Izinga lokwanda kwesifo phakathi kwabantwana abaneminyaka eyi-6 ukuya kwi-10 ubudala yayiyi-2.7 kwi-100 yabantu ngenyanga kwindawo ye-IRS kunye ne-6.8 kwi-100 yabantu kwiinyanga kwindawo yolawulo. Nangona kunjalo, akukho mahluko mkhulu kwizinga lokwanda kwesifo semalariya phakathi kweendawo ezimbini kwiinyanga ezimbini zokuqala (Julayi-Agasti) nasemva kwexesha lemvula (Disemba-Februwari) (jonga uMfanekiso 4).
Iindlela zokusinda zeKaplan-Meier zabantwana abaneminyaka eli-1 ukuya kweli-10 ubudala kwindawo yophando emva kweenyanga ezi-8 zokulandelelana
Olu phononongo luthelekise ukuxhaphaka kwemalariya kunye nokuxhaphaka kwayo kwizithili ezibini kusetyenziswa amaqhinga okulawula imalariya adibeneyo ukuvavanya impembelelo eyongezelelweyo ye-IRS. Idatha iqokelelwe kwizithili ezibini ngokusebenzisa uphando oluphindwe kabini kunye nophando lweenyanga ezili-9 lokufumana amatyala kwiikliniki zempilo. Iziphumo ezivela kuphando oluphindwe kabini ekuqaleni nasekupheleni kwexesha lokusasazeka kwemalariya zibonise ukuba i-malaria parasitaemia yayiphantsi kakhulu kwisithili se-IRS (LLTID+IRS) kunakwisithili solawulo (LLTIN kuphela). Ekubeni ezi zithili zimbini zifana ngokwe-epidemiology yemalariya kunye nokungenelela, lo mahluko ungachazwa lixabiso elongezelelweyo le-IRS kwisithili se-IRS. Enyanisweni, zombini iinethi zokubulala izinambuzane ezihlala ixesha elide kunye ne-IRS zaziwa ngokunciphisa kakhulu umthwalo wemalariya xa zisetyenziswa zodwa. Ke ngoko, izifundo ezininzi [7, 21, 23, 24, 25] zixela kwangaphambili ukuba ukudibana kwazo kuya kubangela ukwehla okukhulu komthwalo wemalariya kunazo zodwa. Nangona i-IRS i-IRS iyanda ukususela ekuqaleni ukuya ekupheleni kwexesha lemvula kwiindawo ezinokudluliselwa kwemalariya ngexesha lonyaka, kwaye le ndlela kulindeleke ukuba ifikelele esiphelweni ekupheleni kwexesha lemvula. Nangona kunjalo, ukwanda kwendawo ye-IRS (53.0%) bekuphantsi kakhulu kunakwindawo yolawulo (220.0%). Iminyaka elithoba yeephulo ze-IRS ezilandelelanayo ngokungathandabuzekiyo zincede ekunciphiseni okanye ekucinezeleni iincopho zokudluliselwa kwentsholongwane kwiindawo ze-IRS. Ngaphezu koko, bekungekho mahluko kwi-gametophyte index phakathi kwezi ndawo zimbini ekuqaleni. Ekupheleni kwexesha lemvula, yayiphezulu kakhulu kwindawo yolawulo (11.5%) kunakwindawo ye-IRS (3.2%). Olu qwalaselo luchaza ngokuyinxenye ukuxhaphaka okuphantsi kwe-malaria parasitemia kummandla we-IRS, kuba i-gametocyte index ingumthombo onokubakho wosulelo lwengcongconi olukhokelela ekudlulisweni kwe-malaria.
Iziphumo zohlalutyo lohlengahlengiso lwe-logistic zibonisa umngcipheko wokwenyani onxulumene nosulelo lwe-malaria kwindawo yolawulo kwaye zibonisa ukuba unxibelelwano phakathi komkhuhlane kunye ne-parasitemia luqikelelwa kakhulu kwaye i-anemia yinto edidayo.
Njengakwi-parasitaemia, ukwanda kwe-malaria phakathi kwabantwana abaneminyaka eyi-0-10 ubudala bekuphantsi kakhulu kwi-IRS kunakwiindawo zolawulo. Ukwanda kwe-malaria ngokwesiko kubonwe kuzo zombini iindawo, kodwa bekuphantsi kakhulu kwi-IRS kunakwindawo yolawulo (Umfanekiso 3). Enyanisweni, nangona izibulali-zinambuzane zihlala malunga neminyaka emi-3 kwi-LLINs, zihlala ukuya kuthi ga kwiinyanga ezi-6 kwi-IRS. Ke ngoko, amaphulo e-IRS aqhutywa minyaka le ukugubungela ubuninzi be-malaria. Njengoko kubonisiwe yi-Kaplan-Meier survival curves (Umfanekiso 4), abantwana abahlala kwiindawo ze-IRS babeneemeko ezimbalwa zeklinikhi ze-malaria kunabo bakwiindawo zolawulo. Oku kuhambelana nezinye izifundo ezibike ukwehla okukhulu kwe-malaria xa i-IRS eyandisiweyo idityaniswe nezinye iindlela zokungenelela. Nangona kunjalo, ixesha elilinganiselweyo lokukhuselwa kwimiphumo eseleyo ye-IRS libonisa ukuba eli cebo linokufuna ukuphuculwa ngokusebenzisa izibulali-zinambuzane ezihlala ixesha elide okanye ukwandisa ukuphindaphinda kokusetyenziswa konyaka.
Umahluko ekuxhaphakeni kwe-anemia phakathi kwe-IRS kunye neendawo zolawulo, phakathi kwamaqela ahlukeneyo eminyaka kunye naphakathi kwabathathi-nxaxheba abanomkhuhlane nabangenawo unokusebenza njengophawu oluhle olungangqalanga lwesicwangciso esisetyenzisiweyo.
Olu phononongo lubonisa ukuba i-pirimiphos-methyl IRS inokunciphisa kakhulu ukuxhaphaka kunye nokuxhaphaka kwemalariya kubantwana abangaphantsi kweminyaka eli-10 ubudala kummandla weKoulikoro onganyangekiyo yi-pyrethroid, kwaye abantwana abahlala kwiindawo ze-IRS banamathuba amaninzi okufumana imalariya kwaye bahlale bengenamalariya ixesha elide kuloo mmandla. Izifundo zibonise ukuba i-pirimiphos-methyl sisibulali-zinambuzane esifanelekileyo sokulawula imalariya kwiindawo apho ukumelana ne-pyrethroid kuxhaphake khona.
Ixesha lokuthumela: Disemba-09-2024