Kwiimvavanyo eAfrika, iibhedi ezenziwe ngePYRETHROIDkwayeFIPRONILibonise iziphumo eziphuculweyo ze-entomological kunye ne-epidemiological.Oku kukhokelele ekonyukeni kwemfuno yale khosi intsha kwi-intanethi kumazwe agqugqisa isifo seengcongconi.I-PermaNet Dual yi-deltamethrin entsha kunye ne-clofenac mesh ephuhliswe yi-Vestergaard Sàrl ukubonelela ngezakhono ezongezelelweyo kwiinkqubo zokulawula i-malaria.Siqhube ulingo lwe-cockpit yokuvavanya ukusebenza kwePermaNet Dual ngokuchasene neengcongconi ezikwaziyo ukumelana nepyrethroid e-Anopheles gambiae eCove, eBenin.I-PermaNet Dual ibangele ukufa kweengcongconi okuphezulu ukuba ayihlanjwanga xa kuthelekiswa neinethi ezinepyrethroid yodwa kunye nenetha ezinepyrethroid kunye nePIPERONYL BUTOXIDE (77% yePermaNet Dual, 23% yePermaNet 2.0 kunye ne-23% yePermaNet 3.0) 56% 0 p <20 iminyaka emva kwe-20. .ukuhlamba okusemgangathweni (i-75% ye-PermaNet Dual, i-14% ye-PermaNet 2.0, i-30% ye-PermaNet 3.0, p <0.001).Ukusebenzisa imida ephakathi engekho ngaphantsi echazwe nguMbutho wezeMpilo weHlabathi, i-PermaNet Dual nayo yayingekho ngaphantsi kokufa kwe-carrier kwi-pyrethroid-clofenazoline, ebonisa ukuphuculwa kwexabiso lempilo yoluntu (Interceptor G2) (79% vs 76).%, OKANYE = 0.878, 95% CI 0.719-1.073), kodwa kungekhona ukukhusela ukunikezelwa kwegazi (35% vs. 26%, OKANYE = 1.424, 95% CI 1.177-1.723).I-PermaNet Dual lukhetho olongezelelweyo kolu hlobo lusebenza kakhulu lwenethi yokuphucula ulawulo lwemalariya esasazwa ziingcongconi ezikwaziyo ukumelana nepyrethroid.
Iinethi zokulala ezityatyiswe ngama-insecticide (ITNs) zezona ndlela zokuthintela isifo seengcongconi zisebenza kakhulu kwaye zisetyenziswa kakhulu.Ziye zaboniswa ngokuphindaphindiweyo ukunciphisa isifo se-malaria kunye nokufa kwiimeko zovavanyo kunye neeprogram kwaye zenze igalelo elikhulu kunawo nawuphi na ukungenelela okutsha nje ukunciphisa iziganeko ze-malaria.Noko ke, ukuxhomekeka kwabo kudidi olunye lwezibulali-zinambuzane (ipyrethroids) kusebenzisa uxinzelelo olukhethekileyo, nto leyo ekhuthaza ukwanda kokunganyangeki kwepyrethroid kwiintsholongwane zemalariya.Phakathi kuka-2010 kunye no-2020, ukuxhathisa kwe-pyrethroid kwafunyaniswa ubuncinane kwi-vector enye kwi-88% yamazwe agqunywe yimalariya.Nangona uphononongo lubonise ukuba iminatha efakwe amayeza okubulala izinambuzane ikhusela isifo seengcongconi nangona ixhathisa, kukho ubungqina obunamandla bokuba iingcongconi ezisesichengeni seenethi ezifakwe kwi-pyrethroid ziye zaphucula ukuphila kunye namandla okutyisa.Ngenxa yokubaluleka kwazo ekuthinteleni nasekulawuleni isifo seengcongconi, naluphi na unciphiso olongezelelekileyo ekusebenzeni kwemanethi enyangwe ngezitshabalalisi kunokukhokelela ekuqalekeni kokugula nokufa.
Ukusabela kwesi soyikiso, iibhedi ezinezibulali zinambuzane ezisebenza kabini, ezidibanisa ipyrethroid kunye nenye ikhompawundi, ziye zaphuhliswa ukubuyisela ulawulo lwentsholongwane yemalariya enganyangekiyo kwipyrethroid.Uhlobo olutsha lokuqala lwe-ITN ludibanisa iipyrethroids kunyeI-PIPERONYL BUTOXIDE (PBO), i-synergist ephucula ukusebenza kwe-pyrethroids ngokunciphisa i-enzymes ye-detoxifying ehambelana ne-pyrethroid resistance10.Kwizindlu zovavanyo kunye neqela lovavanyo olulawulwa ngokungahleliwe (cRCT) I-ITNs equkethe i-pyrethroids kunye ne-PBO ibonise inzuzo ephezulu ye-entomological xa kuthelekiswa ne-ITNs equlethe kuphela i-pyrethroids kunye nokusebenza kwe-epidemiological.Ukususela ngoko baye bafumana isincomo se-WHO esinemiqathango sokusasazwa kwiindawo apho ii-vectors zibonisa ukuchasana ne-pyrethroids, okukhokelela ekwandeni okukhulu kokusasazwa kwazo kumazwe akhoyo kwiminyaka yakutshanje18.Nangona kunjalo, i-pyrethroid-PBO ITN ayikho ngaphandle kwemida.Ngokucacileyo, kukho iinkxalabo malunga nokuqina kwazo emva kokusetyenziswa ixesha elide ekhaya.Izifundo zokulinga eNtshona Afrika zikwacebisa ukuba inethi zeengcongconi zepyrethroid-PBO zinokubonelela ngenzuzo enyiniweyo kwiindawo ezinoxhathiso olwandisiweyo lwepyrethroid olulamlwa ziindlela ezintsonkothileyo nezininzi.Ngoko ke, kulawulo olusebenzayo noluzinzileyo lwezityalo, kuyafuneka ukuba kusetyenziswe iintlobo ezininzi zenethi ezifakwe izibulali zinambuzane, kukhethwa ukuba ziqulathe ezinye izitshabalalisi ezitsha apho izigulane zinovakalelo kuzo.
Kungekudala, iinatha zokulala eziphathwe nge-insecticide ziye zafumaneka ezidibanisa i-pyrethroids kunye ne-fipronil, i-azole insecticide ephazamisa umsebenzi we-mitochondrial.I-Chlorfenopyr imele indlela entsha yokulawula izifo zezifo eziye zaphuhlisa iindlela zokuxhathisa ezintsonkothileyo kwizitshabalalisi ezikhoyo.I-pyrethroid-chlorphenopyr ITN (Interceptor G2), ephuhliswe yi-BASF, ibonise i-pyrethroid-resistant malaria kwizilingo zokulinga eBenin, eBurkina Faso, eCôte naseTanzania.Ulawulo lweVector luphucukile kwaye ngoku uMbutho wezeMpilo weHlabathi ufanelekile.Ulingo olukhulu kunye neenkqubo ezilingwayo zokusasazwa kwamanye amazwe nazo zibonise ubungqina bempembelelo ye-epidemiological.Ngokukodwa, ii-RCT eBenin naseTanzania zibonise ukuba i-Interceptor G2 yanciphisa izehlo zemalariya kubantwana nge-46% kunye ne-44% kwiminyaka eyi-2, ngokulandelelana, xa kuthelekiswa ne-ITN isebenzisa i-pyrethroids eqhelekileyo yodwa.Ngokusekelwe kwezi ziphumo, uMbutho wezeMpilo weHlabathi usanda kukhupha isindululo esinamandla sokusetyenziswa kweinetha zokulala eziphathwe nge-insecticide pyrethroid-chlorphenopyr kunokuba inethi zokulala ezine-pyrethroids zodwa kwiindawo apho ii-vectors zixhathisa kwi-pyrethroids.Iinethi ezifakwe izibulali zinambuzane ukukhusela isifo seengcongconi.Oku kukhokelele ekwenyukeni okukhulu kwemfuno yehlabathi kunye nee-odolo zenethi zengcongconi ezifakwe kwi-pyrethroid kumazwe axhaphakileyo.Ukuphuhliswa kweentlobo ezintsha ezisebenza kakhulu ze-pyrethroid kunye ne-fipronil bed net ngabavelisi abaninzi abanamandla okwenza izinto eziqinileyo kuya kunceda ukuphucula imarike ye-bed ene-insecticide, ukwandisa ukhuphiswano, kunye nokukhokelela ekufikeleleni lula kwiinethi zokulala eziphethwe zizinambuzane.Iminatha yokulala.Iminatha yokubulala izitshabalalisi zolawulo olululo lwe vector.
Ixesha lokuposa: Oct-17-2023