Ukwehla kwamva nje komthwalo wemalariya eCôte d'Ivoire kubangelwa ikakhulu kukusetyenziswa kweminatha ebulala izinambuzane ehlala ixesha elide (LIN).Noko ke, le nkqubela isongelwa kukuxhathisa amayeza okubulala izinambuzane, utshintsho kwindlela yokuziphatha kwabantu baseAnopheles gambiae, nokudluliselwa kwemalariya okushiyekileyo, nto leyo ebangela ukuba kufuneke izixhobo ezongezelelekileyo.Ngoko ke, injongo yolu phononongo yayikukuvavanya ukuphumelela kokusetyenziswa okudibeneyo kwe-LLIN kunye ne-Bacillus thuringiensis (Bti) kwaye uyiqhathanise ne-LLIN.
Uphononongo lwenziwe ukusuka ngoMatshi ka-2019 ukuya kuFebruwari ka-2020 kwiingalo ezimbini zokufunda (i-LLN + Bti ingalo kunye nengalo ye-LLIN kuphela) kwingingqi yezempilo yaseKorhogo kumantla eCôte d'Ivoire.Kwiqela le-LLIN + Bti, iindawo zokuhlala ze-Anopheles zombungu zanyangwa nge-Bti rhoqo emva kweeveki ezimbini ukongeza kwi-LLN.Iingcongconi zeLarval kunye nabantu abadala zaqokelelwa kwaye zachongwa ngokwe-morphologically kwi-genus kunye neentlobo zisebenzisa iindlela eziqhelekileyo.Ilungu uAnn.I-complex yaseGambia yamiselwa ngokusebenzisa iteknoloji ye-polymerase chain reaction.Usulelo ngePlasmodium An.Isiganeko sesifo seengcongconi eGambia kunye nabemi bendawo nabo bavavanywa.
Lilonke, uAnopheles spp.Ubuninzi be-Larval buphantsi kwiqela le-LLN + Bti xa kuthelekiswa ne-LLN yodwa iqela 0.61 [95% CI 0.41-0.81] i-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 sisonke se-An.Isiganeko sokuluma kwe-S. gambiae ngu-0.59 [95% CI 0.43-0.75] ngomntu / ubusuku kwiqela le-LLN + Bti yedwa, xa kuthelekiswa ne-2.97 [95% CI 2.02-3.93] ukuluma ngomntu ngamnye / ubusuku kwiqela le-LLN kuphela (P <0.001).I-Anopheles gambiae sl ichongwa njengengcongconi i-Anopheles.U-Anopheles gambiae (ss) (95.1%; n = 293), elandelwa ngu-Anopheles gambiae (4.9%; n = 15).Isalathisi segazi lomntu kwindawo yokufunda sasiyi-80.5% (n = 389).I-EIR yeqela le-LLIN + Bti yayiyi-1.36 yokuluma umntu ngamnye ngonyaka (ib/p/y), kanti i-EIR ye-LLIN kuphela iqela yayiyi-47.71 ib/p/y.Isiganeko se-malaria sehla ngokukhawuleza ukusuka kwi-291.8‰ (n = 765) ukuya kwi-111.4‰ (n = 292) kwiqela le-LLN + Bti (P <0.001).
Ukudibanisa kwe-LLN kunye ne-Bti kunciphise kakhulu iziganeko ze-malaria.Indibaniselwano ye-LLIN kunye ne-Bti ingaba yindlela edibeneyo ethembisayo yokulawula okusebenzayo kwe-An.IGambia ayinaso isifo seengcongconi.
Ngaphandle kwenkqubela phambili kulawulo lwemalariya kule minyaka imbalwa idlulileyo, umthwalo wemalariya uhlala uyingxaki enkulu kwi-Afrika engezantsi kweSahara [1].Umbutho wezeMpilo weHlabathi (i-WHO) usanda kunika ingxelo yokuba kukho i-249 yezigidi zeemeko zesifo seengcongconi kunye nokuqikelelwa kwe-608,000 yokufa okunxulumene nesifo seengcongconi kwihlabathi ngo-2023 [2].Ummandla we-WHO wase-Afrika uthatha i-95% yeemeko ze-malaria zehlabathi kunye ne-96% yokufa kwe-malaria, kunye nabasetyhini abakhulelweyo kunye nabantwana abangaphantsi kweminyaka emi-5 ubudala abachaphazelekayo [2, 3].
Iminatha ehlala ixesha elide yokubulala izinambuzane (LLIN) kunye nokutshiza okushiyekileyo kwangaphakathi (IRS) kudlale indima ephambili ekunciphiseni umthwalo wemalariya e-Afrika [4].Ukwandiswa kwezi zixhobo zokulawula i-malaria kubangele ukunciphisa i-37% kwisiganeko se-malaria kunye nokunciphisa i-60% yokufa phakathi kwe-2000 kunye ne-2015 [5].Nangona kunjalo, iindlela ezibonwe ukusukela ngo-2015 ziye zema ngendlela eyothusayo okanye zakhawuleza, kunye nokufa kwesifo seengcongconi kuhlala kuphezulu ngendlela engamkelekanga, ngakumbi kwi-Afrika engezantsi kweSahara [3].Uphononongo oluninzi luchonge ukuvela kunye nokusasazeka koxhathiso phakathi kweyona ntsholongwane iphambili yesifo seengcongconi i-Anopheles kwizibulali-zinambuzane ezisetyenziswa kwimpilo yoluntu njengomqobo kwimpumelelo yexesha elizayo ye-LLN kunye ne-IRS [6,7,8].Ukongezelela, utshintsho kwi-vector biting behavior ngaphandle nangaphambili ebusuku luxanduva lokudluliselwa kwe-malaria eseleyo kwaye yinkxalabo ekhulayo [9, 10].Ukulinganiselwa kwe-LLN kunye ne-IRS ekulawuleni ii-vectors ezijongene nokudluliselwa kwe-residual yimda omkhulu wemigudu yangoku yokuphelisa i-malaria [11].Ukongeza, ukuzingisa kwemalariya kuchazwa ziimeko zemozulu kunye nemisebenzi yabantu, enegalelo ekudalweni kwendawo yokuhlala yombungu [12].
Ulawulo lomthombo weLarval (LSM) yindlela esekelwe kwindawo yokuzalela kulawulo lwezityalo ejolise ekunciphiseni inani leendawo zokuzalela kunye nenani lemibungu yeengcongconi kunye neepupa eziqulethwe kuzo [13].I-LSM iye yanconywa ngezifundo ezininzi njengesicwangciso esongezelelweyo esidibeneyo sokulawula i-malaria vector control [14, 15].Ngapha koko, ukusebenza kwe-LSM kubonelela ngenzuzo kabini ngokuchasene nokulunywa ziintlobo zevector yemalariya ngaphakathi nangaphandle [4].Ukongeza, ulawulo lwe-vector kunye ne-LSMs esekwe kwi-larvicide efana ne-Bacillus thuringiensis israelensis (Bti) inokwandisa uluhlu lweendlela zokulawula isifo seengcongconi.Ngokomlando, i-LSM idlale indima ebalulekileyo ekulawuleni ngempumelelo i-malaria e-United States, eBrazil, eYiputa, eAlgeria, eLibya, eMorocco, eTunisia naseZambia [16,17,18].Nangona i-LSM idlale indima ebalulekileyo ekulawuleni izinambuzane ezidibeneyo kumazwe athile aphelise i-malaria, i-LSM ayizange ihlanganiswe ngokubanzi kwimigaqo-nkqubo yokulawula i-malaria kunye nezenzo e-Afrika kwaye isetyenziswe kuphela kwiinkqubo zokulawula i-vector kumazwe athile asezantsi kwe-Sahara.amazwe [14,15,16,17,18,19].Esinye isizathu soku yinkolelo exhaphakileyo yokuba iindawo zokuzalisa zininzi kakhulu kwaye kunzima ukuzifumana, okwenza i-LSM ibize kakhulu ukuphumeza [4, 5, 6, 7, 8, 9, 10, 11, 13, 14].Ngoko ke, uMbutho wezeMpilo weHlabathi ucebise amashumi eminyaka ukuba izixhobo ezihlanganiswe kwi-malaria ye-vector control kufuneka zigxininise kwi-LLN kunye ne-IRS [20, 21].Kwakungekho kude kube yi-2012 ukuba uMbutho wezeMpilo weHlabathi ucebise ukuhlanganiswa kwe-LSM, ngokukodwa ukungenelela kwe-Bti, njengokuncedisa i-LLIN kunye ne-IRS kwiindawo ezithile kwi-Afrika engaphantsi kwe-Sahara [20].Ekubeni i-WHO yenza le ncomo, uphando oluninzi lwe-pilot luye lwaqhutywa malunga nokuba nokwenzeka, ukusebenza kunye neendleko ze-biolarvicides kwi-Afrika ephantsi kwe-Sahara, ebonisa ukusebenza kwe-LSM ekunciphiseni ukuxinana kweengcongconi ze-Anopheles kunye nokusebenza kakuhle kokudluliselwa kwe-malaria ngokwemiqathango ye- [22, 23].., 24].
I-Côte d'Ivoire iphakathi kwamazwe ali-15 anomthwalo ophezulu we-malaria emhlabeni [25].Ukuxhaphaka kwe-malaria e-Côte d'Ivoire imele i-3.0% yomthwalo we-malaria yehlabathi, kunye neziganeko eziqikelelwayo kunye nenani leemeko ezivela kwi-300 ukuya ngaphezu kwe-500 kubemi abayi-1000 [25].Nangona ixesha elide elomileyo ukusuka ngoNovemba ukuya kuMeyi, isifo seengcongconi sisasazeka unyaka wonke kummandla osemantla we-savanna welizwe [26].Ukuhanjiswa kwe-malaria kulo mmandla kuhambelana nobukho benani elikhulu labathwali be-asymptomatic yePlasmodium falciparum [27].Kulo mmandla, elona gciwane lixhaphakileyo kwisifo seengcongconi yi-Anopheles gambiae (SL).Ukhuseleko lwasekhaya.Iingcongconi ze-Anopheles gambiae ikakhulu zenziwe yi-Anopheles gambiae (SS), ekwaziyo ukumelana namayeza okubulala izinambuzane ngoko ke ibeka umngcipheko omkhulu wokosuleleka yimalariya [26].Ukusetyenziswa kwe-LLIN kunokuba nefuthe elilinganiselweyo ekunciphiseni usulelo lwemalariya ngenxa yokuxhathisa inambuzane kwii-vectors zasekhaya kwaye ke ihlala iyindawo yenkxalabo enkulu.Uphononongo olulingwayo olusebenzisa i-Bti okanye i-LLIN lubonise ukusebenza kakuhle ekunciphiseni ukuxinana kweentsholongwane zeengcongconi kumantla eCôte d'Ivoire.Nangona kunjalo, akukho zifundo zangaphambili eziye zavavanya umphumo wezicelo eziphindaphindiweyo ze-Bti ezidityaniswe ne-LLN ekuhanjisweni kwe-malaria kunye nesiganeko se-malaria kulo mmandla.Ngoko ke, olu pho nonongo lujolise ekuhloleni umphumo wokusetyenziswa okudibeneyo kwe-LLN kunye ne-Bti ekuhanjisweni kwe-malaria ngokuthelekisa iqela le-LLIN + Bti kunye neqela le-LLIN yedwa kwiidolophana ezine kummandla osenyakatho weCôte d'Ivoire.Kuye kwacingelwa ukuba ukuphumeza i-LSM esekwe kwi-Bti phezu kwe-LLN kuya kongeza ixabiso ngokunciphisa ngakumbi ukuxinana kweengcongconi zemalariya xa kuthelekiswa ne-LLN yodwa.Le ndlela idibeneyo, ijolise kwiingcongconi ze-Anopheles ezingekavuthwa ezithwala i-Bti kunye neengcongconi ze-Anopheles ezithwele i-LLIN, zingabaluleka ekunciphiseni usulelo lwemalariya kwiindawo ezixhaphake kakhulu yimalariya, njengeelali ezikumantla eCôte d'Ivoire.Ke ngoko, iziphumo zolu phononongo zinokunceda ekuthatheni isigqibo sokuba ingaba ifakwe i-LSM kwiinkqubo zolawulo lwesifo seengcongconi zesizwe (NMCPs) kumazwe asezantsi kweSahara.
Uphononongo lwangoku lwenziwa kwiilali ezine zesebe laseNapieldougou (eyaziwa ngokuba yiNapier) kwindawo yococeko yaseKorhogo emantla eCôte d'Ivoire (Umfanekiso 1).Iilali ezisafundiswayo: Kakologo (9° 14′ 2″ N, 5° 35′ 22″ E), Kolekakha (9° 17′ 24″ N, 5° 31′ 00″ E .), Lofinekaha (9° 17′ 31 ″).) 5° 36′ 24″ N) kunye neNambatiurkaha (9° 18′ 36″ N, 5° 31′ 22″ E).Abemi baseNapierledougou ngo-2021 baqikelelwa ukuba bangabemi abangama-31,000, kwaye iphondo linelali ezingama-53 ezinamaziko ezempilo amabini [28].Kwiphondo laseNapyeledougou, apho isifo seengcongconi sisona sizathu siphambili sokutyelelwa kwezonyango, ukulaliswa esibhedlele kunye nokufa, kuphela i-LLN esetyenziselwa ukulawula i-Anopheles vectors [29].Zone iilali kuwo omabini amaqela ophononongo zikhonzwa liziko lezempilo elinye, elineerekhodi zeklinikhi zezehlo zemalariya ziye zajongwa kolu phononongo.
Imephu yaseCôte d'Ivoire ebonisa indawo ekuqhutyelwa kuyo izifundo.(Umthombo wemephu kunye nesoftware: idatha ye-GADM kunye ne-ArcMap 10.6.1. LLIN ehlala ixesha elide i-insecticidal net, Bti Bacillus thuringiensis israelensis
Ukuxhaphaka kwesifo seengcongconi phakathi kweZiko lezeMpilo laseNapier ekujoliswe kulo lifikelele kuma-82.0% (iimeko ezingama-2038) (idatha yangaphambi kwe-Bti).Kuzo zone iilali, amakhaya asebenzisa kuphela iPermaNet® 2.0 LLIN, esasazwa yi-NMCP yase-Ivorian ngo-2017, nge>80% i-coverage [25, 26, 27, 28, 30].Iilali zengingqi yaseKorhogo, esebenza njengendawo yokujonga kwiBhunga leSizwe leMilitare yase-Ivory Coast kwaye ifikeleleka unyaka wonke.Ilali nganye kwezi zine ubuncinane inamakhaya ali-100 kwaye malunga nabemi abafanayo, kwaye ngokutsho kobhaliso lwezempilo (uxwebhu olusebenzayo lweSebe Lezempilo lase-Ivorian), iimeko ezininzi zemalariya zibikwa nyaka ngamnye.IMalariya ibangelwa ikakhulu yiPlasmodium falciparum (P. falciparum) kwaye idluliselwa ebantwini ngePlasmodium.I-gambiae ikwasasazwa yi-Anopheles kunye ne-Anopheles nili mosquitoes kwingingqi [28].Isakhiwo sengingqi uA.igambiae iqulathe ikakhulu iingcongconi zeAnopheles.I-gambiae ss ine-frequency ephezulu yokuguqulwa kwe-kdr (uluhlu lwe-frequency: 90.70-100%) kunye ne-moderate frequency of ace-1 alleles (uluhlu lwe-frequency: 55.56-95%) [29].
Umyinge wemvula yonyaka kunye namaqondo obushushu asuka kwi-1200 ukuya kwi-1400 mm nama-21 ukuya kuma-35 °C ngokulandelelanayo, kunye nokufuma okuhambelanayo (RH) kuqikelelwa kuma-58%.Lo mmandla wophononongo unemozulu yohlobo lwaseSudan eneenyanga ezi-6 ezomileyo zonyaka (ngoNovemba ukuya kuEpreli) kunye neenyanga ezi-6 zonyaka ezimanzi (ngoMeyi ukuya kuOktobha).Lo mmandla ujamelene nemiphumo ethile yokutshintsha kwemozulu, njengokulahleka kohlaza kunye nexesha elide lonyaka elomileyo, nto leyo ephawulwa kukoma kwemithombo yamanzi (imathafa, amasimi erayisi, amachibi, amadike) anokuba yindawo yokuhlala imibungu yeengcongconi i-Anopheles. .Iingcongconi[26].
Uphononongo lwenziwe kwiqela le-LLN + Bti, elimelwe ziilali zaseKakologo naseNambatiurkaha, kunye neqela le-LLIN kuphela, elimelwe ziilali zaseKolekaha naseLofinekaha.Ngexesha lolu phononongo, abantu kuzo zonke ezi lali bebesebenzisa kuphela iPermaNet® 2.0 LLIN.
Ukusebenza kwe-LLIN (PermaNet 2.0) kudityaniswe ne-Bti ngokuchasene neengcongconi ze-Anopheles kunye nosulelo lwemalariya kwavavanywa kulingo olulawulwa ngokungahleliwe (RCT) ngeengalo ezimbini zophononongo: iqela le-LLIN + Bti (iqela lonyango) kunye neqela le-LLN kuphela (iqela lolawulo ).Imikhono ye-LLIN + Bti imelwe yiKakologo kunye neNambatiourkaha, ngelixa i-Kolékaha kunye ne-Lofinékaha ziyilwe njengamagxa e-LLIN kuphela.Kuzo zonke iilali ezine, abahlali basekuhlaleni basebenzisa i-LLIN PermaNet® 2.0 efunyenwe kwi-NMCP yase-Ivory Coast ngo-2017. Kucingelwa ukuba iimeko zokusebenzisa i-PermaNet® 2.0 ziyafana kwiidolophana ezahlukeneyo kuba bafumana inethiwekhi ngendlela efanayo..Kwiqela le-LLIN + Bti, iindawo ezihlala imibungu ye-Anopheles zanyangwa nge-Bti rhoqo emva kweeveki ezimbini ukongeza kwi-LLN esele isetyenziswa ngabemi.Iindawo zokuhlala zeLarval phakathi kweelali kunye ne-2 km radius ukusuka kumbindi welali nganye ziphathwe ngokuhambelana neengcebiso zoMbutho wezeMpilo weHlabathi kunye ne-NMCP yaseCôte d'Ivoire [31].Ngokwahlukileyo, iqela le-LLN kuphela alifumananga unyango lwe-Bti ye-larvicidal ngexesha lokufunda.
Ifom ye-granular ehlakazekayo yamanzi ye-Bti (i-Vectobac WG, i-37.4% wt; inombolo ye-lot 88-916-PG; i-3000 ye-International Toxicity Units IU / mg; i-Valent BioScience Corp, e-USA) isetyenziswe kwi-dose ye-0.5 mg / L..Sebenzisa i-16L i-backpack sprayer kunye ne-fiberglass yokutshiza umpu onesiphatho kunye nombhobho ohlengahlengiswayo kunye nesantya sokuhamba kwe-52 ml ngesekhondi (3.1 L / min).Ukulungiselela i-nebulizer equkethe i-10 L yamanzi, inani le-Bti ehlanjululwe ekumisweni ngu-0.5 mg / L × 10 L = 5 mg.Ngokomzekelo, kwindawo ene-design water flow ye-10 L, usebenzisa i-sprayer ye-10 L ukunyanga umthamo wamanzi, inani le-Bti elifuna ukuhlanjululwa ngu-0.5 mg / L × 20 L = 10 mg.I-10 mg i-Bti yalinganiswa kwintsimi usebenzisa isikali sombane.Ukusebenzisa i-spatula, lungiselela i-slurry ngokuxuba le mali ye-Bti kwibhakethi ephumelele i-10 L.Eli thamo likhethwe emva kovavanyo lwendawo yokusebenza kwe-Bti ngokuchasene neentlobo ezahlukeneyo ze-Anopheles spp.kunye neCulex spp.kwiimeko zendalo kwindawo eyahlukileyo, kodwa iyafana nendawo yophando lwangoku [32].Umlinganiselo wokusetyenziswa kokunqunyanyiswa kwemibungu kunye nobude bexesha lokufakwa kwesicelo kwindawo nganye yokuzala kubalwa ngokusekelwe kumthamo oqikelelweyo wamanzi kwindawo yokuzalela [33].Faka i-Bti usebenzisa isitshizi sesandla esilungelelanisiweyo.I-Nebulizers ilinganiswe kwaye ivavanywa ngexesha lokuzilolonga komntu kunye nakwiindawo ezahlukeneyo ukuze kuqinisekiswe ubungakanani obuchanekileyo be-Bti.
Ukufumana elona xesha lilungileyo lokunyanga iindawo zokuzalela imibungu, iqela lichonge ukutshiza ngefestile.Ifestile yokutshiza lixesha apho imveliso isetyenziselwa ukufezekisa ukusebenza kakuhle: kolu phononongo, ifestile yokutshiza yayisuka kwiiyure ezili-12 ukuya kwiiveki ezi-2, kuxhomekeke kwi-Bti ukuzingisa.Kuyabonakala ukuba, ukuthathwa kweBti ngezibungu kwindawo yokuzalela kufuna ixesha elithile ukusuka kwi-7:00 ukuya kwi-18:00.Ngale ndlela, amaxesha emvula enkulu anokuthintelwa xa imvula ithetha ukuyeka ukutshiza kwaye iqalise kwakhona ngosuku olulandelayo ukuba imozulu iyasebenzisana.Imihla yokutshiza kunye nemihla namaxesha achanekileyo axhomekeke kwiimeko zemozulu eziqatshelweyo.Ukulinganisa izitshizi zikabhaka ngokwezinga lokufakwa kwe-Bti elifunwayo, igcisa ngalinye liqeqeshelwe ukuhlola ngokubonakalayo nokuseta umlomo wesitshizi kunye nokugcina uxinzelelo.Ukulinganisa kugqitywe ngokuqinisekisa ukuba isixa esichanekileyo sonyango lwe-Bti sisetyenziswe ngokulinganayo kwindawo nganye yeyunithi.Nyanga indawo ehlala imibungu rhoqo kwiiveki ezimbini.Imisebenzi ye-Larvicidal iqhutywa ngenkxaso yeengcali ezine ezinamava kunye nabaqeqeshwe kakuhle.Imisebenzi ye-Larvicidal kunye nabathathi-nxaxheba bajongwa ngabaphathi abanamava.Unyango lweLarvicidal lwaqala ngoMatshi ka-2019 ngexesha elomileyo.Enyanisweni, uphando lwangaphambili lubonise ukuba ixesha elomileyo lelona xesha lifanelekileyo lokungenelela kwe-larvicidal ngenxa yokuzinza kweendawo zokuzalela kunye nokuncipha kobuninzi babo [27].Ukulawula imibungu ngexesha lonyaka elomileyo kulindeleke ukuba kuthintelwe umtsalane weengcongconi ngexesha leemvula.Iikhilogram ezimbini (02) ze-Bti ezixabisa i-US$99.29 ivumela iqela lophononongo elifumana unyango ukuba lifikelele kuzo zonke iindawo.Kwiqela le-LLN + Bti, ukungenelela kwe-larvicidal kwathatha unyaka opheleleyo, ukususela ngo-Matshi 2019 ukuya kuFebruwari 2020. Iitotali ze-22 iimeko zonyango lwe-larvicidal zenzeke kwiqela le-LLN + Bti.
Iziphumo ezinokuthi zibekho (ezifana nokurhawuzelelwa, isiyezi okanye impumlo ebalekayo) zajongwa ngophando lomntu ngamnye lwe-Bti biolarvicide nebulizers kunye nabahlali basekhaya abathatha inxaxheba kwiqela le-LIN + Bti.
Uvavanyo lwekhaya lwenziwe phakathi kwamakhaya angama-400 (amakhaya angama-200 kwiqela ngalinye lophononongo) ukuqikelela ipesenti yokusetyenziswa kwe-LLN phakathi kwabemi.Xa kuvavanywa amakhaya, kusetyenziswa indlela yemibuzo yobungakanani.Ukuxhaphaka kokusetyenziswa kwe-LLIN kwahlulwa ngokwamaqela amathathu eminyaka ubudala: iminyaka eyi-15.Le khweshine yazaliswa yaza yacaciswa ngolwimi lwasekuhlaleni lwesiSenoufo kwintloko yekhaya okanye komnye umntu omdala ongaphezu kweminyaka eli-18 ubudala.
Ubungakanani obuncinci bekhaya eliphononongwayo libalwe kusetyenziswa ifomyula echazwe nguVaughan noMorrow [34].
n ngumlinganiselo wesampulu, u-e ngumda wemposiso, t ngumba wokhuseleko ophuma kwinqanaba lokuzithemba, kwaye p ngumyinge wabazali benani labantu abanophawu olunikiweyo.Into nganye yeqhezu inexabiso elihambelanayo, ngoko (t) = 1.96;Obona buncinane bobungakanani bemizi kule meko kuvavanyo yayiyimizi engama-384.
Phambi kovavanyo lwangoku, iintlobo zeendawo zokuhlala ezahlukeneyo zemibungu ye-Anopheles kumaqela e-LLN+Bti kunye ne-LLIN zachongwa, zathathwa iisampulu, zachazwa, zafakwa kwi-georeferenced zaza zabhalwa.Sebenzisa iteyiphu yokulinganisa ubungakanani bendawo yokuzalela.Uxinaniso lwemibungu yeengcongconi emva koko lwavavanywa rhoqo ngenyanga kangangeenyanga ezili-12 kwiindawo ezingama-30 ezikhethwe ngokungacwangciswanga zokuzalela kwilali nganye, kwiindawo zokuzalela ezingama-60 kwiqela ngalinye.Bekukho iisampulu zombungu ezili-12 kwindawo nganye yophononongo, ehambelana nama-22 onyango lwe-Bti.Injongo yokukhetha ezi ndawo zingama-30 zokuzalela kwilali nganye yayikukuthatha inani elaneleyo leendawo zokuqokelela imibungu kwiilali zonke kunye neeyunithi zophononongo ukunciphisa umkhethe.Imibungu yaqokelelwa ngokuditshwa ngecephe le-60 ml [35].Ngenxa yokuba ezinye ii-nursery zincinci kwaye azinzulu, kuyafuneka ukuba kusetyenziswe ibhakethi encinci ngaphandle kwe-emele ye-WHO (350 ml).Itotali ye-5, i-10 okanye i-20 yokuntywila yenziwe kwiindawo zokuhlala kunye nomjikelezo we-10 m, ngokulandelanayo.Ukuchongwa kwe-morphological ye-larvae eqokelelweyo (umz. i-Anopheles, i-Culex kunye ne-Aedes) yenziwa ngokuthe ngqo endle [36].Imibungu eqokelelweyo yahlulahlulwe yangamacandelo amabini ngokusekwe kwinqanaba lophuhliso: ilarvae yakuqala (inqanaba 1 kunye nelesi-2) kunye ne-instar kade (inqanaba lesi-3 nelesi-4) [37].Imibungu ibalwa ngokwemigangatho nakwinqanaba ngalinye lophuhliso.Emva kokubala, imibungu yeengcongconi iphinda ibuyiselwe kwiindawo zayo zokuzalela ize iphinde ifakwe kumthamo wayo wokuqala ngamanzi omthombo oyongezwa ngamanzi emvula.
Indawo yokuzalela yayigqalwa njengelungileyo ukuba kukho ubuncinane umbungu omnye okanye ipupa yalo naluphi na uhlobo lwengcongconi.Ukuxinana kwemibungu kwamiselwa ngokwahlula inani lemibungu yohlobo olufanayo ngenani lokuntywila.
Uphononongo ngalunye lwaluthatha iintsuku ezimbini ezilandelelanayo, yaye rhoqo emva kweenyanga ezimbini, kwaqokelelwa iingcongconi zabantu abadala kumakhaya ali-10 akhethwa ngokungacwangciswanga kwidolophana nganye.Kulo lonke uphononongo, iqela ngalinye lophando lenze uphando lwesampulu kumakhaya angama-20 kwiintsuku ezintathu ezilandelelanayo.Iimiyane zabanjwa kusetyenziswa imigibe yefestile eqhelekileyo (WT) kunye ne-pyrethrum spray traps (PSC) [38, 39].Ekuqaleni, zonke izindlu kwidolophana nganye zazibalwa.Izindlu ezine kwilali nganye zakhethwa ngokungacwangciswanga njengeendawo zokuqokelela iingcongconi zabantu abadala.Kwindlu nganye ekhethwe ngokungacwangciswanga, iingcongconi zaqokelelwa kwigumbi lokulala elikhulu.Amagumbi okulala akhethiweyo aneengcango kunye neefestile kwaye bekuhlalwa kubusuku obungaphambili.Amagumbi okulala ahlala evaliwe phambi kokuba kuqale umsebenzi kunye naxa kuqokelelwa iingcongconi ukuthintela iingcongconi ukuba zibhabhe ngaphandle kwegumbi.Kwafakelwa i-WT kwifestile nganye yegumbi ngalinye lokulala njengendawo yokulinganisa iingcongconi.Ngosuku olulandelayo, iingcongconi ezazingena kwindawo yokusebenza zisuka kumagumbi okulala zaqokelelwa phakathi kwentsimbi yesi-06:00 neye-08:00 kusasa.Qokelela iingcongconi kwindawo osebenza kuyo usebenzisa umlomo kwaye uzigcine kwikomityi yephepha elahlwayo egqunywe ngesiqwenga esikrwada.Inethi yeengcongconi.Iingcongconi eziphumle kwigumbi elinye lokulala zabanjwa kwangoko emva kokuqokelelwa kwe-WT kusetyenziswa i-PSC esekwe kwipyrethroid.Emva kokusasaza amaphepha amhlophe kumgangatho wegumbi, vala iingcango kunye neefestile kunye ne-spray insecticide (izithako ezisebenzayo: 0.25% transfluthrin + 0.20% permetrin).Emva kwemizuzu eyi-10 ukuya kwe-15 emva kokutshiza, susa i-bedspread kwigumbi lokulala, sebenzisa i-tweezers ukuthabatha naziphi na iingcongconi eziye zafika kumaphepha amhlophe, kwaye uzigcine kwisitya sePetri esizaliswe ngoboya bekotoni obumanzi.Inani labantu abachithe ubusuku kumagumbi okulala akhethiweyo nalo larekhodwa.Iingcongconi eziqokelelweyo zithunyelwa ngokukhawuleza kwilebhu ekwisiza ukuze ziqhubeke nokusebenza.
Kwibhubhoratri, zonke iingcongconi eziqokelelweyo ziye zachongwa ngokwe-morphologically kwi-genus kunye neentlobo [36].Amaqanda ka-Anna.I-gambiae SL isebenzisa i-binocular dissecting microscope ngethontsi lamanzi adiyiliweyo abekwe kwisilayidi seglasi [35].Ubume be-Parity bavavanywa ukwahlula abasetyhini abahlukeneyo kubafazi abangenalwazi ngokusekwe kwi-ovarian kunye ne-tracheal morphology, kunye nokumisela izinga lokuzala kunye nobudala bomzimba [35].
Isalathiso sesalamane simiselwa ngokuvavanya umthombo wesidlo segazi esandula kuqokelelwa.i-gambiae nge-enzyme-linked immunosorbent assay (ELISA) isebenzisa igazi elivela ebantwini, imfuyo (iinkomo, iigusha, iibhokhwe) kunye nemikhosi yeenkukhu [40].I-Entomological infestation (EIR) yabalwa kusetyenziswa i-An.Uqikelelo lwabafazi SL e Gambia [41] Ukongeza, An.Ukusuleleka nge-Plasmodium gambiae kwagqitywa ngokuhlalutya intloko kunye nesifuba sabasetyhini abaninzi basebenzisa i-circumsporozoite antigen ELISA (CSP ELISA) indlela [40].Ekugqibeleni, kukho amalungu ka-Ann.I-gambiae ichongiwe ngokuhlalutya imilenze yayo, amaphiko kunye nesisu ngokusebenzisa ubuchule be-polymerase chain reaction (PCR) [34].
Idatha yezonyango ngesifo seengcongconi ifunyenwe kwirejistri yokubonisana nonyango lweZiko lezeMpilo laseNapyyedugou, eliquka zonke iilali ezine ezibandakanyiweyo kolu phononongo (okt, eKakologo, eKolekaha, eLofinekaha naseNambatiurkaha).Ukuhlaziywa kwerejista kugxininise kwiirekhodi ukusuka ngo-Matshi 2018 ukuya kuFebruwari 2019 kwaye ukususela ngo-Matshi 2019 ukuya kuFebruwari 2020. Idatha yeklinikhi ukususela ngo-Matshi 2018 ukuya kuFebruwari 2019 ibonisa idatha yesiseko okanye i-pre-Bti yokungenelela, ngelixa idatha yeklinikhi ukususela ngo-Matshi 2019 ukuya kuFebruwari 2020 imele i-Bti yangaphambili. idatha yongenelelo.Idatha emva kokungenelela kweBti.Ulwazi lweklinikhi, ubudala kunye nelali yesigulane ngasinye kwiqela le-LLIN + Bti kunye ne-LLIN zaqokelelwa kwirejista yezempilo.Kwisigulane ngasinye, ulwazi olufana nemvelaphi yelali, ubudala, ukuxilongwa, kunye ne-pathology yabhalwa.Kwiimeko ezihlaziywe kolu phononongo, i-malaria yaqinisekiswa luvavanyo lokuxilonga olukhawulezileyo (RDT) kunye/okanye imakroskopu yemalariya emva kokulawulwa kwe-artemisinin-based based combination therapy (ACT) ngumboneleli wezempilo.Iimeko zeMalariya zahlulwa zangamaqela amathathu obudala (okt iminyaka eli-15).Isiganeko sonyaka sesifo seengcongconi kubemi abali-1000 saqikelelwa ngokwahlula ukuxhaphaka kwesifo seengcongconi kubemi abali-1000 ngabemi belali.
Idatha eqokelelwe kolu phononongo yangeniswa kabini kwisiseko sedatha yeMicrosoft Excel kwaye emva koko ingeniswe kwisoftware yomthombo ovulekileyo R [42] inguqulo 3.6.3 yohlalutyo lwamanani.Iphakheji yeggplot2 isetyenziselwa ukuzoba iiploti.Imifuziselo yomgca ngokubanzi kusetyenziswa iPoisson regression isetyenziselwe ukuthelekisa ukuxinana kombungu kunye nenani elivakalayo lokulunywa ziingcongconi ngomntu ngamnye ngobusuku phakathi kwamaqela ophononongo.Imilinganiselo yomlinganiselo (RR) isetyenziselwe ukuthelekisa ukuxinana kombungu ophakathi kunye namazinga okuluma kwiingcongconi zeCulex kunye ne-Anopheles.I-Gambia SL yabekwa phakathi kwamaqela amabini ofundo kusetyenziswa i-LLN + Bti iqela njengesiseko.Ubungakanani bempembelelo bubonakaliswe njengemilinganiselo ye-odds kunye ne-95% yexesha lokuzithemba (95% CI).Umlinganiselo (RR) wovavanyo lwe-Poisson wasetyenziselwa ukuthelekisa umlinganiselo kunye neziganeko ze-malaria ngaphambi nangemva kokungenelela kwe-Bti kwiqela ngalinye lokufunda.Inqanaba lokubaluleka elisetyenzisiweyo yi-5%.
Iprothokholi yophononongo yamkelwa yiKomiti yeSizwe yeeNqobo zoPhando kwiSebe lezeMpilo kunye neMpilo yoLuntu yaseCôte d'Ivoire (N/Ref: 001//MSHP/CNESVS-kp), kunye nesithili sezempilo sommandla kunye nolawulo. eKorhogo.Phambi kokuqokelela imibungu yeengcongconi kunye nabantu abadala, imvume enolwazi esayiniweyo yafunyanwa kubathathi-nxaxheba kuphando lwasekhaya, abanini, kunye/okanye abantu abahlala apho.Idatha yosapho kunye nekliniki ayaziwa kwaye iyimfihlo kwaye ifumaneka kuphela kubaphandi abakhethiweyo.
Ziyi-1198 iziza zokuzalela ezatyelelwa.Kwezi ndawo zendlwane ezihlolwe kwindawo yophando, i-52.5% (n = 629) yayiyeyeqela le-LLN + Bti kunye ne-47.5% (n = 569) kwiqela le-LLN kuphela (RR = 1.10 [95% CI 0.98-1.24) ], P = 0.088).Ngokubanzi, iindawo zokuhlala zengingqi zemibungu zahlulwa ngokweendidi ezili-12, phakathi kwazo ezona ndawo zinkulu zeendawo zokuhlala zemibungu yayingamasimi erayisi (24.5%, n=294), ilandelwa yimvula yamanzi (21.0%, n=252) kunye nodongwe (8.3).%, n = 99), udonga lomlambo (8.2%, n = 100), idama (7.2%, n = 86), idama (7.0%, n = 84), impompo yamanzi kwilali (6.8 %, n = 81), Iiprinta zempuphu (4.8%, n = 58), imigxobhozo (4.0%, n = 48), iingqayi (5.2%, n = 62), amachibi (1.9%, n = 23) kunye namaqula (0.9%, n = 11) .).
Ngokubanzi, i-47,274 imbungu yeengcongconi iqokelelwe kwindawo yophando, kunye nomlinganiselo we-14.4% (n = 6,796) kwiqela le-LLN + Bti xa kuthelekiswa ne-85.6% (n = 40,478) kwiqela le-LLN kuphela ( (RR = . 5.96) [95% CI 5.80-6.11], P ≤ 0.001).Le mibungu ineendidi ezintathu zeengcongconi, olona hlobo lubalaseleyo yiAnopheles.(48.7%, n = 23,041), ilandelwa nguCulex spp.(35.0%, n = 16,562) kunye ne-Aedes spp.(4,9%, n = 2340).Iimpukane zenziwe nge-11.3% yeempukane ezingekakhuli (n = 5344).
Uxinaniso lulonke lwe-Anopheles spp.imibungu.Kulo cwaningo, inani leembungu nge-scoop ngu-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 LLIN kuphela (ukhetho).ifayile 1: Umfanekiso S1).Umyinge woxinaniso lwe-Anopheles spp.Iqela le-LLN yodwa yayiyi-6.5 ngamaxesha aphezulu kuneqela le-LLN + Bti (HR = 6.49; 95% CI 5.80-7.27; P <0.001).Akukho zingcongconi ze-Anopheles ezifunyenweyo ngexesha lonyango.I-Larvae yaqokelelwa kwiqela le-LLN + Bti ukususela ngoJanuwari, ehambelana nonyango lwe-Bti yamashumi amabini.Kwiqela le-LLIN + Bti, kukho ukuhla okubonakalayo kwinqanaba lokuqala kunye nenqanaba lobuninzi be-larval.
Ngaphambi kokuqala konyango lwe-Bti (ngoMatshi), ubuninzi be-instar yokuqala ye-Anopheles mosquitoes kuqikelelwa 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-LLN + Bti.l/dipha./dipha ingalo ye-LLN kuphela (Umfanekiso 2A).Emva kokusetyenziswa konyango lwe-Bti, ukuxinana kweengcongconi zokuqala ze-Anopheles kwiqela le-LLN + Bti ngokubanzi lehla ngokuthe ngcembe ukusuka kwi-0.90 [95% CI 0.19-1.61] ukuya kwi-0.10 [95% CI - 0.03-0.18] l/dip.Ukuxinana kwemibungu ye-Anopheles kwahlala kuphantsi kwiqela le-LLN + Bti.Kwiqela le-LLIN kuphela, ukuguquguquka kubuninzi be-Anopheles spp.Iimbungu zakwa-Early instar zabonwa ngoxinaniso oluphakathi 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 bemibungu yokuqala ye-Anopheles kwiqela le-LLIN-kuphela yayiphezulu ngokwezibalo kwi-1.90 [95% CI 1.70–2.10] L/dive, ngelixa ubuninzi bemibungu yokuqala ye-Anopheles kwiqela le-LLIN yayingu-0.38 [95% CI 0.28 –0.47]) l/dipha.+ Iqela le-Bti (RR = 5.04; 95% CI 4.36-5.85; P <0.001).
Utshintsho kwi-avareji yoxinaniso lwemibungu ye-Anopheles.Early (A) kunye ne-instar kade (B) inethi zengcongconi kwiqela lophononongo ukusuka ngoMatshi 2019 ukuya kuFebruwari 2020 kwingingqi yaseNapier, emantla eCôte d'Ivoire.LLIN: inethi ye-insecticidal ehlala ixesha elide iBti: Bacillus thuringiensis, Israel TRT: unyango;
Umyinge woxinaniso lwe-Anopheles spp.imibungu.iminyaka yobudala kwiqela le-LLN + Bti.Uxinaniso lwe-Bti lwangaphambili lwaluyi-2.98 [95% CI 0.26-5.60] L / dip, kanti ubuninzi kwiqela le-LLIN-lodwa laliyi-1.46 [95% CI 0.26-2.65] l / ngosuku Emva kwesicelo se-Bti, ubuninzi bexesha elide- instar Anopheles imibungu kwiqela LLIN + Bti yehla ukusuka 0.22 [95% CI 0.04-0.40] ukuya 0.03 [95% CI 0.00–0.06] L/dip (Fig. 2B).Kwiqela le-LLN kuphela, ukuxinana kwemibungu ka-Anopheles kade kunyuke ukusuka kwi-0.35 [95% CI - 0.15-0.76] ukuya kwi-2.77 [95% CI 1.13-4.40] l/dive kunye nokwahluka kobuninzi bombungu ngokuxhomekeke kumhla wesampulu.Ubuninzi bobunzima beembungu ze-Anopheles zasemva kwexesha kwiqela le-LLIN kuphela ngu-2.07 [95% CI 1.84-2.29] L / dive, amaxesha alithoba aphezulu kune-0.23 [95% CI 0.11-0.36] l/ukuntywiliselwa e-LLIN.+ Iqela le-Bti (RR = 8.80; 95% CI 7.40-10.57; P <0.001).
Umndilili woxinaniso lweCulex spp.Amaxabiso ayengama-0.33 [95% CI 0.21-0.45] L/dip kwiqela le-LLN + Bti kunye ne-2.67 [95% CI 2.23-3.10] L/dip kwiqela le-LLN kuphela (ifayile eyongezelelweyo 2: Umfanekiso S2).Umndilili woxinaniso lweCulex spp.Iqela le-LLN lodwa laliphezulu kakhulu kuneqela le-LLIN + Bti (HR = 8.00; 95% CI 6.90-9.34; P <0.001).
Umndilili wokuxinana kohlobo lweCulex Culex spp.Ngaphambi kokuba unyango, i-Bti l / idiphu yayingu-1.26 [95% CI 0.10-2.42] l / dip kwiqela le-LLN + Bti kunye ne-1.28 [95% CI 0.37-2.36] kwiqela kuphela LLIN (Umfanekiso 3A).Emva kokusetyenziswa kwonyango lwe-Bti, ukuxinana kweembungu zeCulex zakuqala zehla ukusuka kwi-0.07 [95% CI - 0.001-0.] ukuya kwi-0.25 [95% CI 0.006-0.51] L / dip.Akukho mibungu yeCulex yaqokelelwa kwiindawo ezihlala imibungu enyangwa ngeBti ukuqala kweyoMnga.Ubuninzi beembungu zeCulex zakuqala zancitshiswa zaba ngu-0.21 [95% CI 0.14-0.28] L / dip kwiqela le-LLN + Bti, kodwa laliphezulu kwiqela le-LLN kuphela kwi-1.30 [95% CI 1.10-1.50] l / ukucwiliswa.lahla/d.Ubuninzi beembungu zeCulex zakuqala kwiqela le-LLN kuphela laliphindwe ngamaxesha angama-6 ngaphezu kweqela le-LLIN + Bti (RR = 6.17; 95% CI 5.11-7.52; P <0.001).
Utshintsho kwi-avareji yoxinaniso lweCulex spp.imibungu.Ubomi bokuqala (A) kunye novavanyo lobomi bokuqala (B) kwiqela lokufunda ukusuka ngoMatshi 2019 ukuya kuFebruwari 2020 kwingingqi yaseNapier, emantla eCôte d'Ivoire.Umnatha ohlala ixesha elide obulala izinambuzane i-LLIN, i-Bti Bacillus thuringiensis yakwaSirayeli, unyango lwe-Trt
Ngaphambi konyango lwe-Bti, ubuninzi be-instar instar late Culex larvae kwiqela le-LLN + Bti kunye neqela le-LLIN laliyi-0.97 [95% CI 0.09-1.85] kunye ne-1.60 [95% CI - 0.16-3.37] l / ukucwiliswa ngokufanelekileyo (Umfanekiso. 3b)).Ukuxinana kwentsingiselo yeentlobo zeCulex emva kwexesha elide emva kokuqalisa unyango lwe-Bti.Uxinaniso kwiqela le-LLN + Bti liye lancipha ngokuthe ngcembe kwaye lalingaphantsi kwelo kwiqela le-LLIN kuphela, elihlala liphezulu kakhulu.Ubuninzi be-instar of late instar Culex larvae ngu-0.12 [95% CI 0.07-0.15] L / dive kwiqela le-LLIN + Bti kunye ne-1.36 [95% CI 1.11-1.61] L / ukuntywila kwiqela kuphela i-LLN.Ubuninzi bemilinganiselo ye-Culex ye-late-instar larvae yayiphezulu kakhulu kwiqela le-LLN kuphela kuneqela le-LLIN + Bti (RR = 11.19; 95% CI 8.83-14.43; P <0.001).
Ngaphambi konyango lwe-Bti, ubuninzi be-pupae kwi-ladybug nganye yayingu-0.59 [95% CI 0.24-0.94] kwiqela le-LLN + Bti kunye ne-0.38 [95% CI 0.13-0.63] kwi-LLN kuphela (umzobo 4).Ubuninzi be-pupal density yi-0.10 [95% CI 0.06-0.14] kwiqela le-LLN + Bti kunye ne-0.84 [95% CI 0.75-0.92] kwiqela le-LLN kuphela.Unyango lwe-Bti luye lwanciphisa kakhulu ubuninzi be-pupal kwi-LLN + Bti iqela xa kuthelekiswa neqela le-LLN kuphela (OKANYE = 8.30; 95% CI 6.37-11.02; P <0.001).Kwiqela le-LLN + Bti, akukho pupae zaqokelelwa emva kukaNovemba.
Utshintsho kwi-avareji yobuninzi be-pupae.Uphononongo lwenziwe ukusuka ngoMatshi 2019 ukuya kuFebruwari 2020 kwingingqi yaseNapier kumantla eCôte d'Ivoire.Umnatha ohlala ixesha elide obulala izinambuzane i-LLIN, i-Bti Bacillus thuringiensis yakwaSirayeli, unyango lwe-Trt
Kuqokelelwe iingcongconi zabantu abadala abangama-3456 kwindawo yophando.Iingcongconi ziyi-17 iintlobo ze-5 genera (Anopheles, Culex, Aedes, Eretmapodites) (Itheyibhile 1).Kwiintsholongwane zemalariya An.I-gambiae sl yayiyeyona ntlobo ixhaphakileyo enomlinganiselo we-74.9% (n = 2587), ilandelwa ngu-An.gambiae sl.funestus (2.5%, n = 86) kunye An null (0.7%, n = 24).Ubutyebi bukaAna.i-gambiae sl kwiqela le-LLN + Bti (10.9%, n = 375) yayingaphantsi kuneqela le-LLN kuphela (64%, n = 2212).Akukho luxolo.nli abantu ngabanye badityaniswa kunye LLIN kuphela.Nangona kunjalo, u-An.gambiae kunye no-An.I-funestus yayikhona kuzo zombini iqela le-LLIN + Bti kunye neqela le-LLIN lodwa.
Kwizifundo eziqala ngaphambi kokusetyenziswa kwe-Bti kwindawo yokuzalisa (iinyanga ze-3), inani elipheleleyo leemiyane zobusuku ngomntu ngamnye (b / p / n) kwiqela le-LLN + Bti liqikelelwa ukuba yi-0.83 [95% CI 0.50-1.17] , kanti kwiqela le-LLN + Bti laliyi-0.72 kwiqela le-LLN kuphela [95% CI 0.41-1.02] (Umfanekiso 5).Kwiqela le-LLIN + Bti, umonakalo we-mosquito weCulex wehla kwaye wahlala ephantsi nangona incopho ye-1.95 [95% CI 1.35-2.54] bpp ngoSeptemba emva kwesicelo se-Bti ye-12.Nangona kunjalo, kwiqela le-LLN kuphela, izinga lokuluma i-mosquito linyuka kancane kancane ngaphambi kokunyuka ngoSeptemba kwi-11.33 [95% CI 7.15-15.50] bp / n.Isiganeko esipheleleyo sokulunywa kommiyane sasiphantsi kakhulu kwiqela le-LLIN + Bti xa kuthelekiswa neqela le-LLN yedwa nanini na ngexesha lokufunda (HR = 3.66; 95% CI 3.01-4.49; P <0.001).
Amazinga okulunywa kwizilwanyana zeengcongconi kwindawo yophononongo yengingqi yeNapier kumantla eCôte d'Ivoire ukusuka ngoMatshi ka-2019 ukuya kuFebruwari 2020 LLIN inethi ebulala inambuzane ehlala ixesha elide, iBti Bacillus thuringiensis Israel, unyango lweTrt, ukuluma b/p/night/ human/ busuku
I-Anopheles gambiae yeyona nto ixhaphakileyo kwisifo seengcongconi kwindawo yophononongo.Isantya sokuluma seAn.Kwisiseko, abafazi baseGambia babe ne-b / p / n values 0.64 [95% CI 0.27-1.00] kwiqela le-LLN + Bti kunye ne-0.74 [95% CI 0.30-1.17] kwiqela kuphela LLIN (Umfanekiso 6) .Ngethuba lexesha lokungenelela kwe-Bti, umsebenzi ophezulu wokuluma wabonwa ngoSeptemba, ngokuhambelana nekhosi yeshumi elinesibini yonyango lwe-Bti, kunye nencopho ye-1.46 [95% CI 0.87-2.05] b / p / n kwiqela le-LLN + Bti kunye ne incopho 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 lokusuleleka eGambia laliphantsi kakhulu kwiqela le-LLIN + Bti (0.59 [95% CI 0.43-0.75] b / p / n) kuneqela le-LLN kuphela (2.97 [95% CI 2, 02-3.93] b /p/hayi).(RR = 3.66; 95% CI 3.01-4.49; P <0.001).
Isantya sokuluma sikaAna.gambiae sl, iyunithi yophando kwingingqi yaseNapier, emantla eCote d'Ivoire, ukusuka ngoMatshi 2019 ukuya kuFebruwari 2020 LLIN inethi yokulala ixesha elide, Bti Bacillus thuringiensis Israel, unyango lweTrt, ukuluma b/p/busuku/ umntu/ubusuku.
Iyonke 646 amps.IGambia inqunyulwe.Lilonke, ipesenti yokhuseleko lwasekuhlaleni.Amazinga okulingana eGambia ngokuqhelekileyo> 70% kulo lonke ixesha lokufunda, ngaphandle kukaJulayi, xa kuphela iqela le-LLN lisetyenziswe (Ifayile eyongezelelweyo ye-3: Umfanekiso we-S3).Nangona kunjalo, umyinge wokuchuma kwindawo yophononongo yayingama-74.5% (n = 481).Kwiqela le-LLN + Bti, izinga lokulinganisa lahlala liphezulu, ngaphezu kwe-80%, ngaphandle kweSeptemba, xa izinga lokulinganisa lawela kwi-77.5%.Nangona kunjalo, ukuguquguquka kumlinganiselo wokuchuma kwabonwa kwiqela le-LLN kuphela, kunye nelona qondo lisezantsi eliqikelelwayo lokuzala liyi-64.5%.
Ukusuka 389 Ann.Uphononongo lweeyunithi zegazi ezizimeleyo ezivela eGambia zifumene ukuba i-80.5% (n = 313) yayiyimvelaphi yomntu, i-6.2% (n = 24) yabasetyhini idla igazi elixutywe (umntu kunye nekhaya) kunye ne-5.1% (n = 20) idla igazi. .Isondlo esiphuma kwimfuyo (iinkomo, iigusha neebhokhwe) kunye ne-8.2% (n = 32) yeesampulu ezihlalutyiweyo azikhange zifumane ukutya kwegazi.Kwiqela le-LLN + Bti, umlinganiselo wabasetyhini abafumana igazi lomntu ngu-25.7% (n = 100) xa kuthelekiswa ne-54.8% (n = 213) kwiqela le-LLN kuphela (Ifayile eyongezelelweyo 5: I-Table S5).
Iyonke 308 amps.I-P. gambiae yavavanywa ukuchonga amalungu eentlobo eziyinkimbinkimbi kunye nosulelo lwe-P. falciparum (Ifayile eyongezelelweyo ye-4: I-Table S4).Zimbini “iintlobo ezinxulumeneyo” ezihlala kwindawo yophando, ezizezi, iAn.gambiae ss (95.1%, n = 293) kunye An.coluzzii (4,9%, n = 15).I-Anopheles gambiae ss yayiphantsi kakhulu kwiqela le-LLN + Bti kuneqela le-LLN kuphela (66.2%, n = 204) (RR = 2.29 [95% CI 1.78-2.97], P <0.001) .Umlinganiselo ofanayo weemiyane ze-Anopheles zifunyenwe kwiqela le-LLIN + Bti (3.6%, n = 11) kunye ne-LLIN kuphela iqela (1.3%, n = 4) (RR = 2.75 [95% CI 0.81-11 .84], P = .118).Ukuxhaphaka kosulelo lwe-Plasmodium falciparum phakathi kwe-An.I-SL eGambia yayingu-11.4% (n = 35).Amazinga osulelo lwePlasmodium falciparum.Izinga lokusuleleka eGambia laliphantsi kakhulu kwiqela le-LLIN + Bti (2.9%, n = 9) kuneqela le-LLIN yedwa (8.4%, n = 26) (RR = 2.89 [95% CI 1. 31-7.01) ], P = 0.006).).Xa kuthelekiswa neengcongconi ze-Anopheles, iingcongconi ze-Anopheles gambiae zinelona nani liphezulu losulelo lwe-Plasmodium kuma-94.3% (n=32).coluzzii kuphela 5.7% (n = 5) (RR = 6.4 [95% CI 2.47-21.04], P <0.001).
Bebonke abantu abangama-2,435 abaphuma kumakhaya angama-400 baye bahlolwa.Umyinge woxinaniso ngabantu abayi-6.1 kwikhaya ngalinye.Izinga lobunini be-LLIN phakathi kwemizi yi-85% (n = 340), xa kuthelekiswa ne-15% (n = 60) kumakhaya angenayo i-LLIN (RR = 5.67 [95% CI 4.29-7.59], P <0.001) (Ifayile eyongezelelweyo 5 : Uluhlu lwe-S5)..Ukusetyenziswa kwe-LLIN kwakuyi-40.7% (n = 990) kwiqela le-LLN + Bti xa kuthelekiswa ne-36.2% (n = 882) kwiqela le-LLN yedwa (RR = 1.12 [95% CI 1.02-1.23], P = 0.013).Umndilili wokusetyenziswa kwenetha ngokubanzi kwindawo yophononongo yayingama-38.4% (n = 1842).Umyinge wabantwana abangaphantsi kweminyaka emihlanu ubudala usebenzisa i-Intanethi wawufana kumaqela omabini ofundo, kunye namazinga okusetyenziswa kwenetha ye-41.2% (n = 195) kwiqela le-LLN + Bti kunye ne-43.2% (n = 186) kwiqela kuphela LLIN.(HR = 1.05 [95% CI 0.85-1.29], P = 0.682).Phakathi kwabantwana abaneminyaka eyi-5 ukuya kwiminyaka eyi-15, kwakungekho mmahluko kumazinga okusetyenziswa kwenetha phakathi kwe-36.3% (n = 250) kwiqela le-LLIN + Bti kunye ne-36.9% (n = 250) kwiqela le-LLN kuphela (RR = 1. 02 [ 95% CI 1.02-1.23], P = 0.894).Nangona kunjalo, abo bangaphezu kweminyaka eyi-15 ubudala basebenzisa iinetha zokulala i-42.7% (n = 554) ngaphantsi kweqela le-LLIN + Bti kune-33.4% (n = 439) kwiqela le-LLN kuphela (RR = 1.26 [95% CI 1.11-1.43) ], P <0.001).
Iimeko zeklinikhi ezipheleleyo ze-2,484 zirekhodwa kwiZiko lezeMpilo laseNapier phakathi kuka-Matshi 2018 kunye noFebruwari 2020. Ukuxhaphaka kwe-malaria yeklinikhi kuluntu jikelele kwakuyi-82.0% yazo zonke iimeko ze-pathology yekliniki (n = 2038).Amazinga onyaka eziganeko zendawo ye-malaria kule ndawo yophononongo yayingama-479.8 ‰ kunye ne-297.5 ‰ ngaphambi nangemva konyango lwe-Bti (Itheyibhile 2).
Ixesha lokuposa: Jul-01-2024