Iyafakaisibulala-zinambuzaneamanetha amafasitela (ama-ITN) ezindlebeni ezivulekile, amafasitela, nezintuba zodonga ezindlini ezingaqinisiwe kuyisinyathelo esinamandla sokulawula umalaleveva. Ingakwaziukuvimbela omiyanekusukela ekungeneni ekhaya, ukuhlinzeka ngemiphumela ebulalayo neyingozi kuma-vectors umalaleveva futhi okungenzeka kunciphise ukudluliswa kukamalaleveva. Ngakho-ke, senze ucwaningo lwe-epidemiological emakhaya aseTanzania ukuze sihlole ukusebenza kahle kwamanethi efasitelana aphethwe zinambuzane (ITNs) ekuvikeleni ukutheleleka nge-malaria kanye nama-vectors angaphakathi endlini.
Esifundeni saseCharinze, eTanzania, imindeni engama-421 yabelwa amaqembu amabili ngokungahleliwe. Kusukela ngoJuni kuya kuJulayi 2021, amanetha omiyane aqukethe i-deltamethrin ne-synergist afakwa kuma-eaves, amafasitela, nezintuba zodonga eqenjini elilodwa, kanti elinye iqembu alizange lifakwe. Ngemva kokufakwa, ekupheleni kwenkathi yemvula ende (Juni/Julayi 2022, umphumela oyinhloko) kanye nenkathi yemvula emfishane (uMasingana/Februwari 2022, umphumela wesibili), wonke amalungu omndeni abambe iqhaza (aneminyaka engu-≥6 izinyanga) ahlolelwe ukutheleleka nge-PCR ngobuningi. Imiphumela yesibili ihlanganisa isamba sezibalo zomiyane ngomgibe ngobusuku ngabunye (Juni/Julayi 2022), ukusabela okungekuhle ngenyanga eyodwa ngemva kokubekwa kwenetha (Agasti 2021), kanye nokutholakala kwe-chemobioavailability nezinsalela ngonyaka owodwa ngemva kokusetshenziswa kwenetha (Juni/Julayi 2022). Ekupheleni kokuqulwa kwecala, iqembu elilawulayo liphinde lathola amanetha omiyane.
Ucwaningo alukwazanga ukufinyelela esiphethweni ngenxa yosayizi wesampula onganele ngenxa yokwenqaba kwezakhamuzi ezithile ukubamba iqhaza. Isilingo esikhulu esilawulwa yiqoqo ngokungahleliwe, ngokufanelekile esibandakanya ukufakwa kwezikrini zamawindi eziphathwe ngesibulala-zinambuzane esihlala isikhathi eside, siyadingeka ukuze kuhlolwe lokhu kungenelela.
Idatha yokusabalala kukamalaleveva yahlaziywa kusetshenziswa indlela ye-protocol, okusho ukuthi abantu ababehambe emasontweni amabili ngaphambi kocwaningo noma abaphuze imishanguzo yokulwa nomalaleveva abafakwanga ekuhlaziyeni.
Ngenxa yokuthi inani lomiyane ababanjwe ngesikhathi sokuhlolwa lalincane, imodeli yomiyane engalungisiwe kuphela engalungiswanga yenani lomiyane ababanjwa ubusuku ngabunye yisicupho ngasinye yasetshenziswa ukuze kutholwe inani lomiyane egumbini.
Emizini efanelekile engu-450 ekhethiwe kuzo zonke izigodi eziyisishiyagalolunye, eyisishiyagalolunye ayifakwanga ngoba ibingenalo uphahla oluvulekile noma amafasitela ngaphambi kokungahleliwe. NgoMeyi 2021, imindeni engama-441 yafakwa ngaphansi kwe-randomization elula ehlelwe yidolobhana: imindeni engama-221 yabelwa iqembu le-intelligent ventilation system (IVS), kwathi engama-220 esele yabelwa iqembu elilawulayo. Ekugcineni, i-208 yemindeni ekhethiwe yaqeda ukufakwa kwe-IVS, kuyilapho i-195 yahlala eqenjini lokulawula (Umfanekiso 3).
Okunye ukuhlola kusikisela ukuthi i-ITS ingase isebenze kangcono ekuvikeleni umalaleveva kumaqembu athile eminyaka yobudala, izakhiwo zezindlu, noma lapho isetshenziswa namanethi omiyane. Ukufinyelela ezimpahleni zokulawula umalaleveva, ikakhulukazi amanetha omiyane, kubikwe ukuthi kulinganiselwe, ikakhulukazi ezinganeni ezisafunda isikole.[46] Ukutholakala okuncane kwamanetha ezindlini kunomthelela ekusetshenzisweni okulinganiselwe kwenethi phakathi kwemindeni, futhi izingane ezifunda isikole ngokuvamile azinakwa, ngaleyo ndlela ziba umthombo wokuphikelela kokudluliselwa komalaleveva.[16, 47, 48] ITanzania isebenzisa izinhlelo eziqhubekayo zokusabalalisa, kuhlanganise nohlelo lwenethi yesikole, lokwandisa ukufinyelela kumanethi omiyane ezinganeni ezisafunda isikole.[14, 450] kanye neqiniso lokuthi leli qembu lingase libe nobunzima obuningi bokufinyelela amanetha, kungenzeka ukuthi i-ITS inikeze ukuvikelwa kwaleli qembu, ngaleyo ndlela igcwalise igebe lokuvikela ekusetshenzisweni kwenetha. Izakhiwo zezindlu ngaphambilini bezixhunyaniswa nokwanda kokusuleleka komalaleveva; isibonelo, imifantu ezindongeni zodaka kanye nezimbobo ophahleni lwendabuko kwenza kube lula ukungena komiyane.[8] Nokho, abukho ubufakazi obusekela lesi simangalo; ukuhlaziywa kwamaqembu ocwaningo ngohlobo lodonga, uhlobo lophahla, kanye nokusetshenziswa kwangaphambilini kwama-ITN akuvezanga umehluko phakathi kweqembu elilawulayo neqembu le-ITN.
Yize imindeni esebenzisa uhlelo lokulawula omiyane lwangaphakathi (ITS) inomiyane i-Anopheles abambalwa ababanjwa isicupho ngobusuku ngabunye, umehluko mncane uma kuqhathaniswa nemizi engenayo i-ITS. Izinga eliphansi lokubanjwa ezindlini esebenzisa i-ITS lingase libangelwe ukusebenza kahle kwayo ngokumelene nezinhlobo zomiyane ezibalulekile ezidla futhi zihlale endlini (isb., i-Anopheles gambiae [50]) kodwa ingase ingasebenzi kahle ezinhlotsheni zomiyane okungenzeka ukuthi zisebenze ngaphandle (isb, i-Anopheles africanus). Ngaphezu kwalokho, ama-ITS amanje angeke aqukathe ukugxila okuphelele nokulinganiselwe kwe-pyrethroids ne-PBO futhi, ngakho-ke, angase angasebenzi ngokwanele ngokumelene ne-Anopheles gambiae engamelana ne-pyrethroid, njengoba kukhonjisiwe ocwaningweni oluyingxenye yenkundla [i-Odufuwa, ezayo]. Lo mphumela ungase futhi ubangelwe amandla ezibalo anganele. Ukuze kutholwe umehluko we-10% phakathi kweqembu le-ITS neqembu elilawulayo elinamandla ezibalo angu-80%, kwakudingeka imizi engu-500 eqenjini ngalinye. Okwenza izinto zibe zimbi kakhulu, lolu cwaningo lwaqondana nesimo sezulu esingajwayelekile eTanzania ngalowo nyaka, ngokwanda kwamazinga okushisa nokuncipha kwemvula[51], obekungaba nomthelela omubi ukuba khona nokuhlala komiyane i-Anopheles[52] futhi bekungaholela ekwehleni kwesibalo somiyane sisonke phakathi nesikhathi socwaningo. Ngokuphambene, bekunomehluko omncane kusilinganiso sansuku zonke sokuminyana kwe-Culex pipiens pallens ezindlini ezine-ITS uma kuqhathaniswa nezindlu ezingenayo. Njengoba kushiwo ngaphambili [i-Odufuwa, ezayo], lesi simo singase sibe ngenxa yobuchwepheshe obuthile bokwengeza ama-pyrethroids ne-PBO ku-ITS, okunciphisa umphumela wabo wezinambuzane kuma-Culex pipiens. Ngaphezu kwalokho, ngokungafani nomiyane be-Anopheles, amapayipi e-Culex angangena ezakhiweni ngeminyango, njengoba kutholakala ocwaningweni lwaseKenya[24] kanye nocwaningo lwe-entomological eTanzania[53]. Ukufaka iminyango yesikrini kungase kungenzeki futhi kuzokhuphula ingcuphe yokuchayeka kwabangaphakathi emithini yokubulala izinambuzane. Omiyane be-Anopheles bangena ngokuyinhloko ngama-eaves[54], futhi ukungenelela okukhulu kungase kube nomthelela omkhulu ekuminyana komiyane, njengoba kuboniswa ukumodela okusekelwe kudatha ye-SFS[Odufuwa, ezayo].
Ukusabela okubi okubikwe ngochwepheshe kanye nabahlanganyeli kwakuhambisana nokusabela okwaziwayo ekuchayekeni kwe-pyrethroid [55]. Ngokuphawulekayo, ukusabela okubi okubikiwe okuningi kwaxazululwa phakathi namahora angu-72 wokuchayeka, njengoba nje inani elincane kakhulu (6%) lamalungu omndeni afuna usizo lwezokwelapha, futhi bonke ababambiqhaza bathola usizo lwezokwelashwa mahhala. Izehlakalo eziphezulu zokuthimula ezibonwe phakathi kochwepheshe abangu-13 (65%) zahlotshaniswa nokwehluleka ukusebenzisa imaski enikeziwe, esho ukungakhululeki kanye nesixhumanisi esingaba khona se-COVID-19. Izifundo zesikhathi esizayo zingacabangela ukugunyaza ukugqoka imaski.
Esifundeni saseCharinze, awukho umehluko ophawulekayo obonwe emazingeni okutholakala umalaleveva noma omiyane abasendlini phakathi kwemizi enezikrini zamafasitela ezigaywe ngesibulala-zinambuzane (ITS). Lokhu kungenzeka kungenxa yedizayini yocwaningo, izakhiwo zezibulala-zinambuzane nezinsalela, kanye nokucwila okukhulu kwabahlanganyeli. Naphezu kokuntuleka komehluko omkhulu, ukwehla kwezinga lezilwane ezifuywayo kwabonakala ngesikhathi sezimvula ende, ikakhulukazi ezinganeni ezisafunda. Izinga lomiyane abangaphakathi endlini i-Anopheles nalo lehlile, okusikisela isidingo sokuqhubeka nocwaningo. Ngakho-ke, ukuze kuqinisekiswe ukubamba iqhaza okuqhubekayo, kunconywa idizayini elawulwa yiqoqo, ehlangene nokuxhumana okusebenzayo nokuxhumana nomphakathi.
Isikhathi sokuthumela: Nov-21-2025