zvisinei, kuti pave nehuwandu hushoma hwehutachiona mushure mekubviswa, zvakakosha kuderedza huwandu hwevectors kudzivirira kutapurirana kunogona kuitika.
Kudzora umhutu muSoutheast Asia kunoitwa kuburikidza nekupfapfaidza mumba (IRS) uchishandisa mishonga yekuuraya zvipembenene yakagadzirwa. Maitiro ekuzorora pachivande kwemakumbo esirivha anoita kuti ive chinangwa chakakodzera chekudzivirira zvipembenene kuburikidza nekupfapfaidza mumba [1]. Kupfapfaidza mukati memba kwe dichlorodiphenyltrichloroethane (DDT) pasi peNational Malaria Control Programme muIndia kwave nemigumisiro yakakura mukudzora huwandu hweumhutu uye kuderedza zvakanyanya nyaya dzeVL [2]. Kudzora uku kusina kurongwa kweVL kwakaita kuti Indian VL Eradication Programme ishandise kupfapfaidza mumba senzira huru yekudzora makumbo esirivha. Muna 2005, hurumende dzeIndia, Bangladesh, neNepal dzakasaina chibvumirano chekunzwisisana nechinangwa chekubvisa VL panosvika 2015 [3]. Kuedza kubvisa, kunosanganisira kusanganisa kudzora vector uye kuongororwa nekukurumidza uye kurapwa kwezvirwere zvevanhu, kwaive nechinangwa chekupinda muchikamu chekubatanidza panosvika 2015, chinangwa chakazogadziriswazve kusvika 2017 uye 2020.[4] Nzira itsva yepasi rose yekubvisa zvirwere zvemunzvimbo dzinopisa zvisina hanya inosanganisira kubviswa kweVL panosvika 2030.[5]
Sezvo India ichipinda muchikamu cheBCD mushure mekubviswa kweBCD, zvakakosha kuve nechokwadi chekuti kuramba kwakanyanya ku beta-cypermethrin hakukure. Chikonzero chekuramba kwacho ndechekuti DDT ne cypermethrin zvese zvine maitiro akafanana ekushanda, kureva kuti, zvinonanga protein yeVGSC [21]. Saka, njodzi yekukura kwekusagona kurwisa mujecha inogona kuwedzerwa nekushushikana kunokonzerwa nekusangana ne cypermethrin ine simba rakawanda nguva dzose. Saka zvakakosha kutarisa nekuona huwandu hwejecha hunogona kuramba huchirwisa mushonga uyu. Muchirevo ichi, chinangwa chechidzidzo ichi chaive chekutarisa mamiriro ekusagona kurwisa zvipembenene zvemusango uchishandisa madosi ekuongorora uye nguva yekusangana yakatemwa naChaubey et al. [20] vakadzidza P. argentipes kubva kumamisha akasiyana mudunhu reMuzaffarpur kuBihar, India, iyo yaigara ichishandisa masisitimu ekupfapfaidza emukati akarapwa ne cypermethrin (misha inoenderera mberi yeIPS). Kukanganiswa kwezvipembenene zveP. argentipes zvemusango kubva kumisha yakanga yarega kushandisa masisitimu ekupfapfaidza emukati akarapwa necypermethrin (yaimbova misha yeIPS) neiyo yakanga isati yamboshandisa masisitimu ekupfapfaidza emukati akarapwa necypermethrin (misha isiri yeIPS) kwakaenzaniswa uchishandisa CDC bottle bioassay.
Misha gumi yakasarudzwa kuti iongororwe (Mufananidzo 1; Tafura 1), misere yacho yaive nenhoroondo yekupfapfaidza mishonga yemhando ye "synthetic pyrethroids" mukati meimba (hypermethrin; yainzi continuous hypermethrin villages) uye yaive neVL cases (kana imwe chete) mumakore matatu apfuura. Pamisha miviri yasara muchidzidzo ichi, musha mumwe chete usina kushandisa beta-cypermethrin (musha usiri wekupfapfaidza mukati meimba) wakasarudzwa semusha wekudzora uye mumwe musha waiva nekupfapfaidza beta-cypermethrin mukati meimba (musha wekupfapfaidza mukati meimba/musha wekare wekupfapfaidza mukati meimba) wakasarudzwa semusha wekudzora. Kusarudzwa kwemisha iyi kwakavakirwa pakushanda pamwe chete neDhipatimendi reHutano neChikwata cheKupfapfaidza Mumba uye kusimbiswa kweIndoor Spraying Micro Action Plan muMuzaffarpur District.
Mepu yenzvimbo yedunhu reMuzaffarpur inoratidza nzvimbo dzemisha dziri muchidzidzo (1–10). Nzvimbo dzekudzidza: 1, Manifulkaha; 2, Ramdas Majhauli; 3, Madhubani; 4, Anandpur Haruni; 5, Pandey; 6, Hirapur; 7, Madhopur Hazari; 8, Hamidpur; 9, Noonfara; 10, Simara. Mepu iyi yakagadzirwa uchishandisa software yeQGIS (vhezheni 3.30.3) uye Open Assessment Shapefile.
Mabhodhoro ekuyedza kuratidzwa akagadzirwa zvichienderana nenzira dzakaitwa naChaubey et al. [20] naDenlinger et al. [22]. Muchidimbu, mabhodhoro egirazi e500 mL akagadzirwa zuva rimwe chete bvunzo isati yaitwa uye rusvingo rwemukati rwemabhodhoro rwakanga rwakafukidzwa nemushonga wezvipembenene wakaratidzwa (muyero wekuongorora weα-cypermethrin waive 3 μg/mL) nekuisa acetone solution yemushonga wezvipembenene (2.0 mL) pasi, madziro nechivharo chemabhodhoro. Bhodhoro rega rega rakabva raomeswa pamochanical roller kwemaminitsi makumi matatu. Munguva iyi, bvisa chivharo zvishoma nezvishoma kuti acetone ipere. Mushure memaminitsi makumi matatu ekuomesa, bvisa chivharo wotenderedza bhodhoro kusvika acetone yese yapera. Mabhodhoro acho akabva asiyiwa akavhurika kuti aome husiku hwese. Pamuedzo wega wega, bhodhoro rimwe, raishandiswa senzira yekudzora, rakaputirwa ne2.0 mL yeacetone. Mabhodhoro ese akashandiswazve mukati mekuyedza mushure mekucheneswa kwakakodzera zvichienderana nemaitiro akatsanangurwa naDenlinger et al. uye World Health Organization [22, 23].
Pazuva rakatevera kugadzirwa kwemishonga yezvipembenene, umhutu hwakabatwa musango hunosvika 30-40 (hukadzi hwakafa nenzara) hwakabviswa mumakeji ari mumabhodhoro ndokuputirwa zvinyoro nyoro mubhodhoro rega rega. Nhamba imwe chete yenhunzi yakashandiswa pabhodhoro rega rega rakaputirwa mishonga yezvipembenene, kusanganisira mushonga wekudzivirira. Dzokorora izvi kanenge kashanu kusvika katanhatu mumusha wega wega. Mushure memaminitsi makumi mana ekushandiswa mushonga wezvipembenene, nhamba yenhunzi dzakadonhedzwa pasi yakanyorwa. Nhunzi dzese dzakabatwa nemuchina wekuchenesa, dzakaiswa mumidziyo yekadhibhodhi yepint yakafukidzwa nemesh yakanaka, ndokuiswa mu incubator yakasiyana pasi pehunyoro hwakafanana uye mamiriro ekupisa ane chikafu chimwe chete (mabhora edonje akanyikwa mu30% shuga solution) semakoloni asina kurapwa. Kufa kwakanyorwa maawa makumi maviri nemana mushure mekuiswa mushonga wezvipembenene. Umhutu hwese hwakachekwa-chekwa uye hwakaongororwa kuti huve nechokwadi chekuti mhando dzemhuka ndedzerudzii. Maitiro akafanana akaitwa nenhunzi dzevana veF1. Kudonha kwemvura nekufa kwakanyorwa maawa makumi maviri nemana mushure mekuiswa mushonga. Kana kufa mumabhodhoro ekudzivirira kwaive pasi pe5%, hapana kugadziriswa kwekufa kwakaitwa mumakopi akatevedzana. Kana kufa mubhodhoro rekudzora raiva ≥ 5% uye ≤ 20%, kufa mubhodhoro rekuyera rekopi iyoyo kwaigadziriswa uchishandisa fomura yaAbbott. Kana kufa muboka rekudzora kwakapfuura 20%, boka rese rekuyera rakaraswa [24, 25, 26].
Avhareji yekufa kweumhutu hweP. argentipes hwakabatwa musango. Mitsetse yekukanganisa inomiririra zvikanganiso zvakajairika zveavhareji. Kusangana kwemitsetse miviri mitsvuku yakatambanuka negirafu (90% uye 98% yekufa, zvichiteerana) kunoratidza hwindo rekufa umo kuramba kwechirwere kunogona kukura.[25]
Avhareji yekufa kwevana veF1 veP. argentipes vanobatwa nemhuka dzesango. Mitsetse yekukanganisa inomiririra zvikanganiso zvakajairika zveavhareji. Makomba anosanganisirwa nemitsetse miviri mitsvuku yakatambanuka (90% uye 98% yekufa, zvichiteerana) anomiririra huwandu hwekufa uko kusawirirana kunogona kukura [25].
Umhutu huri mumusha wekutonga/usiri weIRS (Manifulkaha) hwakawanikwa huchinyanya kubatwa nemishonga yezvipembenene. Avhareji yerufu (±SE) rweumhutu hwakabatwa musango maawa makumi maviri nemana mushure mekudonha uye kupararira kwahwo hwaive 99.47 ± 0.52% uye 98.93 ± 0.65%, zvichiteerana, uye avhareji yerufu rwevana veF1 yaive 98.89 ± 1.11% uye 98.33 ± 1.11%, zvichiteerana (Matafura 2, 3).
Zvakabuda muchidzidzo ichi zvinoratidza kuti nhunzi dzejecha dzine makumbo machena dzinogona kuramba dzisiri dzepyrethroid (SP) α-cypermethrin mumisha yaishandiswa nguva dzose nepyrethroid (SP) α-cypermethrin. Kusiyana neizvi, nhunzi dzejecha dzine makumbo machena dzakaunganidzwa kubva mumisha isina kuvharwa neIRS/chirongwa chekudzora zvakaonekwa kuti dzine hutachiona hwakanyanya. Kutarisa hutachiona hwenhunzi dzejecha dzemusango kwakakosha pakutarisa kushanda kwemishonga yekuuraya zvipembenene inoshandiswa, sezvo ruzivo urwu runogona kubatsira mukugadzirisa hutachiona. Kuwanda kwehutachiona hweDDT kwagara kuchitaurwa munhunzi dzejecha dzinobva munzvimbo dzakapararira muBihar nekuda kwekumanikidzwa kwekare kubva kuIRS ichishandisa mushonga uyu wezvipembenene [1].
Takawana kuti P. argentipes inonzwa zvakanyanya kuzvirwere zvepyrethroids, uye miedzo yekumunda muIndia, Bangladesh neNepal yakaratidza kuti IRS yaishanda zvakanyanya pazvipembenene kana ikashandiswa pamwe chete ne cypermethrin kana deltamethrin [19, 26, 27, 28, 29]. Munguva pfupi yapfuura, Roy et al. [18] vakataura kuti P. argentipes yakanga yave nekudzivirira kuzvirwere zvepyrethroids muNepal. Ongororo yedu yekugona kurwara mumunda yakaratidza kuti nhunzi dzejecha dzakatorwa kubva kumisha isiri yeIRS dzaive nehutachiona zvakanyanya, asi nhunzi dzakatorwa kubva kumisha yeIRS yaimbovepo uye yaimbovepo (kufa kwaibva pa90% kusvika 97% kunze kwenhunzi dzejecha kubva kuAnandpur-Haruni iyo yaive ne89.34% yekufa kwemaawa makumi maviri nemana mushure mekusangana nehutachiona) dzaive dzisingagoni kubatwa ne cypermethrin inoshanda zvakanyanya [25]. Chimwe chikonzero chingangove chekuvandudzwa kwekusagona kurwisa uku kudzvanywa kunoitwa nekupfapfaidza kwemukati (IRS) uye mapurogiramu ekupfapfaidza emunharaunda akavakirwa pazviitiko, ayo ari maitiro akajairwa ekugadzirisa kubuda kwechirwere chekala-azar munzvimbo/mabhuroko/misha inowanikwa (Standard Operating Procedure for Outbreak Investigation and Management [30]. Mhedzisiro yechidzidzo ichi inopa zviratidzo zvekutanga zvekuvandudzwa kwekumanikidzwa kwekusarudza kurwisa cypermethrin inoshanda zvakanyanya. Zvinosuwisa kuti, data rekare rekusagona kurwisa chirwere munzvimbo ino, rakawanikwa uchishandisa CDC bottle bioassay, harisipo kuti rienzaniswe; zvidzidzo zvese zvekare zvakatarisa kusagona kurwisa chirwere cheP. argentipes uchishandisa bepa reWHO rakaiswa zvipembenene. Madhigirii ekuongorora ezvipembenene muWHO test strips ndiwo anokurudzirwa ekuziva kuwanda kwezvipembenene zvekushandisa kurwisa malaria vectors (Anopheles gambiae), uye kushanda kwehuwandu uhwu kuzvipembenene zvejecha hakuna kujeka nekuti zvipembenene zvejecha zvinobhururuka zvishoma pane umhutu, uye zvinopedza nguva yakawanda zvichisangana nesubstrate iri mu bioassay [23].
Mishonga yepyrethroids yakagadzirwa yave ichishandiswa munzvimbo dzeVL muNepal kubvira muna 1992, ichichinjana neSPs alpha-cypermethrin nelambda-cyhalothrin yekudzora sandfly [31], uye deltamethrin yave ichishandiswawo muBangladesh kubvira muna 2012 [32]. Kusagona kwePhenotypic kwakaonekwa mumapoka emusango esilverlegged sandflies munzvimbo dzave dzichishandiswa kwenguva yakareba [18, 33, 34]. Mutation isingafananidzi (L1014F) yakaonekwa mumapoka emusango eIndian sandfly uye yakabatana nekusagona kubatwa neDDT, zvichiratidza kuti kusagona kubatwa nepyrethroid kunoitika padanho remamorekuru, sezvo DDT nepyrethroid (alpha-cypermethrin) zvichinanga jini rimwe chete muhurongwa hwetsinga dzezvipembenene [17, 34]. Nokudaro, kuongororwa kwakarongeka kwekusagona kubatwa necypermethrin uye kutarisa kusagona kubatwa neumhutu kwakakosha panguva yekubviswa uye mushure mekubviswa.
Dambudziko rinogona kukonzerwa nekudzidza uku nderekuti takashandisa CDC vial bioassay kuyera kubatwa nechirwere, asi kuenzanisa kwese kwakashandisa mhedzisiro kubva muzvidzidzo zvekare tichishandisa WHO bioassay kit. Mhedzisiro kubva muongororo mbiri idzi inogona kusaenzaniswa zvakananga nekuti CDC vial bioassay inoyera knockdown pakupera kwenguva yekuongorora, nepo WHO kit bioassay inoyera kufa kwemaawa makumi maviri nemana kana makumi manomwe nemaviri mushure mekusangana nechirwere (chekupedzisira chemakemikari anoshanda zvishoma nezvishoma) [35]. Chimwe chirambidzo chinogona kuitika huwandu hwemisha yeIRS muchidzidzo ichi zvichienzaniswa nemusha mumwe chete usiri weIRS uye mumwe usiri weIRS/waimbova weIRS. Hatigone kufunga kuti huwandu hwehutachiona hwemhutu hunoonekwa mumisha yega yega mudunhu rimwe chete hunomiririra huwandu hwehutachiona mune mimwe misha nematunhu muBihar. Sezvo India ichipinda muchikamu chekupedzisira chechirwere cheleukemia, zvakakosha kudzivirira kukura kwakakosha kwehutachiona. Kutarisa nekukurumidza kwekudzivirira kwehutachiona mumapoka ejecha kubva kumadunhu akasiyana, mabhuroko nenzvimbo dzenzvimbo kunodiwa. Ruzivo rwuri muchidzidzo ichi nderwekutanga uye runofanira kusimbiswa nekuenzanisa nehuwandu hwekuzivikanwa hwakaburitswa neWorld Health Organisation [35] kuti tiwane pfungwa chaiyo yemamiriro eP. argentipes munzvimbo idzi tisati tagadzirisa mapurogiramu ekudzivirira vector kuchengetedza huwandu hushoma hwesandfly uye kutsigira kubviswa kwehutachiona hweleukemia.
Utunga hweP. argentipes, ihwo hunokonzera hutachiona hweleukosis, hunogona kutanga kuratidza zviratidzo zvekutanga zvekusagona kurwisa cypermethrin inoshanda zvikuru. Kugara uchitarisa kusagona kurwisa zvipembenene mumarudzi emhuka dzesango dzeP. argentipes kwakakosha kuti pave nekukanganiswa kwezvirwere zvinotapukira. Kuchinjana kwemishonga yezvipembenene nenzira dzakasiyana dzekuita uye/kana kuongorora nekunyoresa mishonga mitsva yezvipembenene kwakakosha uye kunokurudzirwa kudzora kusagona kurwisa zvipembenene uye kutsigira kubviswa kwehutachiona hweleukosis muIndia.
Nguva yekutumira: Kukadzi-17-2025