Mambure epamubhedha ane pyrethroid clofenpyr (CFP) nepyrethroid piperonyl butoxide (PBO) ari kusimudzirwa munyika dzine dambudziko rekuvandudza kudzora kwemarariya inoparadzirwa nemosquito isingaite pyrethroid.CFP inonzi proinsecticide inoda kushandiswa ne mosquito cytochrome P450 monooxygenase (P450), uye PBO inowedzera kushanda kwepyrethroids nekudzivisa kuita kwema enzymes muumhutu hunopikisa pyrethroid.Nokudaro, P450 inhibition nePBO inogona kuderedza kushanda kwemambure e-pyrethroid-CFP kana inoshandiswa mumusha mumwechete se-pyrethroid-PBO nets.
Miedzo miviri yecockpit yekuedza yakaitwa kuti iongorore mhando mbiri dzakasiyana dzepyrethroid-CFP ITN (Interceptor® G2, PermaNet® Dual) chete uye pamwe chete nepyrethroid-PBO ITN (DuraNet® Plus, PermaNet® 3.0).Entomological zvinoreva kushandiswa kwePyrethroid resistance Vector populations kumaodzanyemba kweBenin.Mune zvese zvidzidzo, ese mesh marudzi akaedzwa mune imwechete uye kaviri mesh kurapwa.Bioassays yakaitwa zvakare kuti iongorore kusagadzikana kwezvinodhaka kwevector vanhu muhut uye kudzidza kudyidzana pakati peCFP nePBO.
Huwandu hwevector hwaive nehanya neCFP asi hwakaratidza huwandu hwakanyanya hwekuramba pyrethroids, asi kuramba uku kwakakundwa nekutanga kuratidzwa kuPBO.Kufa kweVector kwakaderedzwa zvakanyanya mudzimba vachishandisa musanganiswa wepyrethroid-CFP nets uye pyrethroid-PBO nets zvichienzaniswa nedzimba dzinoshandisa mambure maviri epyrethroid-CFP (74% yeInterceptor® G2 vs. 85%, PermaNet® Dual 57% vs. 83% ), p <0.001).Pre-kuratidzwa kuPBO kwakaderedza huturu hweCFP mumabhodhoro bioassays, zvichiratidza kuti izvi zvinogona kunge zvakakonzerwa nechikamu chekupesana pakati peCFP nePBO.Kufa kweVector kwaive kwakakwira mudzimba vachishandisa misanganiswa yemambure ane pyrethroid-CFP net zvichienzaniswa netumba dzisina pyrethroid-CFP nets, uye paishandiswa mambure epyrethroid-CFP ari ega semambure maviri.Kana yakashandiswa pamwechete, kufa kwakanyanya (83-85%).
Ichi chidzidzo chakaratidza kuti kushanda kwepyrethroid-CFP meshes kwakaderedzwa kana yakashandiswa pamwe chete nepyrethroid-PBO ITN kana ichienzaniswa nekushandisa yega, asi kushanda kwemambure ekubatanidza ane pyrethroid-CFP meshes akanga akakwirira.Mhedzisiro iyi inoratidza kuti kuisa pamberi kugoverwa kwepyrethroid-CFP network pamusoro pemamwe marudzi etiweki kuchawedzera vector control mhedzisiro mumamiriro akafanana.
Mambure ane mishonga yezvipembenene (Insecticide-treated bed nets (ITNs) ane mishonga inouraya zvipembenene yepyrethroid ndiwo akanyanya kurwisa marariya mumakore makumi maviri apfuura.Kubva muna 2004, mambure anouraya zvipembenene anosvika mabhiriyoni maviri nemazana mashanu akapihwa kunyika dziri kuchamhembe kweSahara muAfrica [1], zvichikonzera kuwedzera kwenhamba yevanhu vanorara pasi pemambure ane mishonga yezvipembenene kubva pa4% kusvika pa47% [2].Mhedzisiro yekushandiswa uku yaive yakakosha.Inofungidzirwa kuti inenge mabhiriyoni maviri emararamiro emarariya uye 6.2 mamiriyoni ekufa kwakadziviswa munyika yose pakati pe2000 ne2021, nekuongorora kwekuenzanisa kunoratidza kuti mambure akabatwa nemishonga yezvipembenene aiva mutyairi mukuru wekubatsira uku [2, 3].Nekudaro, kufambira mberi uku kunouya pamutengo: kukurumidza kushanduka kwepyrethroid kuramba mumarariya vector vanhu.Kunyange zvazvo pyrethroid-yakagadziriswa mambure emubhedha inogona kuramba ichidzivirira munhu kubva kune marariya munzvimbo idzo mavectors anoratidza pyrethroid resistance [4], zvidzidzo zvekuenzanisira zvinofanotaura kuti pamatunhu akakwirira ekudzivisa, mambure emubhedha anogadzirwa nemishonga inoderedza epidemiological impact [5]..Saka, kuramba kwepyrethroid ndeimwe yekutyisidzira kwakakosha kune kuenderera mberi mukudzora marariya.
Mumakore mashomanana adarika, chizvarwa chitsva chemambure ane mishonga yezvipembenene, anobatanidza pyrethroids nekemikari yechipiri, akagadzirwa kuti avandudze kudzora kwemarariya inoparadzirwa neumhutu husingaurayiwi nepyrethroid.Yekutanga kirasi itsva yeITN ine synergist piperonyl butoxide (PBO), iyo inogona kuita pyrethroids nekuita neutralizing detoxifying enzymes inobatanidza nepyrethroid resistance, kunyanya kushanda kwe cytochrome P450 monooxygenases (P450s) [6].Mibhedha inobatwa nefluprone (CFP), anzole insecticide ine nzira itsva yekuita inonangana nekufema kweserura, zvakare yave kuwanikwa.Kutevera kuratidzwa kwekuvandudzwa kweiyo entomological impact muhut pilot trials [7, 8], nhevedzano ye cluster randomized controlled trials (cRCT) yakaitwa kuti iongorore hutano hweveruzhinji hwemambure aya kana ichienzaniswa nemambure anorapwa nemishonga achishandisa pyrethroids chete uye kupa humbowo hunodiwa kuzivisa kurudziro kubva kuWorld Health Organisation (WHO) [9].Zvichienderana neuchapupu hwekuvandudzwa kwechirwere chechirwere kubva kuCRCTs muUganda [11] neTanzania [12], WHO yakatsigira pyrethroid-PBO-inorapwa mibhedha [10].Iyo pyrethroid-CFP ITN yakabudiswawo munguva pfupi yapfuura mushure meRCTs yakafanana muBenin [13] neTanzania [14] yakaratidza kuti prototype ITN (Interceptor® G2) yakaderedza chiitiko chemarariya evana ne 46% uye 44%, zvichiteerana.10].].
Zvichitevera kuedza kutsva kweGlobal Fund nevamwe vatsigiri vakuru vemalaria kuti vagadzirise kurwisa zvipembenene kuburikidza nekukasira kuunzwa kwemambure matsva [15], pyrethroid-PBO nepyrethroid-CFP mambure emubhedha ave kutoshandiswa munzvimbo dzine dambudziko.Inotsiva mishonga yezvipembenene yechinyakare.mambure emubhedha anorapwa anoshandisa mapyrethroids chete.Pakati pa2019 na2022, chikamu chePBO pyrethroid mosquito nets yakapihwa kusub-Saharan Africa chakawedzera kubva pa8% kusvika 51% [1], ukuwo PBO pyrethroid mosquito nets, kusanganisira CFP pyrethroid mosquito nets, "mambure maviri" anotarisirwa kuuraya umhutu. account ye56% yekutakura.Pinda mumusika weAfrica panosvika 2025[16].Sehumbowo hwekushanda kwepyrethroid-PBO uye pyrethroid-CFP mosquito nets inoramba ichikura, mambure aya anotarisirwa kuwanikwa zvakanyanya mumakore anotevera.Nokudaro, pane kudiwa kuri kukura kwekuzadza ruzivo pamusoro pemashandisirwo akakwana emambure ane mishonga yezvipembenene echizvarwa chitsva kuti abudirire zvakanyanya kana akakwidziridzwa kuti ashandiswe zvizere.
Tichifunga kuwanda kuri kuita pyrethroid CFP nepyrethroid PBO mosquito nets, National Malaria Control Programme (NMCP) ine mubvunzo mumwe weongororo yekushanda: Kubudirira kwayo kuchaderedzwa here - PBO ITN?Chikonzero chekunetseka uku ndechekuti PBO inoshanda nekudzivisa mosquito P450 enzymes [6], nepo CFP iri proinsecticide inoda kushandiswa kuburikidza neP450s [17].Nokudaro, zvinofungidzirwa kuti kana pyrethroid-CFP ITN uye pyrethroid-CFP ITN inoshandiswa mumusha mumwe chete, inhibitory effect yePBO paP450 inogona kuderedza kushanda kwepyrethroid-CFP ITN.Ongororo dzinoverengeka dzerabhoritari dzakaratidza kuti kusati kwasvika kuPBO kunoderedza kutyisa kwakanyanya kweCFP kune mosquito vectors mune yakananga exposure bioassays [18,19,20,21,22].Nekudaro, kana uchiitisa zvidzidzo pakati pemambure akasiyana mumunda, kudyidzana pakati pemakemikari aya kuchave kwakaoma.Zvidzidzo zvisina kudhindwa zvakaongorora mhedzisiro yekushandisa mhando dzakasiyana dzemambure ane mishonga yezvipembenene pamwechete.Nokudaro, zvidzidzo zvemumunda zvinoongorora kukanganisa kwekushandisa musanganiswa wemishonga inouraya pyrethroid-CFP uye pyrethroid-PBO mambure emubhedha muimba imwechete zvichabatsira kuona kana kupesana kunogona kuitika pakati pemhando idzi dzemambure kunokonzera dambudziko rekushanda uye kubatsira kuona nzira yakanakisisa yekuisa. .kumatunhu ayo akagoverwa zvakafanana.
Nguva yekutumira: Sep-21-2023