Ukwehla kwakutshanje komthwalo wemalariya eCôte d'Ivoire kubangelwa kakhulu kukusetyenziswa kweenethi zokubulala izinambuzane ezihlala ixesha elide (i-LIN). Nangona kunjalo, le nkqubela isongelwa kukumelana nezinambuzane, utshintsho kwindlela yokuziphatha kwi-Anopheles gambiae populations, kunye nokudluliselwa kwemalariya okushiyekileyo, nto leyo ebangela isidingo sezixhobo ezongezelelweyo. Ke ngoko, injongo yolu phononongo yayikukuvavanya ukusebenza kakuhle kokusetyenziswa okudibeneyo kwe-LLIN kunye neBacillus thuringiensis (Bti) kunye nokuyithelekisa ne-LLIN.
Olu phononongo lwenziwe ukususela ngoMatshi 2019 ukuya kuFebruwari 2020 kwiingalo ezimbini zophando (i-LLIN + Bti arm kunye ne-LLIN only arm) kummandla wezempilo waseKorhogo kumantla eCôte d'Ivoire. Kwiqela le-LLIN + Bti, iindawo zokuhlala ze-Anopheles larval zanyangwa nge-Bti rhoqo kwiiveki ezimbini ukongeza kwi-LLIN. Iingcongconi ze-Larval kunye ne-Old Mothers zaqokelelwa kwaye zachongwa ngokwemo yazo ngokwe-genus kunye neentlobo kusetyenziswa iindlela eziqhelekileyo. Ilungu u-Ann. I-Gambian complex yachongwa kusetyenziswa ubuchwepheshe be-polymerase chain reaction. Usulelo lwePlasmodium An. Ukwanda kwe-malaria eGambia nakubemi basekuhlaleni nako kwahlolwa.
Ngokubanzi, uxinano lwee-larval ze-Anopheles spp. lwaluphantsi kwiqela le-LLIN + Bti xa kuthelekiswa neqela le-LLIN lodwa elingu-0.61 [95% CI 0.41–0.81] larvae/dive (l/dive) 3.97 [95% CI 3.56–4 .38] l/dive (RR = 6.50; 95% CI 5.81–7.29 P < 0.001). Isantya sokuluma se-An ngokubanzi. Ukuxhaphaka kokuluma kwe-S. gambiae kwakuyi-0.59 [95% CI 0.43–0.75] ngomntu/ngobusuku kwiqela le-LLIN + Bti lodwa, xa kuthelekiswa nokuluma kwe-2.97 [95% CI 2.02–3. 93] ngomntu/ngobusuku kwiqela le-LLIN lodwa (P < 0.001). I-Anopheles gambiae sl ichongwa kakhulu njenge-Anopheles mosquito. I-Anopheles gambiae (ss) (95.1%; n = 293), ilandelwa yi-Anopheles gambiae (4.9%; n = 15). Isalathisi segazi lomntu kwindawo yophando yayiyi-80.5% (n = 389). I-EIR yeqela le-LLIN + Bti yayiyi-1.36 ukulunywa ngumntu ngamnye ngonyaka (ib/p/y), ngelixa i-EIR yeqela le-LLIN kuphela yayiyi-47.71 ib/p/y. Ukuxhaphaka kwemalariya kwehle kakhulu ukusuka kwi-291.8‰ (n = 765) ukuya kwi-111.4‰ (n = 292) kwiqela le-LLIN + Bti (P < 0.001).
Ukudityaniswa kwe-LLIN kunye ne-Bti kunciphisa kakhulu ukwanda kwe-malaria. Ukudityaniswa kwe-LLIN kunye ne-Bti kunokuba yindlela edibeneyo ethembisayo yokulawula ngempumelelo i-An. IGambia ayinayo i-malaria.
Nangona kubekho inkqubela phambili ekulawuleni imalariya kwiminyaka embalwa edlulileyo, umthwalo wemalariya useyingxaki enkulu kwi-Afrika esemazantsi eSahara [1]. I-World Health Organization (WHO) isandula ukubika ukuba bekukho iimeko zemalariya ezizigidi ezingama-249 kunye nokufa okuqikelelwa kuma-608,000 okunxulumene nemalariya kwihlabathi liphela ngo-2023 [2]. Ummandla we-WHO wase-Afrika ubandakanya ama-95% eemeko zemalariya zehlabathi kunye nama-96% okufa kwemalariya, apho abafazi abakhulelweyo kunye nabantwana abangaphantsi kweminyaka emi-5 ubudala bachaphazeleka kakhulu [2, 3].
Iinethi zokubulala izinambuzane ezihlala ixesha elide (i-LLIN) kunye nokutshiza okusele ngaphakathi (i-IRS) zidlale indima ebalulekileyo ekunciphiseni umthwalo wemalariya e-Afrika [4]. Ukwandiswa kwezi zixhobo zokulawula imalariya kubangele ukwehla kwama-37% kwinani lemalariya kunye nokwehla kwama-60% ekufeni phakathi kowama-2000 nowama-2015 [5]. Nangona kunjalo, iindlela ezibonwe ukusukela ngo-2015 ziye zama ngendlela eyoyikisayo okanye yakhawuleza, kunye nokufa kwemalariya okuhlala kuphezulu ngendlela engamkelekanga, ingakumbi kwi-Afrika esezantsi kweSahara [3]. Izifundo ezininzi zichonge ukuvela kunye nokusasazeka kokumelana phakathi kwe-Anopheles enkulu yemalariya i-Anopheles kwi-insecticide esetyenziswa kwimpilo yoluntu njengomqobo ekusebenzeni kwe-LLIN kunye ne-IRS kwixesha elizayo [6,7,8]. Ukongeza, utshintsho kwindlela yokuziphatha yokuluma kwe-vector ngaphandle nangaphambi kobusuku lubangela ukusasazwa kwemalariya eseleyo kwaye luyinkxalabo ekhulayo [9, 10]. Imida ye-LLIN kunye ne-IRS ekulawuleni ii-vectors ezinoxanduva lokusasazwa kwemalariya eseleyo ngumda omkhulu kwimizamo yokuphelisa imalariya yangoku [11]. Ukongeza, ukuqhubeka kwe-malaria kuchazwa ziimeko zemozulu kunye nemisebenzi yabantu, enegalelo ekudalweni kweendawo zokuhlala zee-larval [12].
Ulawulo lomthombo weenkuni (LSM) yindlela esekwe kwindawo yokuzalela yokulawula iintsholongwane ejolise ekunciphiseni inani leendawo zokuzalela kunye nenani leempuku zeengcongconi kunye neempuku ezikwii-in [13]. I-LSM icetyisiwe zizifundo ezininzi njengecebo elongezelelweyo lokulawula iintsholongwane zeengcongconi [14, 15]. Enyanisweni, ukusebenza kwe-LSM kubonelela ngenzuzo ephindwe kabini ngokuchasene nokulunywa kweentlobo zeentsholongwane zeengcongconi ngaphakathi nangaphandle [4]. Ukongeza, ulawulo lweentsholongwane ngee-LSM ezisekelwe kwi-larvicide ezifana neBacillus thuringiensis israelensis (Bti) zinokwandisa uluhlu lweendlela zokulawula i-malaria. Ngokwembali, i-LSM idlale indima ebalulekileyo ekulawuleni ngempumelelo i-malaria e-United States, eBrazil, e-Egypt, e-Algeria, eLibya, eMorocco, eTunisia naseZambia [16,17,18]. Nangona i-LSM idlale indima ebalulekileyo ekulawuleni izinambuzane ezidibeneyo kwamanye amazwe aphelise i-malaria, i-LSM ayifakwanga ngokubanzi kwimigaqo-nkqubo kunye nezenzo zokulawula izinambuzane zeengcongconi e-Afrika kwaye isetyenziswa kuphela kwiinkqubo zokulawula izinambuzane kwamanye amazwe angaphantsi kweSahara. amazwe [14,15,16,17,18,19]. Esinye isizathu soku yinkolelo ebanzi yokuba iindawo zokuzalela zininzi kakhulu kwaye kunzima ukuzifumana, nto leyo eyenza i-LSM ibize kakhulu ukuyisebenzisa [4, 5, 6, 7, 8, 9, 10, 11, 13, 14]. Ke ngoko, i-World Health Organisation icebise kangangamashumi eminyaka ukuba izixhobo eziqokelelweyo zokulawula i-malaria vector zigxile kwi-LLIN kunye ne-IRS [20, 21]. Kwakungo-2012 kuphela apho i-World Health Organisation yacebisa ukuhlanganiswa kwe-LSM, ingakumbi ukungenelela kwe-Bti, njengenkxaso kwi-LLIN kunye ne-IRS kwiindawo ezithile kwi-Afrika engaphantsi kweSahara [20]. Ukusukela oko i-WHO yenze esi sindululo, kuye kwenziwa izifundo ezininzi zovavanyo malunga nokuba kunokwenzeka, ukusebenza kakuhle kunye neendleko ze-biolarvicides kwi-Afrika engaphantsi kweSahara, nto leyo ebonisa ukusebenza kakuhle kwe-LSM ekunciphiseni ubuninzi be-Anopheles mosquitoes kunye nokusebenza kakuhle kokudluliselwa kwe-malaria ngokwe-[22, 23]. . , 24].
ICôte d'Ivoire iphakathi kwamazwe ali-15 ane-malaria ephezulu emhlabeni [25]. Ukuxhaphaka kwe-malaria eCôte d'Ivoire kubonisa i-3.0% yomthwalo we-malaria kwihlabathi liphela, kunye nokuqikelelwa kweziganeko kunye nenani lamatyala ukusuka kuma-300 ukuya ngaphezulu kwama-500 kubantu abali-1000 [25]. Nangona ixesha elide lemvula liqala ngoNovemba ukuya kuMeyi, i-malaria isasazeka unyaka wonke kummandla we-savanna osemantla welizwe [26]. Ukusasazeka kwe-malaria kule ndawo kunxulunyaniswa nokuba khona kwenani elikhulu labathwali be-Plasmodium falciparum abangenazimpawu [27]. Kule ndawo, i-malaria vector eqhelekileyo yi-Anopheles gambiae (SL). Ukhuseleko lwengingqi. Iingcongconi ze-Anopheles gambiae zenziwe ikakhulu yi-Anopheles gambiae (SS), enganyangekiyo kakhulu kwii-insecticide kwaye ke ngoko ibeka umngcipheko omkhulu wokusasazeka kwe-malaria eseleyo [26]. Ukusetyenziswa kwe-LLIN kunokuba nefuthe elincinci ekunciphiseni ukusasazeka kwe-malaria ngenxa yokunganyangeki kwe-insecticide kwi-vectors zasekuhlaleni kwaye ke ngoko kuhlala kuyindawo exhalabisa kakhulu. Izifundo zovavanyo ezisebenzisa i-Bti okanye i-LLIN zibonakalise ukusebenza kakuhle ekunciphiseni uxinano lwe-moth vector kumantla eCôte d'Ivoire. Nangona kunjalo, akukho zifundo zangaphambili eziye zavavanya impembelelo yokusetyenziswa okuphindaphindiweyo kwe-Bti kunye ne-LLIN ekudlulisweni kwe-malaria kunye nokwanda kwe-malaria kulo mmandla. Ke ngoko, olu phononongo lujolise ekuvavanyeni impembelelo yokusetyenziswa okudibeneyo kwe-LLIN kunye ne-Bti ekudlulisweni kwe-malaria ngokuthelekisa iqela le-LLIN + Bti kunye neqela le-LLIN lodwa kwiilali ezine kummandla osemantla eCôte d'Ivoire. Kwakucingelwa ukuba ukusebenzisa i-LSM esekelwe kwi-Bti phezu kwe-LLIN kuya kongeza ixabiso ngokunciphisa uxinano lwe-malaria xa kuthelekiswa ne-LLIN yodwa. Le ndlela idibeneyo, ejolise kwiingcongconi ze-Anopheles ezingakavuthwa ezithwala i-Bti kunye neengcongconi ze-Anopheles ezindala ezithwala i-LLIN, inokuba luncedo ekunciphiseni uxinano lwe-malaria kwiindawo ezixhaphake kakhulu kwi-malaria, njengeelali ezikumantla eCôte d'Ivoire. Ke ngoko, iziphumo zolu phononongo zinokunceda ekugqibeni ukuba kufuneka zifakwe na i-LSM kwiinkqubo zolawulo lwe-malaria vector zesizwe (i-NMCPs) kumazwe asemazantsi eSahara.
Olu phononongo lwenziwe kwiilali ezine zesebe laseNapieldougou (ekwaziwa ngokuba yiNapier) kwindawo yococeko yaseKorhogo emantla eCôte d'Ivoire (Umzobo 1). Iilali eziphantsi kophando: iKakologo (9° 14′ 2″ N, 5° 35′ 22″ E), iKolekakha (9° 17′ 24″ N, 5° 31′ 00″ E .), iLofinekaha (9° 17′ 31″). ) 5° 36′ 24″ N) kunye neNambatiurkaha (9° 18′ 36″ N, 5° 31′ 22″ E). Inani labantu baseNapierledougou ngo-2021 liqikelelwa ukuba libemi abangama-31,000, kwaye eli phondo linama-53 eelali anamaziko empilo amabini [28]. Kwiphondo laseNapyeledougou, apho imalariya iyeyona nto iphambili yokutyelelwa kwezonyango, ukulaliswa esibhedlele kunye nokufa, yiLLIN kuphela esetyenziswa ukulawula ii-Anopheles vectors [29]. Zonke iilali ezine kumaqela omabini ophando zikhonzwa liziko lempilo elifanayo, elineerekhodi zeklinikhi zeemeko zemalariya ezihlolwe kolu phononongo.
Imephu yaseCôte d'Ivoire ebonisa indawo yophando. (Umthombo wemephu kunye nesoftware: Idatha ye-GADM kunye ne-ArcMap 10.6.1. Inethi yokubulala izinambuzane ehlala ixesha elide ye-LLIN, i-Bti Bacillus thuringiensis israelensis
Ukuxhaphaka kweMalariya phakathi kwabantu ekujoliswe kubo kwiNapier Health Center kufikelele kwi-82.0% (iimeko ezingama-2038) (idatha yangaphambi kwe-Bti). Kuzo zonke iilali ezine, iintsapho zisebenzisa i-PermaNet® 2.0 LLIN kuphela, esasazwa yi-Ivorian NMCP ngo-2017, kunye ne-80% yokugubungela [25, 26, 27, 28, 30]. Ezi lali ziphantsi kommandla waseKorhogo, osebenza njengendawo yokujonga iBhunga leMikhosi leSizwe lase-Ivory Coast kwaye lifikeleleka unyaka wonke. Ilali nganye kwezi zine inezindlu ezili-100 ubuncinane kunye nabemi abalinganayo, kwaye ngokutsho kwerejista yezempilo (uxwebhu olusebenzayo lweSebe lezeMpilo lase-Ivorian), amatyala amaninzi emalariya axelwa minyaka le. Imalariya ibangelwa kakhulu yiPlasmodium falciparum (P. falciparum) kwaye idluliselwa ebantwini yiPlasmodium. I-gambiae ikwadluliselwa yi-Anopheles kunye ne-Anopheles nili mosquitoes kulo mmandla [28]. I-complex yendawo i-An. gambiae iqulathe ikakhulu i-Anopheles mosquitoes. I-gambiae ss ine-frequency ephezulu ye-kdr mutations (uluhlu lwe-frequency: 90.70–100%) kunye ne-frequency ephakathi ye-ace-1 alleles (uluhlu lwe-frequency: 55.56–95%) [29].
Imvula ephakathi yonyaka kunye nobushushu buqala kwi-1200 ukuya kwi-1400 mm kunye ne-21 ukuya kwi-35 °C ngokulandelelana, kwaye umswakama ohambelanayo (RH) uqikelelwa kwi-58%. Le ndawo yophando inemozulu efana neyaseSudan enexesha lonyaka elomileyo leenyanga ezi-6 (Novemba ukuya ku-Epreli) kunye nexesha lonyaka lemvula leenyanga ezi-6 (Meyi ukuya ku-Okthobha). Lo mmandla ufumana ezinye zeziphumo zotshintsho lwemozulu, ezifana nokulahlekelwa zizityalo kunye nexesha lonyaka elomileyo elide, elibonakaliswa kukoma kwamanzi (amathafa asezantsi, amasimi erayisi, amachibi, amadama) anokusebenza njengendawo yokuhlala ye-Anopheles mosquitoes larvae. Mosquitoes[26].
Olu phononongo lwenziwe kwiqela le-LLIN + Bti, elimelwe ziilali zaseKakologo naseNambatiurkaha, nakwiqela le-LLIN kuphela, elimelwe ziilali zaseKolekaha naseLofinekaha. Ngexesha lolu phononongo, abantu kuzo zonke ezi lali babesebenzisa i-PermaNet® 2.0 LLIN kuphela.
Ukusebenza kakuhle kwe-LLIN (PermaNet 2.0) kunye ne-Bti ngokuchasene neengcongconi ze-Anopheles kunye nokudluliselwa kwemalariya kuhlolwe kuvavanyo olulawulwayo olungacwangciswanga (RCT) oluneendawo ezimbini zophando: iqela le-LLIN + Bti (iqela lonyango) kunye neqela le-LLIN lodwa (iqela lolawulo). Iingalo ze-LLIN + Bti zimelwe yiKakologo kunye neNambatiourkaha, ngelixa iKolékaha kunye neLofinékaha zazenziwe njengamagxa e-LLIN kuphela. Kuzo zonke iilali ezine, abemi basekuhlaleni basebenzisa i-LLIN PermaNet® 2.0 efunyenwe kwi-Ivory Coast NMCP ngo-2017. Kucingelwa ukuba iimeko zokusebenzisa i-PermaNet® 2.0 ziyafana kwiilali ezahlukeneyo kuba zifumene inethiwekhi ngendlela efanayo. . Kwiqela le-LLIN + Bti, iindawo zokuhlala ze-Anopheles larval zanyangwa nge-Bti rhoqo kwiiveki ezimbini ukongeza kwi-LLIN esele isetyenziswa ngabantu. Iindawo zokuhlala zeenkuku ngaphakathi kwiilali ezikumgama we-2 km ukusuka embindini welali nganye ziphathwe ngokweengcebiso zeWorld Health Organisation kunye ne-NMCP yaseCôte d'Ivoire [31]. Ngokwahlukileyo koko, iqela le-LLIN kuphela alizange lifumane unyango lwe-Bti olubulala iinkuku ngexesha lophando.
Uhlobo lwe-Bti oluqhekeka ngamanzi (iVectobac WG, 37.4% wt; inombolo yelothi 88–916-PG; 3000 International Toxicity Units IU/mg; Valent BioScience Corp, USA) lusetyenziswe ngedosi ye-0.5 mg/L. . Sebenzisa isitshizi se-backpack se-16L kunye nesibhamu sokutshiza se-fiberglass esinesiphatho kunye nomlomo ohlengahlengiswayo onesantya sokuhamba se-52 ml ngomzuzwana (3.1 L/min). Ukulungiselela i-nebulizer equlethe i-10 L yamanzi, isixa se-Bti esixutywe kwi-suspension yi-0.5 mg/L × 10 L = 5 mg. Umzekelo, kwindawo enomlinganiselo wamanzi we-10 L, kusetyenziswa isitshizi se-10 L ukunyanga umthamo wamanzi, isixa se-Bti ekufuneka sixutywe yi-0.5 mg/L × 20 L = 10 mg. I-10 mg Bti ilinganiswe ebaleni kusetyenziswa isikali se-elektroniki. Sebenzisa i-spatula, lungisa i-slurry ngokuxuba eli nani le-Bti kwibhakethi ephuhliswe nge-10 L. Eli dosi likhethwe emva kovavanyo lwasendle lokusebenza kwe-Bti ngokuchasene ne-instars ezahlukeneyo ze-Anopheles spp. kunye ne-Culex spp. kwiimeko zendalo kwindawo eyahlukileyo, kodwa efana nendawo yophando lwanamhlanje [32]. Izinga lokusetyenziswa kwe-larvicide suspension kunye nobude bexesha lokusetyenziswa kwindawo nganye yokuzalela libalwe ngokusekelwe kumthamo wamanzi oqikelelweyo kwindawo yokuzalela [33]. Faka i-Bti usebenzisa i-scatter yesandla elinganisiweyo. Ii-Nebulizers ziyalinganiswa kwaye zivavanywa ngexesha lokuzilolonga komntu ngamnye nakwiindawo ezahlukeneyo ukuqinisekisa ukuba inani elifanelekileyo le-Bti liyaziswa.
Ukuze kufunyanwe ixesha elifanelekileyo lokunyanga iindawo zokuzalela ii-larva, iqela lichonge ukutshiza ngefestile. Ifestile yokutshiza lixesha apho imveliso isetyenziswa khona ukuze kufezekiswe ukusebenza kakuhle: kolu phononongo, ifestile yokutshiza yayiqala kwiiyure ezili-12 ukuya kwiiveki ezi-2, kuxhomekeke ekubeni i-Bti ihlala ixesha elingakanani na. Kubonakala ngathi, ukufunxwa kwe-Bti yi-larva kwindawo yokuzalela kufuna ixesha eliqala ngentsimbi yesi-7:00 ukuya kweyesi-18:00. Ngale ndlela, amaxesha emvula enkulu anokuthintelwa xa imvula ithetha ukuyeka ukutshiza nokuqalisa kwakhona ngosuku olulandelayo ukuba imozulu iyasebenzisana. Imihla yokutshiza kunye nemihla echanekileyo kunye namaxesha axhomekeke kwiimeko zemozulu ezibonwayo. Ukulinganisa izitshizi zebhegi ukuze zilungele izinga lokufaka i-Bti elifunekayo, ingcali nganye iqeqeshwe ukujonga ngamehlo nokuseta umlomo wokutshiza kunye nokugcina uxinzelelo. Ukulinganisa kugqitywa ngokuqinisekisa ukuba unyango oluchanekileyo lwe-Bti lusetyenziswa ngokulinganayo kwindawo nganye. Phatha indawo yokuhlala yee-larva rhoqo kwiiveki ezimbini. Imisebenzi yokubulala ii-larva yenziwa ngenkxaso yeengcali ezine ezinamava neziqeqeshwe kakuhle. Imisebenzi yokubulala ii-larva kunye nabathathi-nxaxheba bajongwa ngabaphathi abanamava. Unyango lokubulala iintsholongwane luqale ngoMatshi 2019 ngexesha lonyaka owomileyo. Enyanisweni, uphando lwangaphambili lubonise ukuba ixesha lonyaka owomileyo lelona xesha lifanelekileyo lokungenelela kokubulala iintsholongwane ngenxa yokuzinza kweendawo zokuzalela kunye nokuncipha kobuninzi bazo [27]. Ukulawula iintsholongwane ngexesha lonyaka owomileyo kulindeleke ukuba kuthintele ukutsala kweengcongconi ngexesha lonyaka wemvula. Iikhilogram ezimbini (02) ze-Bti ezibiza i-US$99.29 zivumela iqela lophando elifumana unyango ukuba ligubungele zonke iindawo. Kwiqela le-LLIN+Bti, ukungenelela kokubulala iintsholongwane kuthathe unyaka wonke, ukususela ngoMatshi 2019 ukuya kuFebruwari 2020. Amatyala angama-22 ewonke onyango lokubulala iintsholongwane enzeka kwiqela le-LLIN+Bti.
Iziphumo ebezingalindelekanga (ezifana nokurhawuzelelwa, isiyezi okanye impumlo egobhozayo) zijongiwe ngophando lomntu ngamnye lwe-Bti biolarvicide nebulizers kunye nabahlali basekhaya abathatha inxaxheba kwiqela le-LIN + Bti.
Uphando lwemizi lwenziwe phakathi kwemizi engama-400 (imizi engama-200 kwiqela ngalinye lophando) ukuze kuqikelelwe ipesenti yokusetyenziswa kwe-LLIN phakathi kwabemi. Xa kuphandwa imizi, kusetyenziswa indlela yemibuzo yobungakanani. Ukuxhaphaka kokusetyenziswa kwe-LLIN kwahlulwe ngokwamaqela amathathu eminyaka: iminyaka eli-15. Iphepha lemibuzo lagqitywa laza lachazwa ngolwimi lwesiSenoufo lwengingqi kwintloko yekhaya okanye komnye umntu omdala oneminyaka engaphezu kwe-18 ubudala.
Ubungakanani obuncinci bosapho oluphandwe lubalwe kusetyenziswa ifomula echazwe nguVaughan noMorrow [34].
u-n bungakanani besampulu, u-e ngumda wempazamo, u-t luluphawu lokhuseleko oluvela kwinqanaba lokuzithemba, kwaye u-p lulumlinganiselo wabazali boluntu abanophawu olunikiweyo. Into nganye yeqhezu inexabiso elifanayo, ngoko ke (t) = 1.96; Ubungakanani obuncinci bendlu kule meko kuphando yayiyimizi engama-384.
Ngaphambi kovavanyo lwangoku, iintlobo ezahlukeneyo zeendawo zokuhlala ze-Anopheles larvae kumaqela e-LLIN+Bti kunye ne-LLIN zachongwa, zathathwa iisampulu, zachazwa, zajongwa ngokwendawo kwaye zaphawulwa. Sebenzisa iteyipu yokulinganisa ubungakanani bekoloni yokuzalela. Ubuninzi be-mosquito larval bavavanywa inyanga nenyanga kangangeenyanga ezili-12 kwiindawo ezingama-30 zokuzalela ezikhethwe ngokungacwangciswanga kwilali nganye, kwiindawo ezingama-60 zokuzalela kwiqela ngalinye lophando. Kwakukho iisampulu ze-larval ezili-12 kwindawo nganye yophando, ezihambelana nonyango lwe-Bti ezingama-22. Injongo yokukhetha ezi ndawo zingama-30 zokuzalela kwilali nganye yayikukubamba inani elaneleyo leendawo zokuqokelelwa kwe-larvae kuzo zonke iilali kunye neeyunithi zophando ukunciphisa ukuthambekela. Ii-larvae zaqokelelwa ngokudipha ngecephe le-60 ml [35]. Ngenxa yokuba ezinye iindawo zokugcina izityalo zincinci kakhulu kwaye azinzulu, kuyimfuneko ukusebenzisa ibhakethi encinci ngaphandle kwebhakethi eqhelekileyo ye-WHO (350 ml). I-dive epheleleyo ye-5, 10 okanye 20 yenziwe kwiindawo zokuzalela ezinomjikelezo we-10 m, ngokulandelanayo. Ukuchonga ngokwemo yeempungutye eziqokelelweyo (umz. iAnopheles, iCulex kunye neAedes) kwenziwe ngqo ebaleni [36]. Iimpungutye eziqokelelweyo zahlulwe zibe ngamacandelo amabini ngokusekelwe kwinqanaba lokukhula: iimpungutye zasekuqaleni (inqanaba loku-1 nelesi-2) kunye neempungutye zasekupheleni (inqanaba lesi-3 nelesi-4) [37]. Iimpungutye zabalwa ngokweendidi kwaye kwinqanaba ngalinye lokukhula. Emva kokubalwa, iimpungutye zengcongconi zibuyiselwa kwiindawo zazo zokuzalela kwaye zizaliswe kumthamo wazo wokuqala ngamanzi avelayo ancediswa ngamanzi emvula.
Indawo yokuzalela yayithathwa njengelungileyo ukuba ubuncinci kukho i-larva okanye i-pupa enye yeentlobo zeengcongconi. Ubuninzi bee-larval buchongwa ngokwahlula inani lee-larva zohlobo olufanayo ngenani lee-dive.
Uphononongo ngalunye luthathe iintsuku ezimbini zilandelelana, kwaye qho emva kweenyanga ezimbini, iingcongconi ezindala zaziqokelelwa kwimizi eli-10 ekhethwe ngokungacwangciswanga kwilali nganye. Kuyo yonke le sifundo, iqela ngalinye lophando lenze uphando lweesampulu zemizi engama-20 kwiintsuku ezintathu ezilandelelana. Iingcongconi zabanjwa kusetyenziswa iingcongconi eziqhelekileyo (WT) kunye neingcongconi ze-pyrethrum spray (PSC) [38, 39]. Ekuqaleni, zonke izindlu kwilali nganye zazibalwa. Izindlu ezine kwilali nganye zakhethwa ngokungacwangciswanga njengeendawo zokuqokelela iingcongconi ezindala. Kwindlu nganye ekhethwe ngokungacwangciswanga, iingcongconi zaqokelelwa kwigumbi lokulala eliphambili. Amagumbi okulala akhethiweyo aneengcango kunye neefestile kwaye ahlalwa ngobusuku bangaphambili. Amagumbi okulala ahlala evaliwe ngaphambi kokuba kuqalwe umsebenzi nangexesha lokuqokelelwa kweengcongconi ukuthintela iingcongconi ukuba zingaphumi kwigumbi. I-WT yafakwa kwifestile nganye yegumbi lokulala ngalinye njengendawo yokuvavanya iingcongconi. Ngosuku olulandelayo, iingcongconi ezazingena kwindawo yokusebenza zivela kumagumbi okulala zaqokelelwa phakathi kwentsimbi yesi-06:00 neyesi-08:00 kusasa. Qokelela iingcongconi kwindawo yakho yokusebenza usebenzisa umlomo kwaye uzigcine kwikomityi yephepha elahlwayo egqunywe yinxalenye eluhlaza. Inethi yeengcongconi. Iingcongconi ezilele kwigumbi lokulala elinye zibanjwe kwangoko emva kokuqokelelwa kwe-WT kusetyenziswa i-PSC esekelwe kwi-pyrethroid. Emva kokusasaza amashiti amhlophe kumgangatho wegumbi lokulala, vala iingcango neefestile uze utshize i-insecticide (izithako ezisebenzayo: 0.25% transfluthrin + 0.20% permethrin). Malunga nemizuzu eli-10 ukuya kweli-15 emva kokutshiza, susa i-bedspread kwigumbi lokulala elinyangiweyo, sebenzisa ii-tweezers ukucola naziphi na iingcongconi ezifike kumashiti amhlophe, kwaye uzigcine kwisitya sePetri esizaliswe yi-cotton wool emanzi. Inani labantu abachithe ubusuku kumagumbi okulala akhethiweyo nalo lirekhodwe. Iingcongconi eziqokelelweyo zidluliselwa ngokukhawuleza kwilebhu ekwindawo ukuze ziqhubeke nokusetyenzwa.
Kwilabhoratri, zonke iingcongconi eziqokelelweyo zachongwa ngokwesimo seentsholongwane kunye nohlobo [36]. Ii-ovari zika-Anna. gambiae SL kusetyenziswa i-binocular dissecting microscope kunye nethontsi lamanzi acociweyo abekwe kwislayidi yeglasi [35]. Isimo sokulingana savavanywa ukuze kwahlulwe abafazi abanezibeleko ezininzi kubasetyhini abanezibeleko ezingapheliyo ngokusekelwe kwisimo se-ovari kunye ne-tracheal, kunye nokumisela izinga lokuzala kunye nobudala be-physiological [35].
Isalathisi esihambelanayo simiselwa ngokuvavanya umthombo wokutya kwegazi okuqokelelweyo. gambiae nge-enzyme-linked immunosorbent assay (ELISA) kusetyenziswa igazi elivela ebantwini, kwimfuyo (iinkomo, iigusha, iibhokhwe) kunye neenkukhu ezihlala kuzo [40]. Usulelo lwe-Entomological (EIR) lubalwe kusetyenziswa i-An. Uqikelelo lwabasetyhini abane-SL eGambia [41] Ukongeza, i-An. Usulelo lwePlasmodium gambiae lumiselwe ngokuhlalutya intloko nesifuba sabasetyhini abanezibeleko ezininzi kusetyenziswa indlela ye-circumsporozoite antigen ELISA (CSP ELISA) [40]. Okokugqibela, kukho amalungu e-Ann. gambiae achongiwe ngokuhlalutya imilenze yayo, amaphiko kunye nesisu kusetyenziswa iindlela ze-polymerase chain reaction (PCR) [34].
Idatha yeklinikhi malunga nemalariya ifunyenwe kwirejista yokubonisana kweklinikhi yeZiko lezeMpilo laseNapyeledugou, eligubungela zonke iilali ezine ezibandakanyiweyo kolu phononongo (oko kukuthi iKakologo, iKolekaha, iLofinekaha kunye neNambatiurkaha). Uphononongo lwerejista lugxile kwiirekhodi ukusuka ngoMatshi 2018 ukuya kuFebruwari 2019 kwaye ukusukela ngoMatshi 2019 ukuya kuFebruwari 2020. Idatha yeklinikhi ukusuka ngoMatshi 2018 ukuya kuFebruwari 2019 imele idatha yesiseko okanye yokungenelela kwe-Bti, ngelixa idatha yeklinikhi ukusuka ngoMatshi 2019 ukuya kuFebruwari 2020 imele idatha yokungenelela kwe-Bti. Idatha emva kokungenelela kwe-Bti. Ulwazi lweklinikhi, ubudala kunye nelali yesigulana ngasinye kumaqela ophando lwe-LLIN+Bti kunye ne-LLIN ziqokelelwe kwirejista yezempilo. Kwisigulana ngasinye, ulwazi olufana nemvelaphi yelali, ubudala, ukuxilongwa, kunye nezifo zirekhodwe. Kwiimeko eziphononongiweyo kolu phononongo, imalariya iqinisekiswe ngovavanyo lokuxilonga olukhawulezileyo (RDT) kunye/okanye nge-microscopy yemalariya emva kokunikwa unyango oludibeneyo olusekelwe kwi-artemisinin (ACT) ngumniki-nkonzo wezempilo. Amatyala emalariya ahlulwe ngokwamaqela amathathu eminyaka (oko kukuthi, iminyaka eli-15). Ukuxhaphaka kwemalariya ngonyaka kubantu abali-1000 kuqikelelwe ngokwahlula ukuxhaphaka kwemalariya kubantu abali-1000 ngokwabemi belali.
Idatha eqokelelweyo kolu phononongo ifakwe kabini kwisiseko sedatha seMicrosoft Excel yaze yangeniswa kwisoftware evulekileyo i-R [42] inguqulelo 3.6.3 ukuze kuhlalutywe izibalo. Iphakheji ye-ggplot2 isetyenziselwa ukuzoba iiploti. Iimodeli ezicwangcisiweyo ezisebenzisa i-Poisson regression zisetyenzisiwe ukuthelekisa uxinano lwe-larval kunye nenani eliphakathi lokulunywa yiingcongconi ngomntu ngamnye ngobusuku phakathi kwamaqela ophando. Ukulinganiswa komlinganiselo wokubaluleka (RR) kusetyenzisiwe ukuthelekisa uxinano lwe-larval oluphakathi kunye namazinga okuluma kwe-Culex kunye ne-Anopheles mosquitoes. I-Gambia SL ibekwe phakathi kwamaqela ophando amabini kusetyenziswa iqela le-LLIN + Bti njengesiseko. Ubungakanani beziphumo bubonakaliswe njengemilinganiselo yokungabikho kunye ne-95% yezithuba zokuzithemba (95% CI). Umlinganiselo (RR) wovavanyo lwePoisson usetyenzisiwe ukuthelekisa umlinganiselo kunye namazinga okuvela kwe-malaria ngaphambi nasemva kokungenelela kwe-Bti kwiqela ngalinye lophando. Inqanaba lokubaluleka elisetyenzisiweyo yayiyi-5%.
Le nkqubo yophando yamkelwe yiKomiti yeSizwe yoPhando lwezeMithetho yoMphathiswa wezeMpilo kunye neMpilo yoLuntu yaseCôte d'Ivoire (Akukho nombolo: 001//MSHP/CNESVS-kp), kunye nesithili sezempilo sengingqi kunye nolawulo lwaseKorhogo. Ngaphambi kokuba kuqokelelwe iimbungu zeengcongconi kunye nabantu abadala, kwafunyanwa imvume enolwazi kubathathi-nxaxheba kuphando lwasekhaya, abanini, kunye/okanye abantu abahlala apho. Idatha yosapho kunye neyeklinikhi ayichazwanga kwaye iyimfihlo kwaye ifumaneka kuphela kubaphandi abakhethiweyo.
Zizonke iindawo zokuzalela eziyi-1198 ezityelelweyo. Kwezi ndawo zokuzalela eziphandwe kwindawo yophando, ama-52.5% (n = 629) ayengamaqela e-LLIN + Bti kwaye ama-47.5% (n = 569) ayengamaqela e-LLIN kuphela (RR = 1.10 [95% CI 0 .98–1.24], P = 0.088). Ngokubanzi, iindawo zokuhlala zee-larval zasekuhlaleni zahlulwe zaba ziintlobo ezili-12, phakathi kwazo uninzi lweendawo zokuhlala zee-larval yayingamasimi erayisi (24.5%, n=294), kulandele ukutsalwa kwamanzi ngesiphepho (21.0%, n=252) kunye neembiza (8.3). %, n = 99), unxweme lomlambo (8.2%, n = 100), ichibi (7.2%, n = 86), ichibi (7.0%, n = 84), ipompo yamanzi yelali (6.8 %, n = 81), iiprinti zeempuphu (4.8%, n = 58), amadama (4.0%, n = 48), iimbiza (5.2%, n = 62), amachibi (1.9%, n = 23) kunye nemithombo (0.9%, n = 11). ) .
Lilonke, kuqokelelwe imibungu yeengcongconi engama-47,274 kwindawo efundwayo, kunye nenani eliyi-14.4% (n = 6,796) kwiqela le-LLIN + Bti xa kuthelekiswa ne-85.6% (n = 40,478) kwiqela le-LLIN lodwa ((RR = 5.96) [95% CI 5.80–6.11], P ≤ 0.001). Le mibungu ineentlobo ezintathu zeengcongconi, uhlobo oluphambili yi-Anopheles. (48.7%, n = 23,041), ilandelwa yi-Culex spp. (35.0%, n = 16,562) kunye ne-Aedes spp. (4.9%, n = 2340). Iipupae zaziyi-11.3% yeempukane ezingavuthwanga (n = 5344).
Umyinge woxinano lwe-Anopheles spp. larvae. Kolu phononongo, inani le-larvae nge-scoop nganye yayiyi-0.61 [95% CI 0.41–0.81] L/dip kwiqela le-LLIN + Bti kunye ne-3.97 [95% CI 3.56–4.38] L /dive kwiqela le-LLIN kuphela (ukhetho). ifayile 1: Umfanekiso S1). Umyinge woxinano lwe-Anopheles spp. Iqela le-LLIN lodwa laliphezulu ngokuphindwe ka-6.5 kuneqela le-LLIN + Bti (HR = 6.49; 95% CI 5.80–7.27; P < 0.001). Akukho zinambuzane ze-Anopheles ezifunyenweyo ngexesha lonyango. Ii-larvae ziqokelelwe kwiqela le-LLIN + Bti ukususela ngoJanuwari, okuhambelana nonyango lwe-Bti lwamashumi amabini. Kwiqela le-LLIN + Bti, bekukho ukwehla okukhulu koxinano lwe-larval lwasekuqaleni nolwasekupheleni kwesigaba.
Ngaphambi kokuba kuqalwe unyango lwe-Bti (ngoMatshi), ubuninzi be-Anopheles instar yokuqala buqikelelwe ukuba yi-1.28 [95% CI 0.22–2.35] L/dive kwiqela le-LLIN + Bti kunye ne-1.37 [95% CI 0.36–2.36] l/dive kwiqela le-LLIN + Bti. l/dip. /dip kuphela ingalo ye-LLIN (Umzobo 2A). Emva kokusetyenziswa konyango lwe-Bti, ubuninzi be-Anopheles instar yokuqala kwiqela le-LLIN + Bti ngokubanzi behla kancinci ukusuka kwi-0.90 [95% CI 0.19–1.61] ukuya kwi-0.10 [95% CI – 0.03–0.18] l/dip. Ubuninzi be-Anopheles larval yokuqala buhlale buphantsi kwiqela le-LLIN + Bti. Kwiqela le-LLIN kuphela, ukuguquguquka kobuninzi be-Anopheles spp. Iimbungu zakuqala ezikwinqanaba lokuqala zibonwe ngobuninzi obuphakathi ukusuka kwi-0.23 [95% CI 0.07–0.54] L/dive ukuya kwi-2.37 [95% CI 1.77–2.98] L/dive. Ngokubanzi, ubuninzi obuphakathi beembungu zakuqala ze-Anopheles kwiqela le-LLIN kuphela buphezulu ngokwezibalo kwi-1.90 [95% CI 1.70–2.10] L/dive, ngelixa ubuninzi obuphakathi beembungu zakuqala ze-Anopheles kwiqela le-LLIN babuyi-0.38 [95% CI 0.28–0.47]) l/dip. + Bti group (RR = 5.04; 95% CI 4.36–5.85; P < 0.001).
Utshintsho kubuninzi obuqhelekileyo bee-Anopheles larvae. Iinethi zomngundo zasekuqaleni (A) kunye nezasemva kwexesha (B) kwiqela lophando ukususela ngoMatshi 2019 ukuya kuFebruwari 2020 kummandla waseNapier, emantla eCôte d'Ivoire. LLIN: inethi yokubulala izinambuzane ehlala ixesha elide Bti: Bacillus thuringiensis, Israel TRT: unyango;
Uxinaniso oluphakathi lwe-Anopheles spp. larvae. ubudala bayo basemva kwiqela le-LLIN + Bti. Uxinaniso lwe-Bti ngaphambi konyango yayiyi-2.98 [95% CI 0.26–5.60] L/dip, ngelixa uxinaniso kwiqela le-LLIN lodwa yayiyi-1.46 [95% CI 0.26–2.65] l/ngosuku Emva kokusetyenziswa kwe-Bti, uxinaniso lwe-Anopheles larvae ezisandula ukuzalwa kwiqela le-LLIN + Bti lwehle ukusuka kwi-0.22 [95% CI 0.04–0.40] ukuya kwi-0.03 [95% CI 0.00–0.06] L/dip (Umzobo 2B). Kwiqela le-LLIN kuphela, uxinano lwee-Anopheles late larvae lunyuke ukusuka kwi-0.35 [95% CI - 0.15-0.76] ukuya kwi-2.77 [95% CI 1.13-4.40] l/dive kunye notshintsho oluthile kuxinano lwee-larval ngokuxhomekeke kumhla wokuthatha isampuli. Uxinano oluphakathi lwee-Anopheles larvae zamva nje kwiqela le-LLIN kuphela yayiyi-2.07 [95% CI 1.84–2.29] L/dive, iphindwe kasithoba kune-0.23 [95% CI 0.11–0. 36] l/immersion kwi-LLIN. + Iqela le-Bti (RR = 8.80; 95% CI 7.40–10.57; P < 0.001).
Amaxabiso aphakathi e-Culex spp. yayiyi-0.33 [95% CI 0.21–0.45] L/dip kwiqela le-LLIN + Bti kunye ne-2.67 [95% CI 2.23–3.10] L/dip kwiqela le-LLIN kuphela (ifayile eyongezelelweyo 2: Umfanekiso S2). Ubuninzi be-Culex spp. Iqela le-LLIN lodwa laliphezulu kakhulu kuneqela le-LLIN + Bti (HR = 8.00; 95% CI 6.90–9.34; P < 0.001).
Uxinano oluphakathi lwe-genus Culex Culex spp. Ngaphambi konyango, i-Bti l/dip yayiyi-1.26 [95% CI 0.10–2.42] l/dip kwiqela le-LLIN + Bti kunye ne-1.28 [95% CI 0.37–2.36] kwiqela le-LLIN kuphela (Umzobo 3A). Emva kokusetyenziswa konyango lwe-Bti, uxinano lwee-larvae zakuqala ze-Culex lwehla ukusuka kwi-0.07 [95% CI - 0.001–0.] ukuya kwi-0.25 [95% CI 0.006–0.51] L/dip. Akukho zi-larvae ze-Culex eziqokelelwe kwiindawo zokuhlala zee-larvae ezinyangwe nge-Bti ukususela ngoDisemba. Ubuninzi beempungutye zaseCulex zakuqala buncitshiswe ukuya kwi-0.21 [95% CI 0.14–0.28] L/dip kwiqela le-LLIN + Bti, kodwa bebuphezulu kwiqela le-LLIN kuphela kwi-1.30 [95% CI 1.10– 1.50] l/immersion. drop/d. Ubuninzi beempungutye zaseCulex zakuqala kwiqela le-LLIN zodwa bebuphezulu ngokuphindwe kathandathu kuneqela le-LLIN + Bti (RR = 6.17; 95% CI 5.11–7.52; P < 0.001).
Utshintsho kubuninzi obuphakathi beCulex spp. larvae. Uvavanyo lobomi bokuqala (A) kunye nobomi bokuqala (B) kwiqela lophando ukususela ngoMatshi 2019 ukuya kuFebruwari 2020 kummandla waseNapier, emantla eCôte d'Ivoire. Inethi yokubulala izinambuzane ehlala ixesha elide i-LLIN, i-Bti Bacillus thuringiensis Israel, unyango lwe-Trt
Ngaphambi konyango lwe-Bti, uxinano oluphakathi lwee-larvae ze-instar Culex ezisandula ukuzalwa kwiqela le-LLIN + Bti kunye neqela le-LLIN lwaluyi-0.97 [95% CI 0.09–1.85] kunye ne-1.60 [95% CI – 0.16–3.37] l/immersion ngokufanelekileyo (Umzobo 3B) ). Uxinano oluphakathi lwee-larvae ze-Culex ezisandula ukuzalwa emva kokuqaliswa konyango lwe-Bti. Uxinano oluphakathi kwiqela le-LLIN + Bti lwehla kancinci kancinci kwaye lwalungaphantsi kunolo olukwiqela le-LLIN kuphela, oluhlala luphezulu kakhulu. Uxinano oluphakathi lwee-larvae ze-instar Culex ezisandula ukuzalwa lwaluyi-0.12 [95% CI 0.07–0.15] L/i-dive kwiqela le-LLIN + Bti kunye ne-1.36 [95% CI 1.11–1.61] L/i-dive kwiqela le-LLIN kuphela. Ubuninzi be-avareji ye-Culex larvae yasekupheleni yayiphezulu kakhulu kwiqela le-LLIN kuphela kunakwiqela le-LLIN + Bti (RR = 11.19; 95% CI 8.83–14.43; P < 0.001).
Ngaphambi konyango lwe-Bti, ubuninzi be-pupae nge-ladybug nganye yayiyi-0.59 [95% CI 0.24–0.94] kwiqela le-LLIN + Bti kunye ne-0.38 [95% CI 0.13–0.63] kwi-LLIN kuphela (Umzobo 4). Ubuninzi be-pupal density yayiyi-0.10 [95% CI 0.06–0.14] kwiqela le-LLIN + Bti kunye ne-0.84 [95% CI 0.75–0.92] kwiqela le-LLIN kuphela. Unyango lwe-Bti luye lwanciphisa kakhulu ubuninzi be-pupal kwiqela le-LLIN + Bti xa kuthelekiswa neqela le-LLIN kuphela (OR = 8.30; 95% CI 6.37–11.02; P < 0.001). Kwiqela le-LLIN + Bti, akukho pupae eqokelelweyo emva kukaNovemba.
Utshintsho kubuninzi beenkumbi. Olu phononongo lwenziwe ukususela ngoMatshi 2019 ukuya kuFebruwari 2020 kummandla waseNapier kumantla eCôte d'Ivoire. Inethi yokubulala izinambuzane ehlala ixesha elide i-LLIN, i-Bti Bacillus thuringiensis Israel, unyango lwe-Trt
Iingcongconi ezindala ezingama-3456 ziqokelelwe kwindawo efundwayo. Iingcongconi ziphakathi kweentlobo ezili-17 zeentlobo ezi-5 (ii-Anopheles, iiCulex, ii-Aedes, ii-Eretmapodites) (Itheyibhile 1). Kwi-malaria vectors i-An. gambiae sl yayiyeyona ntlobo ininzi kakhulu ene-74.9% (n = 2587), ilandelwa yi-An. gambiae sl. funestus (2.5%, n = 86) kunye ne-An null (0.7%, n = 24). Ubutyebi buka-Anna. gambiae sl kwiqela le-LLIN + Bti (10.9%, n = 375) babuphantsi kunakwiqela le-LLIN lodwa (64%, n = 2212). Akukho xolo. Iingcongconi zabantu ngabanye zahlanganiswa ne-LLIN kuphela. Nangona kunjalo, i-An. gambiae kunye ne-An. funestus zazikho kwiqela le-LLIN + Bti kunye neqela le-LLIN lodwa.
Kwiimvavanyo eziqale ngaphambi kokusetyenziswa kwe-Bti kwindawo yokuzalela (iinyanga ezi-3), inani eliqhelekileyo leengcongconi zasebusuku ngomntu ngamnye (b/p/n) kwiqela le-LLIN + Bti liqikelelwe ukuba liyi-0.83 [95% CI 0.50–1.17], ngelixa kwiqela le-LLIN + Bti yayiyi-0.72 kwiqela le-LLIN kuphela [95% CI 0.41–1.02] (Umzobo 5). Kwiqela le-LLIN + Bti, umonakalo weengcongconi zeCulex wehla waza wahlala uphantsi nangona incopho ye-1.95 [95% CI 1.35–2.54] bpp ngoSeptemba emva kokusetyenziswa kwe-12 ye-Bti. Nangona kunjalo, kwiqela le-LLIN kuphela, incopho yokulunywa yiingcongconi yanda kancinci kancinci ngaphambi kokuba incopho yenzeke ngoSeptemba kwi-11.33 [95% CI 7.15–15.50] bp/n. Iziganeko zokulunywa ziingcongconi beziphantsi kakhulu kwiqela le-LLIN + Bti xa kuthelekiswa neqela le-LLIN lodwa nangaliphi na ixesha ngexesha lophando (HR = 3.66; 95% CI 3.01–4.49; P < 0.001).
Amanani okuluma kwezilwanyana zeengcongconi kwindawo yophando lwengingqi yaseNapier kumantla eCôte d'Ivoire ukususela ngoMatshi 2019 ukuya kuFebruwari 2020 LLIN Inethi yokubulala izinambuzane ehlala ixesha elide, iBti Bacillus thuringiensis Israel, Unyango lweTrt, ukulunywa b/p/night/human/night
I-Anopheles gambiae yeyona vector yemalariya ixhaphakileyo kwindawo yophando. Isantya sokuluma se-An. Ekuqaleni, abafazi baseGambia babenexabiso le-b/p/n eliyi-0.64 [95% CI 0.27–1.00] kwiqela le-LLIN + Bti kunye ne-0.74 [95% CI 0.30–1.17] kwiqela le-LLIN kuphela (Umzobo 6). Ngexesha lokungenelela kwe-Bti, umsebenzi ophezulu wokuluma wabonwa ngoSeptemba, ohambelana nekhosi yeshumi elinesibini yonyango lwe-Bti, kunye nencopho ye-1.46 [95% CI 0.87–2.05] b/p/n kwiqela le-LLIN + Bti kunye nencopho ye-9 .65 [95% CI 0.87–2.05] w/n 5.23–14.07] iqela le-LLIN kuphela. Isantya sokuluma sisonke se-An. Izinga lokosuleleka eGambia laliphantsi kakhulu kwiqela le-LLIN + Bti (0.59 [95% CI 0.43–0.75] b/p/n) kunakwiqela le-LLIN lodwa (2.97 [95% CI 2, 02–3.93] b/p/no). (RR = 3.66; 95% CI 3.01–4.49; P < 0.001).
Isantya sokuluma sika-Anna. gambiae sl, iyunithi yophando kummandla waseNapier, emantla eCote d'Ivoire, ukususela ngoMatshi 2019 ukuya kuFebruwari 2020 Inethi yokulala ehlala ixesha elide ephathwa ngezibulala-zinambuzane ye-LLIN, i-Bti Bacillus thuringiensis Israel, Unyango lwe-Trt, ukulunywa b/p/night/ umntu/night
I-amps ezingama-646 iyonke. IGambia inqunyulwe amalungu. Lilonke, ipesenti yokhuseleko lwasekuhlaleni. Amazinga okulingana eGambia ngokubanzi ayengaphezulu kwama-70% kulo lonke ixesha lophando, ngaphandle kukaJulayi, xa kwakusetyenziswa iqela le-LLIN kuphela (Ifayile eyongezelelweyo 3: Umfanekiso S3). Nangona kunjalo, izinga lokuzala eliqhelekileyo kwindawo yophando yayiyi-74.5% (n = 481). Kwiqela le-LLIN+Bti, izinga lokulingana lahlala likwinqanaba eliphezulu, ngaphezulu kwama-80%, ngaphandle kukaSeptemba, xa izinga lokulingana lehla laya kuma-77.5%. Nangona kunjalo, umahluko kumazinga okuzala aphakathi wabonwa kwiqela le-LLIN kuphela, kunye nezinga lokuzala eliphantsi eliqikelelweyo liyi-64.5%.
Ukusuka kwi-389 Ann. Uphononongo lweeyunithi zegazi zomntu ngamnye ezivela eGambia lufumanise ukuba ama-80.5% (n = 313) ayevela ebantwini, ama-6.2% (n = 24) abafazi batya igazi elixutyiweyo (lomntu nelasekhaya) kunye nama-5.1% (n = 20) batya igazi. Ukutya okuvela kwimfuyo (iinkomo, iigusha neebhokhwe) kunye nama-8.2% (n = 32) eesampuli ezihlalutyiweyo zazinegative kwisidlo segazi. Kwiqela le-LLIN + Bti, inani labasetyhini abafumana igazi lomntu yayiyi-25.7% (n = 100) xa kuthelekiswa nama-54.8% (n = 213) kwiqela le-LLIN kuphela (Ifayile eyongezelelweyo 5: Itheyibhile S5).
Ii-amps ezingama-308 zizonke. I-P. gambiae ivavanyiwe ukuze kufunyanwe amalungu e-species complex kunye nosulelo lwe-P. falciparum (Ifayile eyongezelelweyo 4: Itheyibhile S4). "Iintlobo ezimbini ezinxulumeneyo" ziyafana kwindawo yophando, ezizezi i-An. gambiae ss (95.1%, n = 293) kunye ne-An. coluzzii (4.9%, n = 15). Ii-Anopheles gambiae ss zaziphantsi kakhulu kwiqela le-LLIN + Bti kunakwiqela le-LLIN lodwa (66.2%, n = 204) (RR = 2.29 [95% CI 1.78–2.97], P < 0.001). Inxalenye efanayo yeengcongconi ze-Anopheles ifunyenwe kwiqela le-LLIN + Bti (3.6%, n = 11) kunye neqela le-LLIN kuphela (1.3%, n = 4) (RR = 2.75 [95% CI 0.81–11 .84], P = .118). Ukuxhaphaka kosulelo lwePlasmodium falciparum phakathi kwe-An. SL eGambia yayiyi-11.4% (n = 35). Amazinga okosulela kwePlasmodium falciparum. Izinga lokosulela eGambia laliphantsi kakhulu kwiqela le-LLIN + Bti (2.9%, n = 9) kunakwiqela le-LLIN kuphela (8.4%, n = 26) (RR = 2.89 [95% CI 1. 31–7.01], P = 0.006). ). Xa kuthelekiswa neengcongconi zeAnopheles, iingcongconi zeAnopheles gambiae zazinenani eliphezulu losulelo lwePlasmodium kwi-94.3% (n=32). I-coluzzii yi-5.7% kuphela (n = 5) (RR = 6.4 [95% CI 2.47–21.04], P < 0.001).
Kuye kwahlolwa abantu abayi-2,435 abavela kwimizi engama-400. Umyinge woxinano ngabantu abayi-6.1 kwimizi nganye. Izinga lobunini be-LLIN phakathi kwemizi yayiyi-85% (n = 340), xa kuthelekiswa ne-15% (n = 60) kwimizi engenayo i-LLIN (RR = 5.67 [95% CI 4.29–7.59], P < 0.001) (Ifayile eyongezelelweyo 5: Itheyibhile S5). . Ukusetyenziswa kwe-LLIN yayiyi-40.7% (n = 990) kwiqela le-LLIN + Bti xa kuthelekiswa ne-36.2% (n = 882) kwiqela le-LLIN lodwa (RR = 1.12 [95% CI 1.02–1.23], P = 0.013). Izinga eliqhelekileyo lokusetyenziswa kwe-net kwindawo yophando yayiyi-38.4% (n = 1842). Inani labantwana abangaphantsi kweminyaka emihlanu ubudala abasebenzisa i-intanethi lalifana kuwo omabini amaqela ophando, kunye namazinga okusetyenziswa apheleleyo angama-41.2% (n = 195) kwiqela le-LLIN + Bti kunye nama-43.2% (n = 186) kwiqela le-LLIN kuphela. (HR = 1.05 [95% CI 0.85–1.29], P = 0.682). Phakathi kwabantwana abaneminyaka emi-5 ukuya kweli-15, bekungekho mahluko kumazinga okusetyenziswa apheleleyo phakathi kwama-36.3% (n = 250) kwiqela le-LLIN + Bti kunye nama-36.9% (n = 250) kwiqela le-LLIN kuphela (RR = 1. 02 [95% CI 1.02–1.23], P = 0.894). Nangona kunjalo, abo baneminyaka engaphezulu kwe-15 ubudala basebenzise iminatha yebhedi ngama-42.7% (n = 554) ngaphantsi rhoqo kwiqela le-LLIN + Bti kune-33.4% (n = 439) kwiqela le-LLIN kuphela (RR = 1.26 [95% CI 1.11–1.43], P <0.001).
Iziganeko zeklinikhi ezingama-2,484 zirekhodwe kwiZiko lezeMpilo laseNapier phakathi koMatshi 2018 noFebruwari 2020. Ukuxhaphaka kwemalariya yeklinikhi kuluntu ngokubanzi yayiyi-82.0% yazo zonke iimeko zesifo seklinikhi (n = 2038). Amanani onyaka okuxhaphaka kwemalariya kule ndawo yophando ayeyi-479.8‰ kunye ne-297.5‰ ngaphambi nasemva konyango lwe-Bti (Itheyibhile 2).
Ixesha lokuthumela: Julayi-01-2024