Kwizilingo eAfrika, iminatha yebhedi eyenziweI-PYRETHROIDkwayeI-FIPRONILibonise iziphumo eziphucukileyo ze-entomological kunye ne-epidemiological. Oku kukhokelele ekwandeni kwemfuno yale khosi intsha ekwi-intanethi kumazwe anesifo se-malaria. I-PermaNet Dual yi-deltamethrin entsha kunye ne-clofenac mesh eyenziwe yiVestergaard Sàrl ukubonelela ngezakhono ezongezelelweyo kwiinkqubo zokulawula i-malaria. Siqhube uvavanyo lwe-cockpit yovavanyo ukuvavanya ukusebenza kwe-PermaNet Dual ngokuchasene neengcongconi ze-Anopheles gambiae zasendle, ezimelana ne-pyrethroid ezibhabha ngokukhululekileyo eCove, eBenin. I-PermaNet Dual ibangele ukufa okuphezulu kweengcongconi ukuba ayihlanjwanga xa kuthelekiswa neengcongconi ezine-pyrethroid zodwa kunye neengcongconi ezine-pyrethroid kunye ne-PIPERONYL BUTOXIDE (77% ye-PermaNet Dual, 23% ye-PermaNet 2.0 kunye ne-23% ye-PermaNet 3.0) 56% p < 0.001) emva kweminyaka engama-20. ukuhlamba okuqhelekileyo (75% kwiPermaNet Dual, 14% kwiPermaNet 2.0, 30% kwiPermaNet 3.0, p < 0.001). Ukusebenzisa imida ephakathi engengophantsi echazwe yiWorld Health Organisation, iPermaNet Dual yayingekho phantsi ekufeni kwabantu abathwala i-pyrethroid-clofenazoline, nto leyo ebonise ukuba ixabiso lempilo yoluntu liphucukile (Interceptor G2) (79% vs 76). %, OR = 0.878, 95% CI 0.719–1.073), kodwa kungekhona ukukhuselwa ekunikezelweni kwegazi (35% vs. 26%, OR = 1.424, 95% CI 1.177–1.723). IPermaNet Dual lukhetho olongezelelweyo kolu hlobo lwenethi olusebenzayo kakhulu ukuphucula ulawulo lwemalariya edluliselwa ziingcongconi ezimelana ne-pyrethroid.
Iinethi zokulala eziphathwa ngezibulala-zinambuzane (ii-ITN) zezona ndlela zisebenzayo nezisetyenziswa kakhulu zokuthintela imalariya. Ziye zabonakaliswa ngokuphindaphindiweyo ukuba zinciphisa ukugula nokufa kwemalariya kwiimeko zovavanyo kunye neenkqubo kwaye zenze igalelo elikhulu kunalo naluphi na ungenelelo lwakutshanje lokunciphisa ukwanda kwemalariya. Nangona kunjalo, ukuxhomekeka kwazo kudidi olunye lwezibulala-zinambuzane (ii-pyrethroids) kunika uxinzelelo olukhethiweyo, okukhuthaza ukusasazeka kokumelana ne-pyrethroid kwiivectors zemalariya. Phakathi kowama-2010 nowama-2020, ukumelana ne-pyrethroid kwafunyanwa ubuncinane kuhlobo olunye lwezibulala-zinambuzane kwi-88% yamazwe ahlala enesifo semalariya. Nangona uphando lubonise ukuba iinethi zokulala eziphathwa ngezibulala-zinambuzane zikhusela kwimalariya nangona zixhathisa, kukho ubungqina obuqinileyo bokuba iingcongconi ezivezwe kwiinethi zokulala eziphathwa nge-pyrethroid ziphucule amandla okuphila kunye nokondla. Ngenxa yokubaluleka kwazo ekuthinteleni nasekulawuleni imalariya, naluphi na unciphiso olungakumbi ekusebenzeni kweenethi eziphathwa ngezibulala-zinambuzane kunokukhokelela ekuvukeni kwakhona kwezifo nokufa.
Ukuphendula kwesi sisongelo, iminatha yokulala enyangwa ngezibulali-zinambuzane esebenza kabini, edibanisa i-pyrethroid nenye ikhompawundi, iye yaphuhliswa ukuze kubuyiselwe ulawulo lwe-vectors ye-malaria enganyangekiyo yi-pyrethroid. Uhlobo olutsha lokuqala lwe-ITN ludibanisa i-pyrethroid kunyeI-PIPERONYL BUTOXIDE (PBO), i-synergist ephucula ukusebenza kwe-pyrethroids ngokunciphisa ii-enzymes zokususa ubuthi ezinxulumene nokumelana ne-pyrethroid10. Kwii-huts zovavanyo kunye nezilingo ezilawulwayo ezingacwangciswanga zeqela (cRCT) ii-ITN eziqulethe i-pyrethroids kunye ne-PBO zibonise iingenelo eziphezulu ze-entomological xa kuthelekiswa ne-ITN eziqulethe i-pyrethroids kuphela kunye nokusebenza kakuhle kwe-epidemiological. Ukususela ngoko zifumene isincomo se-WHO esixhomekeke kwimiqathango yokusasazwa kwiindawo apho ii-vectors zibonisa ukumelana ne-pyrethroids, nto leyo ekhokelela ekwandeni okukhulu kokusasazwa kwazo kumazwe ahlala ekhona kwiminyaka yakutshanje18. Nangona kunjalo, i-pyrethroid-PBO ITN ayinayo imida. Okuphawulekayo kukuba, kukho iinkxalabo malunga nokuqina kwazo emva kokusetyenziswa ekhaya ixesha elide. Izifundo zovavanyo eNtshona Afrika zikwacebisa ukuba ii-pyrethroid-PBO mosquito nets zinokubonelela ngenzuzo encinci kwiindawo ezinokumelana okuphezulu kwe-pyrethroid okubangelwa ziindlela ezintsonkothileyo nezininzi. Ke ngoko, ukuze kulawulwe ii-vector ngempumelelo nangokuzinzileyo, kuyimfuneko ukusebenzisa iintlobo ezininzi zee-bed nets eziphathwe ngezinambuzane, kungcono ukuba ziqulathe ezinye izibulala-zinambuzane ezintsha apho ii-vectors zibuthathaka kuzo.
Kutshanje, kuye kwafumaneka iinethi zokulala eziphathwa ngezibulala-zinambuzane ezidibanisa iipyrethroids kunye ne-fipronil, isibulali-zinambuzane se-azole esiphazamisa ukusebenza kwe-mitochondrial. I-Chlorfenopyr imele indlela entsha yokulawula iivectors zezifo eziye zaphuhlisa iindlela ezintsonkothileyo zokuxhathisa izibulali-zinambuzane ezikhoyo. I-pyrethroid-chlorphenopyr ITN (Interceptor G2), eyenziwe yi-BASF, ibonakalise i-malaria engamelani ne-pyrethroid kwizilingo zovavanyo eBenin, eBurkina Faso, eCôte naseTanzania. Ulawulo lwe-vector luphucukile kwaye ngoku lufanelekile kwi-World Health Organisation. Izilingo ezinkulu kunye neenkqubo zokusasazwa kwezilingo kwamanye amazwe nazo zibonise ubungqina bempembelelo ye-epidemiological. Ngokukodwa, ii-RCTs eBenin naseTanzania zibonise ukuba i-Interceptor G2 inciphise ukwanda kwe-malaria yabantwana ngama-46% kunye nama-44% kwiminyaka emi-2, ngokwahlukeneyo, xa kuthelekiswa ne-ITN esebenzisa ii-pyrethroids eziqhelekileyo zodwa. Ngokusekelwe kwezi ziphumo, i-World Health Organisation isandula ukukhupha isindululo esinamandla sokusetyenziswa kweenethi zebhedi ezinyangiweyo nge-insecticide pyrethroid-chlorphenopyr endaweni yeenethi zebhedi eziqulethe i-pyrethroid zodwa kwiindawo apho iivectors zingamelaniyo ne-pyrethroids. Iinethi zebhedi ezinyangiweyo ukuze kuthintelwe i-malaria. Oku kukhokelele ekwandeni okukhulu kwemfuno yehlabathi kunye nee-odolo zeenethi zezinambuzane ezinyangiweyo ze-pyrethroid ezifakwe kumazwe aqhelekileyo. Uphuhliso lweentlobo ezintsha zeenethi zebhedi ze-pyrethroid kunye ne-fipronil ezisebenza kakuhle ngabavelisi abaliqela abanezakhono zokuvelisa ezinamandla luya kunceda ukuphucula imakethi yeenethi zebhedi ezinyangiweyo, kwandiswe ukhuphiswano, kwaye kukhokelele ekufikeleleni lula kwiinethi zebhedi ezinyangiweyo ezingabizi kakhulu. Iinethi zebhedi. Iinethi zebhedi ezibulala izinambuzane zokulawula i-vector ngokufanelekileyo.
Ixesha leposi: Oktobha-17-2023