Iinethi zokulala ezine-pyrethroid clofenpyr (CFP) kunye nepyrethroid piperonyl butoxide (PBO) ziyakhuthazwa kumazwe axhaphakileyo ukuze kuphuculwe ulawulo lwemalariya esasazwa ziingcongconi ezikwaziyo ukumelana nepyrethroid.I-CFP yi-proinsecticide efuna ukuqaliswa kwe-mosquito cytochrome P450 monooxygenase (P450), kwaye i-PBO iphucula ukusebenza kwe-pyrethroids ngokuvimbela isenzo sezi enzyme kwiimiyane ezixhathisa i-pyrethroid.Ngaloo ndlela, i-P450 inhibition yi-PBO inokunciphisa ukusebenza kweenetha ze-pyrethroid-CFP xa isetyenziswe kwikhaya elifanayo njengeminatha ye-pyrethroid-PBO.
Iimvavanyo ezimbini zovavanyo lwe-cockpit zenziwa ukuvavanya iindidi ezimbini ezahlukeneyo ze-pyrethroid-CFP ITN (Interceptor® G2, PermaNet® Dual) yodwa kunye kunye ne-pyrethroid-PBO ITN (DuraNet® Plus, PermaNet® 3.0).Iimpembelelo ze-Entomological zokusetyenziswa kwePyrethroid resistance Vector populations kumazantsi eBenin.Kuzo zombini izifundo, zonke iintlobo ze-mesh zavavanywa kunyango olulodwa kunye noluphindwe kabini lwe-mesh.Ii-Bioassays nazo zaqhutywa ukuvavanya ukunganyangeki kweziyobisi kubantu bezilwanyana kwindlu kunye nokufunda intsebenziswano phakathi kwe-CFP kunye ne-PBO.
Uluntu lwe-vector lwalunovakalelo kwi-CFP kodwa lubonise amanqanaba aphezulu okuchasana ne-pyrethroids, kodwa oku kuxhathisa koyiswa kukuvezwa kwangaphambili kwi-PBO.Ukufa kwe-Vector kwancitshiswa kakhulu kwii-huts usebenzisa i-pyrethroid-CFP inet kunye ne-pyrethroid-PBO net xa kuthelekiswa ne-huts esebenzisa iinethi ezimbini ze-pyrethroid-CFP (74% ye-Interceptor® G2 vs. 85%, i-PermaNet® Dual 57% vs. 83% ), p <0.001).Ukuvezwa kwangaphambili kwi-PBO kunciphisa ubuthi be-CFP kwi-bioassays yebhotile, ebonisa ukuba le mpembelelo ingaba ngenxa yenxalenye yokuchasana phakathi kwe-CFP kunye ne-PBO.Ukufa kweVector bekuphezulu kumanqugwala kusetyenziswa imidibaniso yeinethi ene-pyrethroid-CFP inethi xa kuthelekiswa nezindlu ezingenazo inethi zepyrethroid-CFP, kwaye xa inethi zepyrethroid-CFP zazisetyenziswa zodwa njengeminatha ezimbini.Xa zisetyenziswa kunye, ukufa kuphezulu (83-85%).
Olu phononongo lubonise ukuba ukusebenza kwe-pyrethroid-CFP meshes kwancitshiswa xa kusetyenziswe ngokudityaniswa ne-pyrethroid-PBO ITN xa kuthelekiswa nokusetyenziswa yodwa, ngelixa ukusebenza kwendibaniselwano ye-mesh equlethe i-pyrethroid-CFP meshes yayiphezulu.Ezi ziphumo zibonisa ukuba ukubeka phambili ukuhanjiswa kweenethiwekhi ze-pyrethroid-CFP ngaphezu kwezinye iindidi zothungelwano kuya kwandisa iziphumo zokulawula i-vector kwiimeko ezifanayo.
Iinethi ezifakwe kwi-insecticide-treated bed nets (ITNs) ezinezitshabalalisi zepyrethroid ziye zaba yeyona nto iphambili kulawulo lwemalariya kule minyaka ingamashumi amabini idlulileyo.Ukusukela ngo-2004, malunga ne-2.5 yeebhiliyoni zeenethi zokubulala izinambuzane zibonelelwe kwi-Afrika ekwi-sub-Saharan [1], nto leyo ekhokelele ekwandeni kwenani labantu abalala phantsi kweinethi ezifakwe izibulali zinambuzane ukusuka kwi-4% ukuya kwi-47% [2].Isiphumo solu phumezo sasibalulekile.Kuqikelelwa ukuba malunga neebhiliyoni ezi-2 zeemeko ze-malaria kunye ne-6.2 yezigidi zokufa zaye zathintelwa emhlabeni jikelele phakathi kwe-2000 kunye ne-2021, kunye nohlalutyo lwemodeli olubonisa ukuba inetha eziphathwe nge-insecticide zingumqhubi omkhulu wale nzuzo [2, 3].Nangona kunjalo, ezi nkqubela phambili ziza ngexabiso: ukuvela ngokukhawuleza kokuxhathisa i-pyrethroid kubantu be-malaria vector.Nangona iminatha ye-pyrethroid ephathwa nge-insecticide ye-insecticide isenokuthi ibonelele ngokhuseleko lomntu kwi-malaria kwiindawo apho i-vectors ibonisa ukuxhathisa i-pyrethroid [4], izifundo zemodeli ziqikelela ukuba kumanqanaba aphezulu okumelana, i-insecticide-treated bed nets iya kunciphisa impembelelo ye-epidemiological [5]..Ke, ukuxhathisa i-pyrethroid sesinye sezona zoyikiso zibalulekileyo kwinkqubela phambili ezinzileyo kulawulo lwemalariya.
Kule minyaka imbalwa idluleyo, kuye kwaveliswa isizukulwana esitsha seminatha enezibulali-zinambuzane, edibanisa ipyrethroids nomchiza wesibini, ukuze kuphuculwe indlela yokuthintela isifo seengcongconi esisasazwa ziingcongconi ezikwaziyo ukumelana nepyrethroid.Iklasi entsha yokuqala ye-ITN iqulethe i-synergist piperonyl butoxide (PBO), eyenza i-pyrethroids ngokunciphisa i-enzymes yokukhupha i-detoxifying ehambelana nokumelana ne-pyrethroid, ngokukodwa ukusebenza kwe-cytochrome P450 monooxygenases (P450s) [6].Iibhedi eziphathwa nge-fluprone (CFP), insecticide ye-azole kunye nenkqubo entsha yesenzo esijolise ekuphefumleni kweselula, nayo isanda kufumaneka.Ukulandela ukubonakaliswa kwempembelelo ephuculweyo ye-entomological kulingo lwe-hut pilot [7, 8], uluhlu lwezilingo ezilawulwa ngokungenamkhethe (cRCT) zenziwa ukuvavanya iinzuzo zempilo yoluntu zale minatha xa kuthelekiswa neminatha enyangwa ngama-insecticide usebenzisa i-pyrethroids yodwa kunye nokubonelela nge ubungqina obuyimfuneko ukwazisa iingcebiso zomgaqo-nkqubo kwi-World Health Organization (WHO) [9].Ngokusekelwe kubungqina bempembelelo ephuculweyo ye-epidemiological evela kwi-CRCTs e-Uganda [11] naseTanzania [12], i-WHO ivume iibhedi eziphathwe nge-insecticide ye-pyrethroid-PBO [10].I-pyrethroid-CFP ITN nayo isanda kupapashwa emva kwe-RCTs efanayo eBenin [13] kunye neTanzania [14] ibonise ukuba i-ITN ye-prototype (Interceptor® G2) yanciphisa iziganeko ze-malaria yabantwana nge-46% kunye ne-44%, ngokulandelanayo.10].].
Ukulandela iinzame ezihlaziyiweyo zeNgxowa-mali yeHlabathi kunye nabanye abaxhasi abakhulu bemalariya ukujongana nokuxhathisa amayeza okubulala izinambuzane ngokukhawulezisa ukuqaliswa kweebhedi ezintsha [15], i-pyrethroid-PBO kunye ne-pyrethroid-CFP bednets sele zisetyenziswa kwiindawo ezihlala zikho.Ithatha indawo yezibulali zinambuzane zesintu.iinethi zokulala eziphathwayo ezisebenzisa iipyrethroids kuphela.Phakathi kwe-2019 kunye ne-2022, umlinganiselo we-PBO pyrethroid mosquito nets ezibonelelwa kwi-Afrika engaphantsi kwe-Sahara yenyuka ukusuka kwi-8% ukuya kwi-51% [1], ngelixa i-PBO pyrethroid inethi zeengcongconi, kuquka ne-CFP pyrethroid mosquito nets , "izenzo ezimbini" zilindeleke ukuba zibe neengcongconi i-akhawunti ye-56% yokuthunyelwa.Ngena kwimarike yaseAfrika ngo-2025[16].Njengobungqina bokusebenza kwe-pyrethroid-PBO kunye ne-pyrethroid-CFP ye-mosquito nets iyaqhubeka nokukhula, le minatha kulindeleke ukuba ifumaneke ngokubanzi kwiminyaka ezayo.Ke ngoko, kukho imfuneko ekhulayo yokuzalisa izikhewu zolwazi malunga nokusetyenziswa ngokukuko kweinetha ezityatyelwe ngezitshabalalisi zesizukulwana esitsha ukuze kuphunyezwe eyona mpembelelo iphezulu xa inyuswa ukuze isetyenziswe ngokupheleleyo.
Ngenxa yokwanda kwangaxeshanye kwe-pyrethroid CFP kunye ne-pyrethroid PBO mosquito nets, iNkqubo yeSizwe yoLawulo lweMalariya (NMCP) inombuzo omnye wophando olusebenzayo: Ingaba ukusebenza kwayo kuya kuncitshiswa - PBO ITN?Isizathu sale nkxalabo kukuba i-PBO yenza ngokunqanda i-mosquito i-P450 enzymes [6], kanti i-CFP i-proinsecticide efuna ukusebenza nge-P450s [17].Ngoko ke, kucingelwa ukuba xa i-pyrethroid-CFP ITN kunye ne-pyrethroid-CFP ITN isetyenziswa kwikhaya elifanayo, umphumo wokuthintela we-PBO kwi-P450 unokunciphisa ukusebenza kwe-pyrethroid-CFP ITN.Izifundo ezininzi zebhubhoratri zibonise ukuba ukuvezwa kwangaphambili kwi-PBO kunciphisa ubuthi obunobungozi be-CFP kwii-mosquito vectors kwi-exposure bioassays ngokuthe ngqo [18,19,20,21,22].Nangona kunjalo, xa uqhuba izifundo phakathi kwamanethiwekhi ahlukeneyo kwintsimi, ukusebenzisana phakathi kwezi khemikhali kuya kuba nzima ngakumbi.Uphononongo olungapapashwanga luphonononge iziphumo zokusetyenziswa kweentlobo ezahlukeneyo zeminatha enyangwa zizinambuzane kunye.Ke, izifundo zentsimi ezivavanya ifuthe lokusebenzisa indibaniselwano ye-insecticide-treated pyrethroid-CFP kunye ne-pyrethroid-PBO bed nets kwikhaya elifanayo ziya kunceda ukufumanisa ukuba ngaba ukuchasana okukhoyo phakathi kwezi ntlobo zenetha kubangela ingxaki yokusebenza kunye nokunceda ukumisela iqhinga elifanelekileyo lokusasazwa. .kwiingingqi zayo ezisasazwe ngokufanayo.
Ixesha lokuposa: Sep-21-2023