Ukwehla kwakamuva komthwalo we-malaria e-Côte d'Ivoire kubangelwa kakhulu ukusetshenziswa kwamanethi ahlala isikhathi eside ezinambuzane (LIN).Nokho, le nqubekelaphambili isongelwa ukumelana nezibulala-zinambuzane, izinguquko ekuziphatheni kwabantu base-Anopheles gambiae, kanye nokudluliselwa kukamalaleveva okuyinsalela, okwenza kudingeke ukuba kube nesidingo samathuluzi engeziwe.Ngakho-ke, inhloso yalolu cwaningo kwakuwukuhlola ukuphumelela kokusetshenziswa okuhlangene kwe-LLN ne-Bacillus thuringiensis (Bti) bese uyiqhathanisa ne-LLN.
Ucwaningo lwenziwa kusukela ngoMashi 2019 kuya kuFebhuwari 2020 ezingalweni ezimbili zocwaningo (ingalo ye-LLN + Bti kanye nengalo ye-LLIN kuphela) esifundeni sezempilo saseKorhogo enyakatho ye-Côte d'Ivoire.Eqenjini le-LLIN + Bti, izindawo ezihlala izibungu ze-Anopheles zaziphathwa nge-Bti njalo ngemva kwamasonto amabili ngaphezu kwe-LLN.Izibungu kanye omiyane abadala zaqoqwa futhi morphologically akhonjwe uhlobo kanye nezinhlobo kusetshenziswa izindlela ezijwayelekile.Ilungu u-Ann.Inkimbinkimbi yaseGambia yanqunywa kusetshenziswa ubuchwepheshe be-polymerase chain reaction.Ukutheleleka nge-Plasmodium An.Izigameko zikamalaleveva eGambia kanye nenani labantu bendawo nazo zahlolwa.
Sekukonke, u-Anopheles spp.I-Larval density yayiphansi eqenjini le-LLIN + Bti uma kuqhathaniswa neqembu le-LLN kuphela i-0.61 [95% CI 0.41-0.81] izibungu / i-dive (l/dive) 3.97 [95% CI 3.56-4 .38] l/dive (RR = 6.50; 95% CI 5.81–7.29 P <0.001).Isivinini sokuluma sisonke se-An.Isigameko sokulunywa kwe-S. gambiae sasingu-0.59 [95% CI 0.43–0.75] ngomuntu/ubusuku kuqembu elilodwa le-LLN + Bti, uma kuqhathaniswa no-2.97 [95% CI 2.02–3.93] ukulunywa umuntu/ubusuku kuqembu le-LLN kuphela (P <0.001).I-Anopheles gambiae sl yaziwa kakhulu ngokuthi i-Anopheles mosquito.Anopheles gambiae (ss) (95.1%; n = 293), alandelwe ngu-Anopheles gambiae (4.9%; n = 15).Inkomba yegazi lomuntu endaweni yocwaningo yayingama-80.5% (n = 389).I-EIR yeqembu le-LLN + Bti yayilunywe yi-1.36 umuntu ngamunye ngonyaka (ib/p/y), kanti i-EIR yeqembu le-LLN kuphela yayingu-47.71 ib/p/y.Isigameko se-malaria sehle kakhulu sisuka ku-291.8‰ (n = 765) saya ku-111.4‰ (n = 292) eqenjini le-LLN + Bti (P <0.001).
Inhlanganisela ye-LLN ne-Bti yanciphisa kakhulu izigameko zikamalaleveva.Inhlanganisela ye-LLIN ne-Bti ingase ibe indlela ehlanganisiwe ethembisayo yokulawula okusebenzayo kwe-An.IGambia ayinawo umalaleveva.
Naphezu kwenqubekelaphambili ekulawuleni umalaleveva emashumini ambalwa eminyaka adlule, umthwalo we-malaria useyinkinga enkulu e-Afrika eseningizimu yeSahara [1].I-World Health Organization (WHO) isanda kubika ukuthi kube nezigameko ze-malaria eziyizigidi ezingu-249 kanye nokufa okulinganiselwa ku-608,000 okuhlobene nomalaleveva emhlabeni wonke ngo-2023 [2].I-WHO African Region yenza ama-95% ezigameko zikamalaleveva emhlabeni kanye nama-96% okufa komalaleveva, abesifazane abakhulelwe nezingane ezingaphansi kweminyaka engu-5 ubudala abathinteka kakhulu [2, 3].
Amanethi ahlala isikhathi eside abulala izinambuzane (LLIN) kanye ne-indoor residual spraying (IRS) adlale indima ebalulekile ekwehliseni umthwalo we-malaria e-Afrika [4].Ukunwetshwa kwala mathuluzi okulawula i-malaria kuholele ekwehleni okungama-37% kwezehlakalo zikamalaleveva kanye nokuncipha kokushona kwabantu ngama-60% phakathi kuka-2000 no-2015 [5].Kodwa-ke, ukuthambekela okubonwe kusukela ngo-2015 kumile ngendlela eshaqisayo noma kwaze kwashesha, nokufa kukamalaleveva kusalokhu kuphezulu ngendlela engamukeleki, ikakhulukazi e-Afrika eseningizimu yeSahara [3].Ucwaningo oluningana luhlonze ukuvela nokusabalala kokumelana phakathi kwe-vector enkulu kamalaleveva i-Anopheles kwizibulala-zinambuzane ezisetshenziswa empilweni yomphakathi njengesithiyo ekusebenzeni kwe-LLN ne-IRS esikhathini esizayo [6,7,8].Ukwengeza, izinguquko ekuziphatheni kokuluma kwe-vector ngaphandle nangaphambili ebusuku zibhekene nokudluliselwa kwe-malaria okusalayo futhi kuyinkinga ekhulayo [9, 10].Imikhawulo ye-LLN ne-IRS ekulawuleni ama-vectors anesibopho sokudluliselwa kwensalela kuwumkhawulo omkhulu wemizamo yamanje yokuqeda umalaleveva [11].Ngaphezu kwalokho, ukuphikelela kwe-malaria kuchazwa izimo zezulu kanye nemisebenzi yabantu, enomthelela ekwakhiweni kwendawo yokuhlala yezibungu [12].
Ukulawulwa komthombo wezibungu (LSM) kuyindlela esekelwe endaweni yokuzalela yokulawula i-vector ehlose ukunciphisa inani lezindawo ezizalela kuzo kanye nenani lezibungu zomiyane neziphungumangathi eziqukethwe kuzo [13].I-LSM inconywe izifundo ezimbalwa njengesu elengeziwe elihlanganisiwe lokulawula i-vector ye-malaria [14, 15].Eqinisweni, ukusebenza kahle kwe-LSM kunikeza inzuzo ekabili ngokumelene nokulunywa kwezinhlobo ze-malaria ngaphakathi nangaphandle [4].Ukwengeza, ukulawulwa kwe-vector ngama-LSM asekelwe ku-larvicide njenge-Bacillus thuringiensis israelensis (Bti) kunganweba izinhlobonhlobo zezinketho zokulawula umalaleveva.Ngokomlando, i-LSM ibambe iqhaza elibalulekile ekulawuleni ngempumelelo umalaleveva e-United States, Brazil, Egypt, Algeria, Libya, Morocco, Tunisia naseZambia [16,17,18].Nakuba i-LSM ibambe iqhaza elibalulekile ekulawulweni kwezinambuzane okudidiyelwe kwamanye amazwe aqede umalaleveva, i-LSM ayizange ihlanganiswe kabanzi kuzinqubomgomo nezinqubo zokulawula i-malaria e-Afrika futhi isetshenziswa kuphela ezinhlelweni zokulawula ama-vector kwamanye amazwe angaphansi kweSahara.amazwe [14,15,16,17,18,19].Esinye sezizathu zalokhu inkolelo esabalele yokuthi izindawo zokuzalela ziningi kakhulu futhi kunzima ukuzithola, okwenza i-LSM ibize kakhulu ukuzisebenzisa [4, 5, 6, 7, 8, 9, 10, 11, 13, 14].Ngakho-ke, i-World Health Organization iye yancoma amashumi eminyaka ukuthi izinsiza ezibuthelwe ukulawula i-vector ye-malaria kufanele zigxile ku-LLN ne-IRS [20, 21].Kwaze kwafika ngo-2012 lapho i-World Health Organization yancoma ukuhlanganiswa kwe-LSM, ikakhulukazi ukungenelela kwe-Bti, njengokuhambisana ne-LLIN ne-IRS ezindaweni ezithile e-Afrika eseningizimu yeSahara [20].Kusukela i-WHO yenze lesi sincomo, kuye kwenziwa izifundo eziningana zokuhlola ukuthi kungenzeka yini, ukuphumelela kanye nezindleko ze-biolarvicides e-sub-Saharan Africa, okubonisa ukusebenza kahle kwe-LSM ekunciphiseni ukuminyana komiyane be-Anopheles kanye nokusebenza kahle kokudluliswa kwe-malaria ngokwemigomo ye- [22, 23].., 24].
I-Côte d'Ivoire iphakathi kwamazwe angu-15 anomthwalo omkhulu we-malaria emhlabeni [25].Ukusabalala kwe-malaria e-Côte d'Ivoire imele u-3.0% womthwalo we-malaria emhlabeni wonke, ngezigameko ezilinganiselwe kanye nenani lamacala asukela ku-300 kuya kwangaphezu kwama-500 kubantu abayi-1000 [25].Naphezu kwenkathi eyomile ende kusukela ngoNovemba kuya kuMeyi, umalaleveva usakazeka unyaka wonke endaweni esenyakatho ye-savanna yezwe [26].Ukudluliswa kukamalaleveva kulesi sifunda kuhlotshaniswa nokuba khona kwenani elikhulu labathwali be-asymptomatic be-Plasmodium falciparum [27].Kulesi sifunda, isifo sikamalaleveva esivame kakhulu i-Anopheles gambiae (SL).Ukuphepha kwendawo.Omiyane be-Anopheles gambiae ngokuyinhloko bakhiwe i-Anopheles gambiae (SS), imelana kakhulu nezibulala-zinambuzane futhi ngenxa yalokho ibeka engcupheni enkulu yokudluliselwa kukamalaleveva okuyinsalela [26].Ukusetshenziswa kwe-LLIN kungase kube nomthelela olinganiselwe ekwehliseni ukudluliswa kukamalaleveva ngenxa yokumelana nezibulala-zinambuzane kuma-vector asendaweni futhi ngenxa yalokho kuhlala kuyindawo yokukhathazeka okukhulu.Izifundo zokulinga kusetshenziswa i-Bti noma i-LLIN zibonise ukusebenza kahle ekwehliseni ukuminyana kwamavektha omiyane enyakatho ye-Côte d'Ivoire.Kodwa-ke, azikho izifundo zangaphambilini eziye zahlola umphumela wokusetshenziswa okuphindaphindiwe kwe-Bti kuhlanganiswe ne-LLN ekudlulisweni kwe-malaria kanye nesigameko se-malaria kulesi sifunda.Ngakho-ke, lolu cwaningo luhlose ukuhlola umphumela wokusetshenziswa okuhlangene kwe-LLIN ne-Bti ekudlulisweni kwe-malaria ngokuqhathanisa iqembu le-LLIN + Bti neqembu le-LLIN kuphela emizaneni emine esifundeni esisenyakatho ye-Côte d'Ivoire.Kwacatshangwa ukuthi ukusebenzisa i-LSM esekelwe ku-Bti phezu kwe-LLN kuzongeza inani ngokuqhubeka nokunciphisa ukuminyana komiyane kamalaleveva uma kuqhathaniswa ne-LLN kuphela.Le ndlela edidiyelwe, eqondise omiyane abangakakhuli be-Anopheles abathwala i-Bti kanye nomiyane abadala i-Anopheles abathwele i-LLIN, ingaba semqoka ekwehliseni ukusakazeka kukamalaleveva ezindaweni ezidlange kakhulu umalaleveva, njengamadolobhana asenyakatho ye-Côte d'Ivoire.Ngakho-ke, imiphumela yalolu cwaningo ingasiza ekunqumeni ukuthi ingabe ihlanganisa i-LSM ezinhlelweni zokulawula i-malaria kazwelonke (NMCPs) emazweni ase-sub-Saharan asedlangile.
Ucwaningo lwamanje lwenziwa ezigodini ezine zomnyango waseNapieldougou (owaziwa nangokuthi iNapier) endaweni ye-Korhogo sanitary zone enyakatho yeCôte d'Ivoire (Fig. 1).Amadolobhana asacwaningwayo: Kakologo (9° 14′ 2″ N, 5° 35′ 22″ E), Kolekakha (9° 17′ 24″ N, 5° 31′ 00″ E .), Lofinekaha (9° 17′ 31 ″).) 5° 36′ 24″ N) kanye neNambatiurkaha (9° 18′ 36″ N, 5° 31′ 22″ E).Inani labantu baseNapierledougou ngo-2021 lalilinganiselwa ukuthi laliyizakhamizi ezingama-31,000, kanti lesi sifundazwe sinemizi engama-53 enezikhungo zezempilo ezimbili [28].Esifundazweni saseNapyeledougou, lapho umalaleveva uyimbangela ehamba phambili yokuvakashelwa kwezokwelapha, ukulaliswa esibhedlela nokufa, i-LLN kuphela esetshenziswa ukulawula ama-Anopheles vectors [29].Zone izigodi kuwo womabili amaqembu ocwaningo zisizwa isikhungo sezempilo esifanayo, amarekhodi azo omtholampilo ezimo zikamalaleveva abuyekezwa kulolu cwaningo.
Imephu yaseCôte d'Ivoire ebonisa indawo yokutadisha.(Umthombo wemephu nesofthiwe: idatha ye-GADM ne-ArcMap 10.6.1. LLIN inetha ebulala izinambuzane ehlala isikhathi eside, Bti Bacillus thuringiensis israelensis
Ukuvama kwesifo sikamalaleveva phakathi kwesibalo sabantu okuhlosiwe seSikhungo Sezempilo saseNapier sifinyelele ku-82.0% (amacala ka-2038) (idatha yangaphambi kwe-Bti).Kuzo zozine izigodi, imindeni isebenzisa kuphela i-PermaNet® 2.0 LLIN, esatshalaliswa yi-NMCP yase-Ivorian ngo-2017, ene->80% etholakalayo [25, 26, 27, 28, 30].Amadolobhana angaphansi kwesifunda saseKorhogo, esisebenza njengendawo yokubheka uMkhandlu Kazwelonke Wezempi wase-Ivory Coast futhi utholakala unyaka wonke.Idolobhana ngalinye kulawa mane linemizi okungenani eyikhulu futhi cishe abantu abafanayo, futhi ngokokubhaliswa kwezempilo (umqulu osebenzayo woMnyango Wezempilo wase-Ivorian), izigameko ezimbalwa zomalaleveva ziyabikwa unyaka ngamunye.Umalaleveva ngokuyinhloko ubangelwa i-Plasmodium falciparum (P. falciparum) futhi idluliselwa kubantu nge-Plasmodium.i-gambiae iphinde isakazwe omiyane i-Anopheles kanye ne-Anopheles nili esifundeni [28].Indawo yokuhlala i-An.i-gambiae iqukethe ikakhulukazi omiyane i-Anopheles.I-gambiae ss ine-frequency ephezulu yokuguqulwa kwe-kdr (ububanzi befrikhwensi: 90.70-100%) kanye nemvamisa emaphakathi ye-ace-1 alleles (ububanzi befrikhwensi: 55.56-95%) [29].
Isilinganiso semvula yonyaka kanye nezinga lokushisa lisukela ku-1200 kuya ku-1400 mm no-21 kuya ku-35 °C ngokulandelana, kanti umswakama ohlobene (RH) ulinganiselwa ku-58%.Le ndawo yocwaningo inesimo sezulu sohlobo lwaseSudan enenkathi eyomile eyizinyanga eziyisi-6 (Novemba kuya kuMbasa) kanye nenkathi yemvula eyizinyanga eziyisi-6 (ngoMeyi kuya kuMfumfu).Lesi sifunda sibhekene neminye yemiphumela yokushintsha kwesimo sezulu, njengokulahlekelwa uhlaza kanye nenkathi yokomisa isikhathi eside, okubonakala ngokoma kwemithombo yamanzi (izindawo eziphansi, amasimu erayisi, amachibi, amachibi) angaba yindawo yokuhlala izibungu zomiyane i-Anopheles. .Omiyane[26].
Ucwaningo lwenziwa eqenjini le-LLN + Bti, elimelwe amadolobhana aseKakologo naseNambatiurkaha, naseqenjini le-LLIN kuphela, elimelwe amadolobhana aseKolekaha naseLofinekaha.Ngesikhathi salolu cwaningo, abantu kuzo zonke lezi zigodi bebesebenzisa i-PermaNet® 2.0 LLIN kuphela.
Ukusebenza kwe-LLIN (PermaNet 2.0) ngokuhambisana ne-Bti ngokumelene nomiyane i-Anopheles kanye nokudluliswa kukamalaleveva kwahlolwa ocwaningweni olulawulwa ngokungahleliwe (RCT) ngezingalo ezimbili zocwaningo: iqembu le-LLIN + Bti (iqembu lokwelapha) kanye neqembu le-LLN kuphela (iqembu lokulawula ).Imikhono ye-LLIN + Bti imelwe i-Kakologo kanye ne-Nambatiourkaha, kuyilapho i-Kolekaha ne-Lofinékaha zakhiwe njengamahlombe e-LLN kuphela.Kuzo zonke izigodi ezine, izakhamuzi zendawo zisebenzisa i-LLIN PermaNet® 2.0 etholwe yi-NMCP yase-Ivory Coast ngo-2017. Kucatshangwa ukuthi izimo zokusebenzisa i-PermaNet® 2.0 ziyefana emiphakathini ehlukene ngoba bathole inethiwekhi ngendlela efanayo..Eqenjini le-LLN + Bti, izindawo ezihlala izibungu ze-Anopheles zazilashwa nge-Bti njalo ngemva kwamasonto amabili ngaphezu kwe-LLIN esivele isetshenziswa abantu.Izindawo ezihlala izibungu phakathi kwamadolobhana kanye nebanga elingamakhilomitha angu-2 ukusuka enkabeni yedolobhana ngalinye ziphathwe ngokuvumelana nezincomo ze-World Health Organization kanye ne-NMCP yase-Côte d'Ivoire [31].Ngokuphambene, iqembu le-LLN kuphela alizange lithole ukwelashwa kwe-Bti ye-larvicidal ngesikhathi socwaningo.
Ifomu lembudumbudu elihlakazeka emanzini le-Bti (Vectobac WG, 37.4% wt; inombolo yenkatho 88–916-PG; 3000 International Toxicity Units IU/mg; Valent BioScience Corp, USA) yasetshenziswa ngethamo lika-0.5 mg/L..Sebenzisa isifutho sikajosaka esingu-16L kanye nesibhamu se-fiberglass sokufutha esinesibambo kanye nombhobho olungisekayo onesilinganiso sokugeleza esingu-52 ml ngomzuzwana (3.1 L/min).Ukulungiselela i-nebulizer equkethe i-10 L yamanzi, inani le-Bti elihlanjululwe ekumisweni ngu-0.5 mg / L × 10 L = 5 mg.Isibonelo, endaweni enokugeleza kwamanzi okuklama kwe-10 L, kusetshenziswa i-sprayer engu-10 L ukuphatha umthamo wamanzi, inani le-Bti elidinga ukuhlanjululwa ngu-0.5 mg / L × 20 L = 10 mg.I-10 mg Bti ikalwe ensimini kusetshenziswa isikali sikagesi.Ukusebenzisa i-spatula, lungisa i-slurry ngokuxuba leli nani le-Bti ebhakedeni eliphothule le-10 L.Lesi sithako sikhethwe ngemuva kokuhlolwa kwenkundla ukusebenza kwe-Bti ngokumelene nama-instars ahlukahlukene e-Anopheles spp.kanye neCulex spp.ezimweni zemvelo endaweni ehlukile, kodwa efana nendawo yocwaningo lwanamuhla [32].Izinga lokusetshenziswa kokumiswa kwezibulala-zinambuzane kanye nobude besikhathi sokufakwa kwesicelo endaweni ngayinye yokuzalela kubalwe ngokusekelwe kumthamo olinganiselwe wamanzi endaweni yokuzalela [33].Faka isicelo se-Bti usebenzisa isifafazi sesandla esilinganiselwe.Ama-Nebulizers ayalinganiswa futhi ahlolwe ngesikhathi sokuzivocavoca komuntu ngamunye nasezindaweni ezahlukene ukuze kuqinisekiswe inani elifanele le-Bti lilethwa.
Ukuze uthole isikhathi esingcono kakhulu sokwelapha izindawo zokuzalela izibungu, ithimba lihlonze ukufuthwa kwamafasitela.Ifasitela lesifutho isikhathi lapho umkhiqizo usetshenziswa ukuze kuzuzwe ukusebenza kahle okuphelele: kulolu cwaningo, iwindi lesifutho lalisuka emahoreni ayi-12 kuye kumaviki ama-2, kuye ngokuphikelela kwe-Bti.Ngokusobala, ukutholwa kwe-Bti ngezibungu endaweni yokuzalela kudinga isikhathi kusuka ku-7: 00 kuya ku-18: 00.Ngale ndlela, izikhathi zemvula enkulu zingagwenywa lapho imvula isho ukuyeka ukuchela futhi iqale kabusha ngakusasa uma isimo sezulu sibambisana.Izinsuku zokufafaza kanye nezinsuku eziqondile nezikhathi zincike esimweni sezulu esibonwayo.Ukulinganisa izifutho zikajosaka ngenani elifiswayo lokufaka isicelo se-Bti, uchwepheshe ngamunye uqeqeshelwe ukuhlola ngokubukeka bese usetha umlomo wombhobho wokufafaza futhi agcine ingcindezi.Ukulinganisa kuqedwa ngokuqinisekisa ukuthi inani elilungile lokwelashwa kwe-Bti lisetshenziswa ngokulinganayo endaweni ngayinye yeyunithi.Phatha indawo yezibungu njalo ngemva kwamasonto amabili.Imisebenzi ye-Larvicidal yenziwa ngokusekelwa ochwepheshe abane abanolwazi nabaqeqeshwe kahle.Imisebenzi ye-Larvicidal kanye nabahlanganyeli bagadwa ngabaphathi abanolwazi.Ukwelashwa kwe-Larvicide kwaqala ngoMashi 2019 ngesikhathi esomile.Eqinisweni, ucwaningo lwangaphambilini lubonise ukuthi inkathi eyomile yisikhathi esifanele kakhulu sokungenelela kwezibungu ngenxa yokuzinza kwezindawo zokuzalela kanye nokwehla kobuningi bazo [27].Ukulawula izibungu ngenkathi eyomile kulindeleke ukuthi kuvimbele ukukhangwa omiyane ngesikhathi semvula.Amakhilogremu amabili (02) e-Bti abiza u-US$99.29 avumela iqembu locwaningo elithola ukwelashwa ukuthi lihlanganise zonke izindawo.Eqenjini le-LLN + Bti, ukungenelela kwe-larvicidal kwathatha unyaka ogcwele, kusukela ngo-March 2019 kuya kuFebruwari 2020. Ingqikithi yamacala angu-22 okwelashwa kwe-larvicidal kwenzeka eqenjini le-LLN + Bti.
Imiphumela engemihle engase ibe khona (njengokulunywa, isiyezi noma ikhala eligijimayo) iqashwe ngokuhlolwa ngakunye kwe-Bti biolarvicide nebulizers kanye nezakhamuzi zasendlini ezibambe iqhaza eqenjini le-LIN + Bti.
Inhlolovo yasekhaya yenziwa phakathi kwemizi engama-400 (amakhaya angama-200 ngeqembu ngalinye locwaningo) ukuze kulinganiswe iphesenti lokusetshenziswa kwe-LLN phakathi kwabantu.Lapho kuhlolwa imizi, kusetshenziswa indlela yohlu lwemibuzo yobuningi.Ukusabalala kokusetshenziswa kwe-LLIN kwahlukaniswa ngamaqembu amathathu ubudala: iminyaka engu-15.Uhlu lwemibuzo lwaqedwa futhi lwachazwa ngolimi lwendawo lwesiSenoufo kunhloko yekhaya noma komunye umuntu omdala oneminyaka engaphezu kuka-18.
Ubukhulu obuncane bomndeni ohloliwe bubalwa kusetshenziswa ifomula echazwe nguVaughan noMorrow [34].
n usayizi wesampula, u-e umkhawulo wephutha, t into yokuphepha etholakala kuleveli yokuzethemba, futhi u-p uyinani labazali besibalo sabantu abanesibaluli esinikeziwe.Ingxenye ngayinye yengxenye inenani elingaguquki, ngakho (t) = 1.96;Ubukhulu bemizi obuncane kulesi simo ocwaningweni bekuyimizi engama-384.
Ngaphambi kokuhlolwa kwamanje, izinhlobo ezihlukene zezindawo zokuhlala zezibungu ze-Anopheles emaqenjini e-LLN+Bti kanye ne-LLIN zihlonzwe, zathathwa, zachazwa, zafakwa i-georeferenced futhi zafakwa ilebula.Sebenzisa iteyiphu yokukala ukukala usayizi wekoloni lokuzalela.Izibungu zomiyane zabe sezihlolwa nyanga zonke izinyanga eziyi-12 ezindaweni zokuzalela ezikhethiwe ngokungahleliwe ezingama-30 idolobhana ngalinye, ukuze kube nesamba sezindawo zokuzalela ezingama-60 eqenjini locwaningo.Kwakukhona amasampula wezibungu angu-12 endaweni ngayinye yocwaningo, ehambisana nokwelashwa kwe-Bti engama-22.Inhloso yokukhetha lezi zindawo zokuzalela ezingama-30 isigodi ngasinye kwakuwukuthwebula inani elanele lezindawo zokuqoqa izibungu kuzo zonke izigodi namayunithi ocwaningo ukuze kuncishiswe ukuchema.Izibungu zaziqoqwa ngokucwiliswa ngesipuni esingu-60 ml [35].Ngenxa yokuthi ezinye izinkulisa zincane kakhulu futhi azijulile, kuyadingeka ukusebenzisa ibhakede elincane ngaphandle kwebhakede le-WHO elijwayelekile (350 ml).Isamba esingu-5, 10 noma ama-20 ama-dive enziwe ezindaweni zokuzalela ezinomjikelezo wamamitha ayi-10, ngokulandelana.Ukuhlonza i-morphological yezibungu eziqoqiwe (isb. i-Anopheles, i-Culex ne-Aedes) yenziwa ngokuqondile ensimini [36].Izibungu eziqoqiwe zahlukaniswa zaba izigaba ezimbili ezisekelwe esigabeni sokukhula: izibungu zakuqala (isigaba 1 nese-2) nezibungu zasemuva (izigaba 3 kanye ne-4) [37].Izibungu zazibalwa ngokwezizukulwane futhi esigabeni ngasinye sokukhula.Ngemva kokubala, izibungu zomiyane zibuyiselwa ezindaweni zazo zokuzalela futhi ziphinde zigcwaliswe kumthamo wazo wangempela ngamanzi omthombo ahlanganiswe namanzi emvula.
Indawo yokuzalela yayibhekwa njengenhle uma okungenani isibungu esisodwa noma isiphungumangathi sanoma yiluphi uhlobo lomiyane lwalukhona.Ukuminyana kwezibungu kwanqunywa ngokuhlukanisa inani lezibungu zohlobo olufanayo ngenani lokutshuza.
Ucwaningo ngalunye lwaluthatha izinsuku ezimbili zilandelana, futhi njalo ngemva kwezinyanga ezimbili, omiyane abadala babeqoqwa emizini engu-10 ekhethwa ngokungahleliwe edolobhaneni ngalinye.Kulo lonke ucwaningo, ithimba ngalinye locwaningo lenze amasampula ocwaningo lwemizi engama-20 ezinsukwini ezintathu zilandelana.Omiyane babanjwa kusetshenziswa izicupho ezijwayelekile zamafasitela (WT) kanye nezicupho ze-pyrethrum spray (PSC) [38, 39].Ekuqaleni, zonke izindlu esigodini ngasinye zazibaliwe.Izindlu ezine edolobhaneni ngalinye zabe sezikhethwa ngokungahleliwe njengendawo yokuqoqa omiyane abadala.Endlini ngayinye ekhethwe ngokungahleliwe, omiyane babeqoqwa ekamelweni elikhulu.Amakamelo okulala akhethiwe aneminyango namafasitela futhi bekuhlalwa ngayizolo.Amakamelo okulala ahlala evaliwe ngaphambi kokuqala umsebenzi nangesikhathi sokuqoqwa komiyane ukuze kuvinjelwe omiyane ukuba bandize baphume ekamelweni.Kwafakwa i-WT efasiteleni ngalinye lekamelo ngalinye njengendawo yokusampula omiyane.Ngakusasa, omiyane ababengena emsebenzini bephuma ezindlini zokulala baqoqwa phakathi kuka-06:00 no-08:00 ekuseni.Qoqa omiyane endaweni osebenzela kuyo usebenzisa umlomo bese ubagcina enkomishini yephepha elahlwayo embozwe ngocezu oluluhlaza.Inetha lomiyane.Omiyane ababephumule ekamelweni elilodwa babanjwa ngokushesha ngemva kokuqoqwa kwe-WT kusetshenziswa i-PSC esekelwe ku-pyrethroid.Ngemva kokusabalalisa amashidi amhlophe phansi kwekamelo lokulala, vala iminyango namafasitela bese ufafaza isibulala-zinambuzane (izithako ezisebenzayo: 0.25% transfluthrin + 0.20% permetrin).Ngemva kwemizuzu eyi-10 kuya kweyi-15 ngemva kokufafaza, susa i-bedspread ekamelweni elilashiwe, sebenzisa ama-tweezers ukuze ucoshe noma yiziphi omiyane ezihlale emashidini amhlophe, futhi uzigcine esitsheni se-Petri esigcwele uboya bekotini obufakwe emanzini.Isibalo sabantu abachitha ubusuku emagumbini okulala akhethiwe nawo saqoshwa.Omiyane abaqoqiwe badluliselwa ngokushesha elabhorethri esendaweni ukuze kuqhutshekwe nokucubungula.
Elabhorethri, bonke omiyane abaqoqiwe bahlonzwa ngokwe-morphologically kuhlobo kanye nezinhlobo [36].Amaqanda ka-Anna.i-gambiae SL isebenzisa i-binocular dissecting microscope nethonsi lamanzi acwecwe abekwe esilayidini sengilazi [35].Isimo sokulingana sahlolwa ukuze kuhlukaniswe abesifazane abahlukahlukene kwabesifazane abangenalutho ngokusekelwe ku-ovarian kanye ne-tracheal morphology, kanye nokunquma izinga lokuzala kanye nobudala bokuphila [35].
Inkomba yesihlobo inqunywa ngokuhlola umthombo wesidlo segazi esisanda kuqoqwa.i-gambiae nge-enzyme-linked immunosorbent assay (ELISA) isebenzisa igazi labantu, imfuyo (izinkomo, izimvu, izimbuzi) kanye nezinkukhu [40].I-Entomological infestation (EIR) ibalwe kusetshenziswa i-An.Izilinganiso zabesifazane be-SL e-Gambia [41] Ukwengeza, u-An.Ukutheleleka nge-Plasmodium gambiae kwanqunywa ngokuhlaziya ikhanda nesifuba sabesifazane abahlukahlukene kusetshenziswa indlela ye-circumsporozoite antigen ELISA (CSP ELISA) [40].Ekugcineni, kukhona amalungu ka-Ann.i-gambiae ikhonjwe ngokuhlaziya imilenze yayo, amaphiko kanye nesisu kusetshenziswa amasu e-polymerase chain reaction (PCR) [34].
Idatha yomtholampilo ngomalaleveva itholwe ohlwini lokubonisana nomtholampilo lweSikhungo Sezempilo saseNapyeledugou, esihlanganisa zonke izigodi ezine ezifakwe kulolu cwaningo (okungukuthi, iKakologo, iKolekaha, iLofinekaha neNambatiurkaha).Ukubuyekezwa kokubhalisa kugxile kumarekhodi kusukela ngoMashi 2018 kuya kuFebruwari 2019 futhi kusukela ngoMashi 2019 kuya kuFebruwari 2020. Idatha yomtholampilo kusukela ngoMashi 2018 kuya kuFebruwari 2019 imele idatha yokuqala noma yangaphambi kwe-Bti, kuyilapho idatha yomtholampilo kusukela ngoMashi 2019 kuya kuFebruwari 2020 imele i-pre-Bti idatha yokungenelela.Idatha ngemuva kokungenelela kwe-Bti.Ulwazi lomtholampilo, iminyaka kanye nedolobhana lesiguli ngasinye emaqenjini ocwaningo lwe-LLN+Bti kanye ne-LLIN kwaqoqwa kurejista yezempilo.Esigulini ngasinye, ulwazi olufana nemvelaphi yasesigodini, ubudala, ukuxilongwa, kanye ne-pathology yabhalwa.Ezimeni ezibuyekezwe kulolu cwaningo, umalaleveva waqinisekiswa ukuhlolwa kokuxilonga okusheshayo (RDT) kanye/noma imakroskopu kamalaleveva ngemva kokuphathwa kokwelapha okuhlangene okusekelwe ku-artemisinin (ACT) ngumhlinzeki wokunakekelwa kwezempilo.Izehlakalo zikamalaleveva zahlukaniswa zaba amaqembu obudala obuthathu (okungukuthi iminyaka eyi-15).Isigameko sonyaka sikamalaleveva ezakhamuzini eziyi-1000 salinganiselwa ngokuhlukanisa ukusabalala kukamalaleveva ezakhamuzini eziyi-1000 ngenani labantu basemakhaya.
Idatha eqoqwe kulolu cwaningo ifakwe kabili kusizindalwazi se-Microsoft Excel bese yangeniswa ku-software yomthombo ovulekile R [42] inguqulo 3.6.3 ukuze kuhlaziywe izibalo.Iphakheji ye-ggplot2 isetshenziselwa ukudweba iziza.Amamodeli emigqa ejwayelekile asebenzisa ukuhlehla kwe-Poisson asetshenziswe ukuqhathanisa ukuminyana kwezibungu kanye nenani elisho lokulunywa omiyane kumuntu ngamunye ngobusuku phakathi kwamaqembu ocwaningo.Izilinganiso zokuhlobana (RR) zisetshenziswe ukuqhathanisa ukuminyana kwezibungu kanye nezinga lokuluma komiyane i-Culex ne-Anopheles.I-Gambia SL yabekwa phakathi kwamaqembu ocwaningo amabili kusetshenziswa iqembu le-LLN + Bti njengesisekelo.Osayizi bomphumela bavezwe njengezilinganiso zokungalingani kanye nezikhawu zokuzethemba ezingu-95% (95% CI).Isilinganiso (RR) sokuhlolwa kwe-Poisson sasetshenziswa ukuze kuqhathaniswe izilinganiso nezinga lezehlakalo ze-malaria ngaphambi nangemuva kokungenelela kwe-Bti eqenjini ngalinye locwaningo.Izinga lokubaluleka elisetshenzisiwe lalingu-5%.
Iphrothokholi yocwaningo ivunywe Ikomidi Likazwelonke Lezimiso Zocwaningo Lomnyango Wezempilo Nezempilo Yomphakathi wase-Côte d'Ivoire (N/Ref: 001//MSHP/CNESVS-kp), kanye nesifunda sezempilo sesifunda kanye nabaphathi. we Korhogo.Ngaphambi kokuqoqa izibungu zomiyane nabantu abadala, imvume enolwazi esayiniwe itholwe kubahlanganyeli benhlolovo yasekhaya, abanikazi, kanye/noma abahlala khona.Idatha yomndeni neyomtholampilo ayaziwa futhi iyimfihlo futhi itholakala kuphela kubaphenyi abamisiwe.
Kuvakashelwe izindawo zokuzalela ezingu-1198 sezizonke.Kulezi zindawo zezidleke ezihloliwe endaweni yocwaningo, ama-52.5% (n = 629) abeqembu le-LLN + Bti kanye no-47.5% (n = 569) weqembu le-LLN kuphela (RR = 1.10 [95% CI 0 .98–1.24) ], P = 0.088).Sekukonke, izindawo ezihlala izibungu zendawo zahlukaniswa zaba izinhlobo eziyi-12, phakathi kwazo ingxenye enkulu kakhulu yezindawo ezihlala izibungu kwakungamasimu elayisi (24.5%, n=294), kulandele ukugeleza kwamanzi esiphepho (21.0%, n=252) kanye nezitsha zobumba (8.3).%. Ukuphrinta inselo (4.8%, n = 58), amaxhaphozi (4.0%, n = 48), izimbiza (5.2%, n = 62), amachibi (1.9% , n = 23) kanye nemithombo (0.9%, n = 11) .).
Sekukonke, ingqikithi yezibungu zomiyane ezingu-47,274 zaqoqwa endaweni yocwaningo, nengxenye engu-14.4% (n = 6,796) eqenjini le-LLIN + Bti uma kuqhathaniswa nama-85.6% (n = 40,478) eqenjini le-LLN kuphela ( (RR = 5.96) [95% CI 5.80–6.11], P ≤ 0.001).Lezi zibungu zinezinhlobo ezintathu zomiyane, uhlobo oluvelele i-Anopheles.(48.7%, n = 23,041), kulandele Culex spp.(35.0%, n = 16,562) kanye ne-Aedes spp.(4.9%, n = 2340).Iziphungumangathi zakha u-11.3% wezimpukane ezingavuthiwe (n = 5344).
Isilinganiso sesisonke sokuminyana kwe-Anopheles spp.izibungu.Kulolu cwaningo, inani lezibungu nge-scoop ngayinye lalingu-0.61 [95% CI 0.41-0.81] L/dip eqenjini le-LLIN + Bti kanye ne-3.97 [95% CI 3.56-4.38] L / dive ku-LLN yeqembu kuphela (ongakukhetha).ifayela 1: Umfanekiso S1).Ukuminyana okumaphakathi kwe-Anopheles spp.Iqembu le-LLN lodwa laliyi-6.5 izikhathi eziphakeme kuneqembu le-LLN + Bti (HR = 6.49; 95% CI 5.80-7.27; P <0.001).Abekho omiyane be-Anopheles ababonwa ngesikhathi belashwa.Izibungu zaqoqwa eqenjini le-LLN + Bti kusukela ngoJanuwari, elihambisana nokwelashwa kwe-Bti yamashumi amabili.Eqenjini le-LLN + Bti, kube nokwehla okukhulu ekukhuleni kwezibungu zakuqala nasekupheleni.
Ngaphambi kokuqala kokwelashwa kwe-Bti (Mashi), ukuminyana kwesilinganiso somiyane bokuqala be-Anopheles kulinganiselwa ku-1.28 [95% CI 0.22–2.35] L/dive eqenjini le-LLN + Bti kanye no-1.37 [95% CI 0.36– 2.36] l/dive eqenjini le-LLN + Bti.l/dipha./cwilisa ingalo ye-LLN kuphela (Fig. 2A).Ngemva kokusetshenziswa kokwelashwa kwe-Bti, ukuminyana kwesilinganiso somiyane bokuqala be-Anopheles eqenjini le-LLN + Bti ngokuvamile kwehla kancane kancane kusuka ku-0.90 [95% CI 0.19–1.61] kuya ku-0.10 [95% CI – 0.03–0.18] l/dip.Ukuminyana kwezibungu kwasekuqaleni kuka-Anopheles kwahlala kuphansi eqenjini le-LLN + Bti.Eqenjini le-LLIN kuphela, ukushintshashintsha kokuchichima kwe-Anopheles spp.Izibungu zakuqala zabonwa ngokuminyana kwesilinganiso kusuka ku-0.23 [95% CI 0.07–0.54] L/dive kuya ku-2.37 [95% CI 1.77–2.98] L/dive.Sekukonke, ukuminyana kwezibungu ze-Anopheles zakuqala eqenjini le-LLN kuphela bekuphakeme ngokwezibalo ku-1.90 [95% CI 1.70–2.10] L/dive, kanti ukuminyana kwezibungu ze-Anopheles zakuqala eqenjini i-LLIN bekungu-0.38 [95% CI 0.28 –0.47]) l/diphu.+ Iqembu le-Bti (RR = 5.04; 95% CI 4.36-5.85; P <0.001).
Izinguquko ekuminyana okumaphakathi kwezibungu ze-Anopheles.Early (A) kanye ne-late instar (B) amanethi omiyane eqenjini locwaningo kusukela ngoMashi 2019 kuya kuFebruwari 2020 esifundeni saseNapier, enyakatho ye-Côte d'Ivoire.I-LLIN: inetha elibulala izinambuzane elihlala isikhathi eside i-Bti: Bacillus thuringiensis, Israel TRT: ukwelashwa;
Ukuminyana okumaphakathi kwe-Anopheles spp.izibungu.iminyaka sekwephuzile eqenjini le-LLN + Bti.Ukuminyana kwe-Bti ngaphambi kokwelashwa kwakungu-2.98 [95% CI 0.26–5.60] L/dip, kuyilapho ukuminyana eqenjini le-LLIN-yodwa kwakungu-1.46 [95% CI 0.26–2.65] l/ngosuku Ngemva kokufaka isicelo se-Bti, ukuminyana kwe- late- izibungu ze-Anopheles eqenjini le-LLIN + Bti zehla zisuka ku-0.22 [95% CI 0.04–0.40] zaya ku-0.03 [95% CI 0.00–0.06] L/dip (Fig. 2B).Eqenjini le-LLN kuphela, ukuminyana kwezibungu ezingasekho ze-Anopheles kukhuphuke kusuka ku-0.35 [95% CI - 0.15-0.76] kuya ku-2.77 [95% CI 1.13-4.40] l/dive ngokuhlukahluka okuthile kokuminyana kwezibungu kuye ngedethi yesampula.Isilinganiso sokuminyana kwezibungu ezisanda kuzalwa u-Anopheles eqenjini le-LLN kuphela sasingu-2.07 [95% CI 1.84–2.29] L/dive, ngokuphindwe kasishiyagalolunye ngaphezu kuka-0.23 [95% CI 0.11–0.36] l/ukucwiliswa e-LLIN.+ Iqembu le-Bti (RR = 8.80; 95% CI 7.40-10.57; P <0.001).
Ukuminyana okumaphakathi kwe-Culex spp.Amanani abengu-0.33 [95% CI 0.21–0.45] L/dip eqenjini le-LLN + Bti kanye no-2.67 [95% CI 2.23–3.10] L/dip eqenjini le-LLN kuphela (ifayela elengeziwe 2: Umfanekiso S2).Ukuminyana okumaphakathi kwe-Culex spp.Iqembu le-LLN lodwa laliphakeme kakhulu kuneqembu le-LLIN + Bti (HR = 8.00; 95% CI 6.90-9.34; P <0.001).
Ukuminyana okumaphakathi kohlobo lwe-Culex Culex spp.Ngaphambi kokwelashwa, i-Bti l/dip yayingu-1.26 [95% CI 0.10-2.42] l/dip eqenjini le-LLN + Bti kanye ne-1.28 [95% CI 0.37-2.36] eqenjini kuphela LLIN (Fig. 3A).Ngemuva kokusetshenziswa kokwelashwa kwe-Bti, ukuminyana kwezibungu ze-Culex zakuqala zehla kusuka ku-0.07 [95% CI - 0.001-0.] kuya ku-0.25 [95% CI 0.006-0.51] L/dip.Azikho izibungu ze-Culex ezaqoqwa ezindaweni ezihlala izibungu eziphathwe nge-Bti kusukela ngoDisemba.Ukuminyana kwezibungu ze-Culex zakuqala zehlisiwe zaba ngu-0.21 [95% CI 0.14–0.28] L/dip eqenjini le-LLN + Bti, kodwa laliphezulu eqenjini le-LLIN kuphela ku-1.30 [95% CI 1.10– 1.50] l/ukucwiliswa.lahla/d.Ubuningi bezibungu ze-Culex zakuqala eqenjini le-LLN kuphela laliphindwe izikhathi ezingu-6 kuneqembu le-LLN + Bti (RR = 6.17; 95% CI 5.11-7.52; P <0.001).
Izinguquko ekumineni okumaphakathi kwe-Culex spp.izibungu.Ukuhlolwa kwempilo yangaphambi kwesikhathi (A) kanye nempilo yangaphambi kwesikhathi (B) eqenjini locwaningo kusukela ngoMashi 2019 kuya kuFebruwari 2020 esifundeni saseNapier, enyakatho ye-Côte d'Ivoire.Inethi ebulala izinambuzane ehlala isikhathi eside i-LLIN, i-Bti Bacillus thuringiensis Israel, ukwelashwa kwe-Trt
Ngaphambi kokwelashwa kwe-Bti, ukuminyana kwesilinganiso sezibungu ze-instar Culex sekwephuzile eqenjini le-LLN + Bti kanye neqembu le-LLIN lalingu-0.97 [95% CI 0.09-1.85] kanye no-1.60 [95% CI - 0.16-3.37] l/ukucwiliswa ngokufanele (Fig. 3b)).Ukuminyana okushiwo kwezinhlobo ze-Culex eziphuma sekwephuzile ngemva kokuqaliswa kokwelashwa kwe-Bti.Ukuminyana eqenjini le-LLN + Bti kwehla kancane kancane futhi kwaba ngaphansi kwalelo qembu le-LLIN kuphela, elahlala liphezulu kakhulu.Isilinganiso sokuminyana kwezibungu ze-instar Culex sekwephuzile kwaba ngu-0.12 [95% CI 0.07–0.15] L/dive eqenjini le-LLN + Bti kanye no-1.36 [95% CI 1.11–1.61] L/dive eqenjini kuphela i-LLN.Isilinganiso sokuminyana kwezibungu ze-Culex ezifika sekwephuzile zaziphakeme kakhulu eqenjini le-LLN kuphela kuneqembu le-LLN + Bti (RR = 11.19; 95% CI 8.83–14.43; P <0.001).
Ngaphambi kokwelashwa kwe-Bti, ukuminyana kwe-pupae nge-ladybug ngayinye kwakungu-0.59 [95% CI 0.24-0.94] eqenjini le-LLN + Bti kanye no-0.38 [95% CI 0.13-0.63] ku-LLN kuphela (Fig. 4).Sekukonke ukuminyana komfundi kwaba ngu-0.10 [95% CI 0.06–0.14] eqenjini le-LLN + Bti kanye no-0.84 [95% CI 0.75–0.92] eqenjini le-LLN kuphela.Ukwelashwa kwe-Bti kunciphise kakhulu ukuminyana kwe-pupal emaphakathi eqenjini le-LLN + Bti uma kuqhathaniswa neqembu le-LLN kuphela (NOMA = 8.30; 95% CI 6.37-11.02; P <0.001).Eqenjini le-LLN + Bti, azikho iziphungumangathi ezaqoqwa ngemva kukaNovemba.
Izinguquko kubuningi obumaphakathi beziphungumangathi.Ucwaningo lwenziwe kusukela ngoMashi 2019 kuya kuFebhuwari 2020 esifundeni saseNapier enyakatho yeCôte d'Ivoire.Inethi ebulala izinambuzane ehlala isikhathi eside i-LLIN, i-Bti Bacillus thuringiensis Israel, ukwelashwa kwe-Trt
Kwaqoqwa omiyane abadala abangu-3456 endaweni yocwaningo.Omiyane bayingxenye yezinhlobo ezingu-17 zezinhlobo ezi-5 (i-Anopheles, Culex, Aedes, Eretmapodites) (Ithebula 1).Kumagciwane kamalaleveva An.i-gambiae sl yayiwuhlobo oluningi kakhulu olunengxenye engu-74.9% (n = 2587), ilandelwa i-An.gambia sl.i-funestus (2.5%, n = 86) kanye ne-An null (0.7%, n = 24).Umcebo ka-Anna.I-gambiae sl eqenjini le-LLN + Bti (10.9%, n = 375) yayiphansi kuneqembu le-LLN kuphela (64%, n = 2212).Akukho ukuthula.nli abantu bahlanganiswe ne-LLIN kuphela.Nokho, u-An.gambiae kanye no-An.u-funestus wayekhona kuwo womabili iqembu le-LLIN + Bti kanye neqembu le-LLIN lodwa.
Ezifundweni eziqala ngaphambi kwesicelo se-Bti endaweni yokuzalanisa (izinyanga ze-3), inani eliphelele lezinombolo zomiyane ebusuku ngomuntu ngamunye (b/p/n) eqenjini le-LLN + Bti lalilinganiselwa ku-0.83 [95% CI 0.50-1.17] , kanti eqenjini le-LLN + Bti laliyi-0.72 eqenjini le-LLN kuphela [95% CI 0.41-1.02] (Fig. 5).Eqenjini le-LLN + Bti, umonakalo womiyane we-Culex wehla futhi wahlala uphansi naphezu kwenani eliphakeme le-1.95 [95% CI 1.35-2.54] bpp ngo-September ngemva kwesicelo se-12th Bti.Kodwa-ke, eqenjini le-LLN kuphela, izinga lokulunywa omiyane elilinganiselwe lenyuka kancane kancane ngaphambi kokukhuphuka ngo-September ngo-11.33 [95% CI 7.15–15.50] bp/n.Isigameko esiphelele sokulunywa komiyane sasiphansi kakhulu eqenjini le-LLN + Bti uma kuqhathaniswa neqembu le-LLN kuphela nganoma yisiphi isikhathi ngesikhathi socwaningo (HR = 3.66; 95% CI 3.01-4.49; P <0.001).
Izinga lokulunywa kwezilwane zomiyane endaweni yocwaningo yesifunda saseNapier enyakatho ye-Côte d'Ivoire kusukela ngoMashi 2019 kuya kuFebhuwari 2020 LLIN Net ebulala izinambuzane ehlala isikhathi eside, i-Bti Bacillus thuringiensis Israel, ukwelashwa kwe-Trt, ukulunywa b/p/night/ human/ ebusuku
I-Anopheles gambiae iwumkhuhlane ovame kakhulu umalaleveva endaweni yocwaningo.Ijubane lokuluma lika-An.Ekuqaleni, abesifazane baseGambia babe namanani e-b/p/n angu-0.64 [95% CI 0.27–1.00] eqenjini le-LLN + Bti kanye no-0.74 [95% CI 0.30–1.17] eqenjini kuphela i-LLN (Fig. 6) .Phakathi nesikhathi sokungenelela kwe-Bti, umsebenzi wokuluma ophakeme kakhulu wabonwa ngo-September, ohambisana nenkambo yeshumi nambili yokwelashwa kwe-Bti, enenani eliphakeme le-1.46 [95% CI 0.87-2.05] b/p/n eqenjini le-LLIN + Bti kanye ne- inani eliphakeme elingu-9 .65 [95% CI 0.87–2.05] w/n 5.23–14.07] LLIN iqembu kuphela.Isivinini sokuluma sisonke se-An.Izinga lokutheleleka e-Gambia laliphansi kakhulu eqenjini le-LLIN + Bti (0.59 [95% CI 0.43-0.75] b/p/n) kuneqembu le-LLIN kuphela (2.97 [95% CI 2, 02-3.93] b /p/cha).(RR = 3.66; 95% CI 3.01–4.49; P <0.001).
Ijubane lokuluma lika-Anna.i-gambiae sl, iyunithi yocwaningo esifundeni saseNapier, enyakatho ye-Cote d'Ivoire, kusukela ngoMashi 2019 kuya kuFebhuwari 2020 inethi ehlala isikhathi eside efakwe isibulala-zinambuzane se-LLIN, Bti Bacillus thuringiensis Israel, Trt treatment, ukulunywa b/p/night/ umuntu/ubusuku
Isamba esingu-646 amps.IGambia inqunywe izitho.Sekukonke, iphesenti lokuvikeleka kwasendaweni.Amazinga okulingana e-Gambia ngokuvamile ayengu->70% kuso sonke isikhathi socwaningo, ngaphandle kukaJulayi, lapho kwasetshenziswa iqembu le-LLN kuphela (Ifayela elengeziwe 3: Umfanekiso S3).Nokho, izinga lokuzala elimaphakathi endaweni yocwaningo lalingama-74.5% (n = 481).Eqenjini le-LLN + Bti, izinga lokulinganisa lahlala lisezingeni eliphezulu, ngaphezu kwe-80%, ngaphandle kukaSeptemba, lapho izinga lokulinganisa lehla ku-77.5%.Kodwa-ke, ukuhluka kwamazinga okuzala alinganisiwe kuye kwabonwa eqenjini le-LLN kuphela, nesilinganiso esiphansi esilinganisiwe sesilinganiso sokuzala singama-64.5%.
Kusukela ku-389 Ann.Ucwaningo lwamayunithi egazi ngamanye avela eGambia luthole ukuthi u-80.5% (n = 313) ungowomuntu, u-6.2% (n = 24) wabesifazane udle igazi elixubile (elomuntu nelasekhaya) bese kuthi u-5.1% (n = 20) adle igazi. .Ukudla okuphuma emfuyweni (izinkomo, izimvu nezimbuzi) kanye no-8.2% (n = 32) wamasampula ahlaziywe ayengenalo ukudla kwegazi.Eqenjini le-LLN + Bti, ingxenye yabesifazane abathola igazi lomuntu yayingu-25.7% (n = 100) uma kuqhathaniswa ne-54.8% (n = 213) eqenjini le-LLN kuphela (Ifayela Lokwengeza 5: Ithebula S5).
Isamba esingu-308 amps.I-P. gambiae yahlolelwa ukuhlonza amalungu ezinhlobo zezinhlobo eziyinkimbinkimbi kanye nokutheleleka kwe-P. falciparum (Ifayela elengeziwe 4: Ithebula S4).Izinhlobo ezimbili “ezihlobene” zihlala ndawonye endaweni yocwaningo, okuyi-An.i-gambiae ss (95.1%, n = 293) kanye ne-An.coluzzii (4.9%, n = 15).I-Anopheles gambiae ss yayiphansi kakhulu eqenjini le-LLN + Bti kuneqembu le-LLN kuphela (66.2%, n = 204) (RR = 2.29 [95% CI 1.78–2.97], P <0.001) .Ingxenye efanayo yomiyane i-Anopheles itholwe eqenjini le-LLIN + Bti (3.6%, n = 11) kanye neqembu le-LLIN kuphela (1.3%, n = 4) (RR = 2.75 [95% CI 0.81-11 .84], P = .118).Ukusabalala kokutheleleka nge-Plasmodium falciparum phakathi kwe-An.I-SL e-Gambia yayingu-11.4% (n = 35).Amazinga okutheleleka nge-Plasmodium falciparum.Izinga lokutheleleka eGambia laliphansi kakhulu eqenjini le-LLIN + Bti (2.9%, n = 9) kuneqembu le-LLIN kuphela (8.4%, n = 26) (RR = 2.89 [95% CI 1. 31-7.01 ], P = 0.006).).Uma kuqhathaniswa nomiyane i-Anopheles, omiyane i-Anopheles gambiae babenenani eliphakeme kakhulu lokutheleleka nge-Plasmodium ku-94.3% (n=32).coluzzii kuphela 5.7% (n = 5) (RR = 6.4 [95% CI 2.47-21.04], P <0.001).
Bangu-2,435 sebebonke abantu abavela emakhaya angama-400 abahloliwe.Isilinganiso sokuminyana singabantu abangu-6.1 umuzi ngamunye.Izinga lobunikazi be-LLIN phakathi kwemizi lalingu-85% (n = 340), uma kuqhathaniswa no-15% (n = 60) emakhaya angenayo i-LLIN (RR = 5.67 [95% CI 4.29–7.59], P <0.001) ( Ifayela elengeziwe 5 : Ithebula S5)..Ukusetshenziswa kwe-LLIN kwakungu-40.7% (n = 990) eqenjini le-LLN + Bti uma kuqhathaniswa ne-36.2% (n = 882) eqenjini le-LLIN yedwa (RR = 1.12 [95% CI 1.02-1.23], P = 0.013).Isilinganiso sesilinganiso sengqikithi yokusetshenziswa kwengqikithi endaweni yocwaningo sasingu-38.4% (n = 1842).Ingxenye yezingane ezingaphansi kweminyaka emihlanu ubudala ezisebenzisa i-inthanethi yayifana kuwo womabili amaqembu ocwaningo, ngamanani okusebenzisa inetha angu-41.2% (n = 195) eqenjini le-LLIN + Bti kanye ne-43.2% (n = 186) eqenjini kuphela i-LLN.(HR = 1.05 [95% CI 0.85–1.29], P = 0.682).Phakathi kwezingane ezineminyaka engu-5 kuya ku-15 ubudala, wawungekho umehluko emazingeni okusebenzisa inetha phakathi kuka-36.3% (n = 250) eqenjini le-LLIN + Bti kanye no-36.9% (n = 250) eqenjini le-LLIN kuphela (RR = 1. 02 [ 95% CI 1.02–1.23], P = 0.894).Kodwa-ke, labo abangaphezu kweminyaka engu-15 ubudala basebenzisa amanetha emibhede engu-42.7% (n = 554) ngaphansi kweqembu le-LLIN + Bti kune-33.4% (n = 439) eqenjini le-LLIN kuphela (RR = 1.26 [95% CI 1.11–1.43) ], P <0.001).
Isamba sezehlakalo zomtholampilo ezingu-2,484 zarekhodwa eSikhungweni Sezempilo SaseNapier phakathi kukaMashi 2018 noFebruwari 2020. Ukusabalala kukamalaleveva wasemtholampilo emphakathini jikelele bekungama-82.0% azo zonke izimo ze-clinical pathology (n = 2038).Izibalo zendawo zonyaka ze-malaria kule ndawo yocwaningo zazingama-479.8 ‰ kanye no-297.5‰ ngaphambi nangemva kokwelashwa kwe-Bti (Ithebula 2).
Isikhathi sokuthumela: Jul-01-2024