Umlinganiselo wesiganeko esipheleleyo phakathi kwabantwana abaneminyaka eyi-6 ukuya kwiminyaka eyi-10 yayiyi-2.7 nge-100 yabantu-inyanga kwindawo ye-IRS kunye ne-6.8 nge-100 yeenyanga zomntu kwindawo yokulawula. Nangona kunjalo, akukho mahluko ubalulekileyo kwizehlo zemalariya phakathi kwezi ziza ezibini kwiinyanga ezimbini zokuqala (Julayi-Agasti) nasemva kwexesha lemvula (ngoDisemba-Februwari) (jonga uMfanekiso 4).
I-Kaplan-Meier i-curves yokusinda kubantwana abaneminyaka eyi-1 ukuya kwi-10 iminyaka kwindawo yokufunda emva kweenyanga ezi-8 zokulandelelana
Olu pho nonongo luthelekisa ukuxhaphaka kwe-malaria kunye neziganeko kwizithili ezibini zisebenzisa izicwangciso ezidibeneyo zokulawula i-malaria ukuvavanya umphumo owongezelelweyo we-IRS. Idatha yaqokelelwa kwizithili ezibini ngokusebenzisa uphando olunqamlekileyo kunye neenyanga ezi-9 zokufumana uphando lwenyanga kwiikliniki zempilo. Iziphumo ezivela kuphando lwamacandelo ekuqaleni nasekupheleni kwexesha losulelo lwemalariya zibonise ukuba i-malaria parasitaemia yayisezantsi kakhulu kwisithili se-IRS (LLTID+IRS) kunesithili solawulo (LLTIN kuphela). Ekubeni ezi zithili zibini zithelekiseka ngokubhekiselele kwi-malaria epidemiology kunye nokungenelela, lo mahluko unokuchazwa ngexabiso elongezelelweyo le-IRS kwisithili se-IRS. Ngapha koko, yomibini iminatha ehlala ixesha elide yokubulala izinambuzane kunye ne-IRS zaziwa ngokunciphisa kakhulu umthwalo wemalariya xa zisetyenziswa yodwa. Ke, izifundo ezininzi [7, 21, 23, 24, 25] ziqikelela ukuba indibaniselwano yabo iya kubangela ukuncitshiswa okukhulu komthwalo wemalariya kunokuba yodwa. Ngaphandle kwe-IRS, iPlasmodium parasitaemia iyanda ukusuka ekuqaleni ukuya ekupheleni kwexesha lemvula kwiindawo ezinosulelo lwemalariya ngamaxesha onyaka, kwaye lo mkhwa kulindeleke ukuba unyuke kakhulu ekupheleni kwexesha lemvula. Nangona kunjalo, ukwanda kwendawo ye-IRS (53.0%) yayiphantsi kakhulu kunoko kwindawo yokulawula (220.0%). Iminyaka elithoba yamaphulo e-IRS alandelelanayo ngokungathandabuzekiyo yanceda ukunciphisa okanye ukucinezela iincopho zosulelo lwentsholongwane kwiindawo ze-IRS. Ngaphezu koko, kwakungekho mmahluko kwisalathisi se-gametophyte phakathi kweendawo ezimbini ekuqaleni. Ekupheleni kwexesha lemvula, yayiphezulu kakhulu kwindawo yokulawula (11.5%) kunendawo ye-IRS (3.2%). Oku kujongwa ngokuyinxenye kuchaza obona bukho buphantsi besifo seengcongconi kwingingqi ye-IRS, ekubeni i-gametocyte index isengumthombo wosulelo lweengcongconi olukhokelela ekosulelweni yimalariya.
Iziphumo zohlalutyo lwe-logistic regression lubonisa umngcipheko wokwenene ohambelana nokusuleleka kwe-malaria kwindawo yokulawula kwaye igxininise ukuba umbutho phakathi komkhuhlane kunye ne-parasitemia uqikelelwe kakhulu kwaye i-anemia yinto ephazamisayo.
Njenge-parasitaemia, iziganeko ze-malaria phakathi kwabantwana abaneminyaka eyi-0-10 iminyaka yayiphantsi kakhulu kwi-IRS kuneendawo zokulawula. Iingqungquthela zokuhanjiswa kwemveli zabonwa kwiindawo zombini, kodwa zaziphantsi kakhulu kwi-IRS kunendawo yokulawula (Umfanekiso 3). Ngapha koko, ngelixa izibulali-zinambuzane zihlala malunga neminyaka emi-3 kwii-LLNs, zihlala ukuya kuthi ga kwiinyanga ezi-6 kwi-IRS. Ke ngoko, amaphulo e-IRS aqhutywa minyaka le ukugubungela iincopho zosulelo. Njengoko kuboniswe ngamagophe okusinda e-Kaplan-Meier (Umfanekiso 4), abantwana abahlala kwiindawo ze-IRS babeneziganeko ezimbalwa zekliniki ze-malaria kunezo ziphantsi kolawulo. Oku kuhambelana nolunye uphononongo oluye lwanika ingxelo yokuncipha okukhulu kwezehlo zemalariya xa i-IRS eyandisiweyo idityaniswa nolunye ungenelelo. Nangona kunjalo, ixesha elilinganiselweyo lokhuseleko kwiziphumo ezishiyekileyo ze-IRS licebisa ukuba esi sicwangciso sinokufuna ukuphuculwa ngokusebenzisa izibulali-zinambuzane ezihlala ixesha elide okanye ngokwandiswa kokusetyenziswa rhoqo ngonyaka .
Umahluko ekuxhaphakeni kwe-anemia phakathi kwe-IRS kunye neendawo zokulawula, phakathi kwamaqela ahlukeneyo eminyaka ubudala kunye naphakathi kwabathathi-nxaxheba abanomkhuhlane kunye nabangenayo i-fever inokusebenza njengesalathisi esihle esingathanga ngqo sesicwangciso esisetyenzisiweyo.
Olu pho nonongo lubonisa ukuba i-pirimiphos-methyl IRS inokunciphisa kakhulu ukuxhaphaka kunye nesiganeko se-malaria kubantwana abangaphantsi kweminyaka eyi-10 ubudala kwingingqi ye-pyrethroid-resistant Koulikoro, kwaye abantwana abahlala kwiindawo ze-IRS banokuthi bahlakulele i-malaria kwaye bahlale bengenayo i-malaria. ixesha elide kummandla. Uphononongo lubonise ukuba i-pirimiphos-methyl iyi-insecticide efanelekileyo yokulawula i-malaria kwiindawo apho ukuxhathisa kwe-pyrethroid kuqhelekileyo.
Ixesha lokuposa: Dec-09-2024