Ukwehla kwamuva nje komthwalo we-malaria eCôte d'Ivoire kubangelwa kakhulu ukusetshenziswa kwamanethi okubulala izinambuzane ahlala isikhathi eside (i-LIN). Kodwa-ke, le ntuthuko isongelwa ukumelana nezinambuzane, izinguquko zokuziphatha emiphakathini ye-Anopheles gambiae, kanye nokusabalala kwe-malaria okusele, okwenza kudingeke amathuluzi engeziwe. Ngakho-ke, inhloso yalolu cwaningo kwakuwukuhlola ukusebenza kahle kokusetshenziswa okuhlangene kwe-LLIN kanye ne-Bacillus thuringiensis (Bti) bese kuqhathaniswa ne-LLIN.
Ucwaningo lwenziwe kusukela ngoMashi 2019 kuya kuFebhuwari 2020 kuzo zombili izingalo zocwaningo (ingalo ye-LLIN + Bti kanye nengalo ye-LLIN kuphela) esifundeni sezempilo saseKorhogo enyakatho yeCôte d'Ivoire. Eqenjini le-LLIN + Bti, izindawo zokuhlala zama-larval ze-Anopheles zazelashwa nge-Bti njalo emavikini amabili ngaphezu kwe-LLIN. Omiyane bama-larval kanye nabantu abadala baqoqwa futhi bahlonzwa ngokwesimo sabo ngokohlobo kanye nezinhlobo kusetshenziswa izindlela ezijwayelekile. Ilungu u-Ann. I-Gambian complex yahlolwa kusetshenziswa ubuchwepheshe bokusabela kwe-polymerase chain. Ukutheleleka nge-Plasmodium An. Ukusabalala komalaleveva eGambia kanye nabantu bendawo nakho kwahlolwa.
Sekukonke, i-Anopheles spp. Ubuningi bezibungu babuphansi eqenjini le-LLIN + Bti uma kuqhathaniswa neqembu le-LLIN lodwa elingu-0.61 [95% CI 0.41–0.81] izibungu/ukuntywila (l/ukuntywila) 3.97 [95% CI 3.56–4 .38] l/ukuntywila (RR = 6.50; 95% CI 5.81–7.29 P < 0.001). Isivinini sokuluma se-An. Ukuvama kokuluma kwe-S. gambiae kwakungu-0.59 [95% CI 0.43–0.75] ngomuntu/ngobusuku eqenjini le-LLIN + Bti lodwa, uma kuqhathaniswa nokuluma okungu-2.97 [95% CI 2.02–3. 93] ngomuntu/ngobusuku eqenjini le-LLIN kuphela (P < 0.001). I-Anopheles gambiae sl ibizwa ngokuthi umiyane we-Anopheles. I-Anopheles gambiae (ss) (95.1%; n = 293), ilandelwe yi-Anopheles gambiae (4.9%; n = 15). Inkomba yegazi lomuntu endaweni yocwaningo yayingu-80.5% (n = 389). I-EIR yeqembu le-LLIN + Bti yayingu-1.36 ukulunywa okuthelelekile ngomuntu ngamunye ngonyaka (ib/p/y), kanti i-EIR yeqembu le-LLIN kuphela yayingu-47.71 ib/p/y. Ukusabalala komalaleveva kwehle kakhulu kusuka ku-291.8‰ (n = 765) kuya ku-111.4‰ (n = 292) eqenjini le-LLIN + Bti (P < 0.001).
Ukuhlanganiswa kwe-LLIN ne-Bti kunciphisa kakhulu ukwanda komalaleveva. Ukuhlanganiswa kwe-LLIN ne-Bti kungaba yindlela ehlanganisiwe ethembisayo yokulawula ngempumelelo i-An. IGambia ayinayo umalaleveva.
Naphezu kwentuthuko ekulawulweni kwe-malaria eminyakeni embalwa edlule, umthwalo we-malaria usalokhu uyinkinga enkulu e-Afrika eseningizimu yeSahara [1]. I-World Health Organization (WHO) ibike muva nje ukuthi kube nezigameko ze-malaria eziyizigidi ezingu-249 kanye nokufa okulinganiselwa ku-608,000 okuhlobene ne-malaria emhlabeni wonke ngo-2023 [2]. I-WHO African Region ibala u-95% wezigameko ze-malaria emhlabeni kanye no-96% wezigameko ze-malaria, kanti abesifazane abakhulelwe nezingane ezingaphansi kweminyaka emi-5 ubudala zithinteke kakhulu [2, 3].
Amanethi okubulala izinambuzane ahlala isikhathi eside (i-LLIN) kanye nokufutha okusele endlini (i-IRS) kudlale indima ebalulekile ekunciphiseni umthwalo we-malaria e-Afrika [4]. Ukwandiswa kwala mathuluzi okulawula i-malaria vector kuholele ekunciphiseni okungu-37% kwezehlakalo ze-malaria kanye nokwehla okungu-60% ekufeni phakathi kuka-2000 no-2015 [5]. Kodwa-ke, izitayela ezibonwe kusukela ngo-2015 ziye zama ngendlela eshaqisayo noma ngisho nokusheshisa, kanti ukufa kwe-malaria kusalokhu kuphezulu ngendlela engamukeleki, ikakhulukazi e-Afrika engaphansi kweSahara [3]. Izifundo eziningana zikhombe ukuvela nokusabalala kokumelana phakathi kwe-malaria vector enkulu i-Anopheles kuma-insecticide asetshenziswa empilweni yomphakathi njengesivimbelo ekusebenzeni kwe-LLIN ne-IRS esikhathini esizayo [6,7,8]. Ngaphezu kwalokho, izinguquko ekuziphatheni kokuluma kwe-vector ngaphandle nangaphambi kobusuku zibangela ukusabalala kwe-malaria futhi ziyinkinga ekhulayo [9, 10]. Ukulinganiselwa kwe-LLIN ne-IRS ekulawuleni ama-vector abangela ukusabalala kwe-malaria kuyisithiyo esikhulu semizamo yamanje yokuqeda i-malaria [11]. Ngaphezu kwalokho, ukuqhubeka kwe-malaria kuchazwa yizimo zezulu kanye nemisebenzi yabantu, okufaka isandla ekudalweni kwezindawo zokuhlala zama-larval [12].
Ukuphathwa komthombo wezibungu (i-LSM) kuyindlela esuselwe endaweni yokuzalela yokulawula izimbungu ehlose ukunciphisa inani lezindawo zokuzalela kanye nenani lezibungu zomiyane kanye nezimpungushe eziqukethwe kuzo [13]. I-LSM inconywe yizifundo eziningana njengesu elihlanganisiwe elengeziwe lokulawula izimbungu zomalaleve [14, 15]. Eqinisweni, ukusebenza kahle kwe-LSM kunikeza izinzuzo ezimbili ngokumelene nokulunywa kwezinhlobo zezimbungu zomalaleve ngaphakathi nangaphandle [4]. Ngaphezu kwalokho, ukulawulwa kwezimbungu ngama-LSM asuselwe kuma-larvicide njenge-Bacillus thuringiensis israelensis (Bti) kungandisa ububanzi bezinketho zokulawula umaleveva. Ngokomlando, i-LSM idlale indima ebalulekile ekulawulweni ngempumelelo komaleveva e-United States, eBrazil, eGibhithe, e-Algeria, eLibya, eMorocco, eTunisia naseZambia [16,17,18]. Nakuba i-LSM idlale indima ebalulekile ekuphathweni kwezinambuzane okuhlanganisiwe kwamanye amazwe aqede umaleveva, i-LSM ayizange ihlanganiswe kabanzi ezinqubweni nasezindleleni zokulawula izimbungu zomalaleveva e-Afrika futhi isetshenziswa kuphela ezinhlelweni zokulawula izimbungu kwamanye amazwe angaphansi kweSahara. amazwe [14,15,16,17,18,19]. Esinye isizathu salokhu yinkolelo esakazekile yokuthi izindawo zokuzalela ziningi kakhulu futhi kunzima ukuzithola, okwenza i-LSM ibize kakhulu ukuyisebenzisa [4, 5, 6, 7, 8, 9, 10, 11, 13, 14]. Ngakho-ke, i-World Health Organization isincome amashumi eminyaka ukuthi izinsiza eziqoqwe zokulawula i-malaria vector kufanele zigxile ku-LLIN kanye ne-IRS [20, 21]. Kwaze kwaba ngu-2012 lapho i-World Health Organization yancoma ukuhlanganiswa kwe-LSM, ikakhulukazi ukungenelela kwe-Bti, njengokwengeza ku-LLIN kanye ne-IRS ezindaweni ezithile e-Afrika engaphansi kweSahara [20]. Selokhu i-WHO yenza lesi sincomo, kuye kwenziwa izifundo eziningana zokuhlola mayelana nokungenzeka, ukusebenza kahle kanye nezindleko zemithi yokubulala izinambuzane e-Afrika engaphansi kweSahara, okubonisa ukusebenza kahle kwe-LSM ekunciphiseni ubuningi bomiyane be-Anopheles kanye nokusebenza kahle kokudluliselwa kwemalariya ngokwe-[22, 23]. . , 24].
ICôte d'Ivoire iphakathi kwamazwe ayi-15 anomthwalo omkhulu kakhulu we-malaria emhlabeni [25]. Ukusabalala kwe-malaria eCôte d'Ivoire kumelela u-3.0% womthwalo we-malaria emhlabeni wonke, kanye nokulinganiselwa kwezehlakalo kanye nenani lamacala asukela ku-300 kuya ku-500 kubantu abayi-1000 [25]. Naphezu kwesizini ende yesomiso kusukela ngoNovemba kuya kuMeyi, i-malaria isakazeka unyaka wonke esifundeni sase-savanna esisenyakatho yezwe [26]. Ukusabalala kwe-malaria kulesi sifunda kuhlotshaniswa nokuba khona kwenani elikhulu labathwali be-Plasmodium falciparum abangenazo izimpawu [27]. Kulesi sifunda, i-malaria vector evame kakhulu yi-Anopheles gambiae (SL). Ukuphepha kwendawo. Omiyane be-Anopheles gambiae bakhiwe kakhulu yi-Anopheles gambiae (SS), emelana kakhulu nemithi yokubulala izinambuzane ngakho-ke ibeka ingozi enkulu yokusabalala kwe-malaria esele [26]. Ukusetshenziswa kwe-LLIN kungaba nomthelela omncane ekunciphiseni ukusabalala kwe-malaria ngenxa yokumelana nemithi yokubulala izinambuzane yemithi yokubulala izinambuzane yendawo ngakho-ke kusalokhu kuyindawo ekhathaza kakhulu. Izifundo zokuhlola ezisebenzisa i-Bti noma i-LLIN zibonise ukusebenza kahle ekunciphiseni ubuningi be-vector yomiyane enyakatho yeCôte d'Ivoire. Kodwa-ke, azikho izifundo zangaphambilini ezihlole umphumela wokusetshenziswa okuphindaphindiwe kwe-Bti ehlanganiswe ne-LLIN ekudlulisweni kwe-malaria kanye nokwanda kwe-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 lodwa emadolobhaneni amane esifundeni esisenyakatho yeCôte d'Ivoire. Kwakucatshangwa ukuthi ukusebenzisa i-LSM esekelwe ku-Bti phezu kwe-LLIN kuzokwengeza inani ngokunciphisa ubuningi be-malaria uma kuqhathaniswa ne-LLIN yodwa. Le ndlela ehlanganisiwe, ehlose omiyane abangakavuthwa abathwala i-Bti kanye nomiyane abadala abathwala i-LLIN, ingaba yinto ebalulekile ekunciphiseni ukudluliselwa kwe-malaria ezindaweni ezivame kakhulu yi-malaria, njengezindawo ezisenyakatho yeCôte d'Ivoire. Ngakho-ke, imiphumela yalolu cwaningo ingasiza ekunqumeni ukuthi kufanele yini ifake i-LSM ezinhlelweni zikazwelonke zokulawula i-malaria (NMCPs) emazweni aseningizimu yeSahara.
Ucwaningo lwamanje lwenziwe emadolobhaneni amane omnyango waseNapieldougou (owaziwa nangokuthi iNapier) endaweni yokuhlanzeka yaseKorhogo enyakatho yeCôte d'Ivoire (Isithombe 1). Amadolobhana ahlolwayo: iKakologo (9° 14′ 2″ N, 5° 35′ 22″ E), iKolekakha (9° 17′ 24″ N, 5° 31′ 00″ E .), iLofinekaha (9° 17′ 31″). ) 5° 36′ 24″ N) kanye neNambatiurkaha (9° 18′ 36″ N, 5° 31′ 22″ E). Inani labantu baseNapierledougou ngo-2021 lalinganiselwa ukuthi liyizakhamuzi ezingu-31,000, kanti lesi sifundazwe sakhiwe amadolobhana angu-53 anezikhungo zezempilo ezimbili [28]. Esifundeni saseNapyeledougou, lapho i-malaria iyimbangela ehamba phambili yokuvakashela udokotela, ukulaliswa esibhedlela kanye nokufa, i-LLIN kuphela esetshenziswa ukulawula i-Anopheles vectors [29]. Zonke izindawo ezine emaqenjini ocwaningo womabili zikhonzwa yisikhungo sezempilo esifanayo, esibuyekezwe amarekhodi aso emitholampilo amacala e-malaria kulolu cwaningo.
Imephu yaseCôte d'Ivoire ekhombisa indawo yokutadisha. (Umthombo wemephu kanye nesofthiwe: Idatha ye-GADM kanye ne-ArcMap 10.6.1. Inethi yokubulala izinambuzane ehlala isikhathi eside ye-LLIN, i-Bti Bacillus thuringiensis israelensis
Ukusabalala kwe-malaria phakathi kwabantu abahlosiwe yiNapier Health Center kufinyelele ku-82.0% (amacala angu-2038) (idatha yangaphambi kwe-Bti). Kuzo zonke izindawo ezine, imindeni isebenzisa i-PermaNet® 2.0 LLIN kuphela, esatshalaliswa yi-Ivorian NMCP ngo-2017, ngokumbozwa okungu-80% [25, 26, 27, 28, 30]. Izindawo zingaphansi kwesifunda saseKorhogo, esisebenza njengendawo yokuqapha i-Ivory Coast National Military Council futhi ifinyeleleka unyaka wonke. Indawo ngayinye kwezine inemindeni okungenani eyi-100 kanye nabantu abacishe babe yibo, futhi ngokusho kokubhaliswa kwezempilo (idokhumenti esebenzayo yoMnyango Wezempilo wase-Ivorian), amacala amaningana e-malaria abikwa minyaka yonke. I-malaria ibangelwa kakhulu yi-Plasmodium falciparum (P. falciparum) futhi idluliselwa kubantu yi-Plasmodium. I-gambiae idluliselwa futhi yi-Anopheles kanye ne-Anopheles nili omiyane esifundeni [28]. Indawo yendawo i-An. gambiae yakhiwe ngokuyinhloko omiyane be-Anopheles. I-gambiae ss inemvamisa ephezulu yokuguqulwa kwe-kdr (ububanzi bemvamisa: 90.70–100%) kanye nemvamisa ephakathi yama-allele e-ace-1 (ububanzi bemvamisa: 55.56–95%) [29].
Isilinganiso semvula yonyaka kanye nokushisa sisukela ku-1200 kuya ku-1400 mm kanye no-21 kuya ku-35 °C ngokulandelana, kanti umswakama ohlobene (RH) ulinganiselwa ku-58%. Le ndawo yocwaningo inesimo sezulu sohlobo lwaseSudan esinesizini esomile sezinyanga eziyi-6 (Novemba kuya ku-Ephreli) kanye nesizini yemvula yezinyanga eziyi-6 (Meyi kuya ku-Okthoba). Lesi sifunda sibhekene neminye yemiphumela yokushintsha kwesimo sezulu, njengokulahlekelwa yizitshalo kanye nesizini ende yesomiso, ebonakala ngokoma kwezindawo zamanzi (izindawo eziphansi, amasimu elayisi, amachibi, ama-chiddle) angasebenza njengendawo yokuhlala yezibungu zomiyane ze-Anopheles. Omiyane[26].
Ucwaningo lwenziwe eqenjini le-LLIN + Bti, elimelelwe yizindawo zaseKakologo naseNambatiurkaha, kanye naseqenjini le-LLIN kuphela, elimelelwe yizindawo zaseKolekaha naseLofinekaha. Phakathi nenkathi yalolu cwaningo, abantu kuzo zonke lezi zindawo babesebenzisa i-PermaNet® 2.0 LLIN kuphela.
Ukusebenza kahle kwe-LLIN (PermaNet 2.0) ngokuhlanganiswa ne-Bti ngokumelene nomiyane be-Anopheles kanye nokudluliswa komalaleveva kuhlolwe esivivinyweni esilawulwa ngokungahleliwe (i-RCT) esinezinhlaka ezimbili zocwaningo: iqembu le-LLIN + Bti (iqembu lokwelashwa) kanye neqembu le-LLIN lodwa (iqembu lokulawula). Imikhono ye-LLIN + Bti imelelwe yiKakologo kanye neNambatiourkaha, kuyilapho iKolékaha kanye neLofinékaha zaklanywa njengamahlombe e-LLIN kuphela. Kuzo zonke izindawo ezine, izakhamuzi zendawo zisebenzisa i-LLIN PermaNet® 2.0 eyatholwa yi-Ivory Coast NMCP ngo-2017. Kucatshangwa ukuthi izimo zokusebenzisa i-PermaNet® 2.0 ziyafana ezindaweni ezahlukene ngoba zathola inethiwekhi ngendlela efanayo. . Eqenjini le-LLIN + Bti, izindawo zokuhlala zama-larval ze-Anopheles zaphathwa nge-Bti njalo emavikini amabili ngaphezu kwe-LLIN esivele isetshenziswa ngabantu. Izindawo zokuhlala zezibungu ngaphakathi kwemizi kanye nasebangeni elingamakhilomitha ama-2 ukusuka enkabeni yedolobhana ngalinye zaphathwa ngokuvumelana nezincomo ze-World Health Organization kanye ne-NMCP yaseCôte d'Ivoire [31]. Ngokuphambene nalokho, iqembu le-LLIN kuphela alizange lithole ukwelashwa kwe-Bti okubulala izibungu ngesikhathi socwaningo.
Uhlobo lwe-Bti oluqhekeka ngamanzi (i-Vectobac WG, 37.4% wt; inombolo ye-lot 88–916-PG; 3000 International Toxicity Units IU/mg; Valent BioScience Corp, USA) lusetshenziswe ngesilinganiso esingu-0.5 mg/L. . Sebenzisa i-backpack sprayer engu-16L kanye ne-fiberglass spray gun enesibambo kanye ne-nozzle elungisekayo enesilinganiso sokugeleza esingu-52 ml ngomzuzwana (3.1 L/min). Ukuze ulungiselele i-nebulizer equkethe amalitha ayi-10 amanzi, inani le-Bti elixutshwe ekumisweni lingu-0.5 mg/L × 10 L = 5 mg. Isibonelo, endaweni enomthamo wamanzi oklanyiwe ongu-10 L, kusetshenziswa i-sprayer engu-10 L ukwelapha umthamo wamanzi, inani le-Bti elidinga ukuxutshwa lingu-0.5 mg/L × 20 L = 10 mg. I-10 mg Bti ilinganiswe ensimini kusetshenziswa isikali se-elekthronikhi. Usebenzisa i-spatula, lungisa i-slurry ngokuxuba leli nani le-Bti ebhakedeni eliphelele elingama-10 L. Leli dosi likhethwe ngemuva kokuhlolwa kwensimu kokusebenza kwe-Bti ngokumelene nezinhlobo ezahlukene ze-Anopheles spp. kanye ne-Culex spp. ezimweni zemvelo endaweni ehlukile, kodwa efana nendawo yocwaningo lwanamuhla [32]. Izinga lokusetshenziswa kwe-larvicide suspension kanye nobude besikhathi sokusetshenziswa kwendawo ngayinye yokuzalela kubalwe ngokusekelwe kumthamo wamanzi olinganisiwe endaweni yokuzalela [33]. Faka i-Bti usebenzisa i-sprayer yesandla elinganisiwe. Ama-Nebulizer ayalinganiswa futhi ahlolwe ngesikhathi sokuzivocavoca ngakunye nasezindaweni ezahlukene ukuqinisekisa ukuthi inani elifanele le-Bti liyalethwa.
Ukuze kutholakale isikhathi esingcono kakhulu sokwelapha izindawo zokuzalela zama-larva, ithimba lithole ukufutha ngefasitela. Ifasitela lokufutha yinkathi lapho umkhiqizo usetshenziswa khona ukuze kufezwe ukusebenza kahle: kulolu cwaningo, ifasitela lokufutha lalisukela emahoreni ayi-12 kuya emavikini ama-2, kuye ngokuphikelela kwe-Bti. Kubonakala sengathi ukufuthwa kwe-Bti yizibungu endaweni yokuzalela kudinga isikhathi kusukela ngo-7:00 kuya ku-18:00. Ngale ndlela, izikhathi zemvula enkulu zingagwenywa lapho imvula isho ukuyeka ukufutha nokuqala kabusha ngosuku olulandelayo uma isimo sezulu sivumelana. Izinsuku zokufutha nezinsuku eziqondile nezikhathi kuncike ezimweni zezulu eziqashelwayo. Ukuze kulinganiswe izifutho zesikhwama sezinyawo ukuze kutholakale izinga lokufaka i-Bti elifunekayo, uchwepheshe ngamunye uqeqeshwe ukuhlola ngokubonakalayo nokusetha umlomo wokufutha nokugcina ingcindezi. Ukulinganisa kuqedwa ngokuqinisekisa ukuthi inani elifanele lokwelashwa kwe-Bti lisetshenziswa ngokulinganayo endaweni ngayinye. Phatha indawo yokuhlala yezibungu njalo emavikini amabili. Imisebenzi yokubulala izibungu yenziwa ngokusekelwa ochwepheshe abane abanolwazi nabaqeqeshwe kahle. Imisebenzi yokubulala izibungu kanye nabahlanganyeli baqondiswa abaqondisi abanolwazi. Ukwelashwa ngokubulala izibungu kwaqala ngoMashi 2019 ngesikhathi sonyaka owomile. Eqinisweni, ucwaningo lwangaphambilini lukhombisile ukuthi isikhathi sonyaka owomile yisikhathi esifanele kakhulu sokungenelela kokubulala izibungu ngenxa yokuzinza kwezindawo zokuzalela kanye nokwehla kobuningi bazo [27]. Ukulawula izibungu ngesikhathi sonyaka owomile kulindeleke ukuthi kuvimbele ukukhangwa komiyane ngesikhathi sonyaka wemvula. Amakhilogremu amabili (02) e-Bti abiza u-US$99.29 avumela iqembu locwaningo elithola ukwelashwa ukuthi limboze zonke izindawo. Eqenjini le-LLIN+Bti, ukungenelela kokubulala izibungu kwathatha unyaka wonke, kusukela ngoMashi 2019 kuya kuFebhuwari 2020. Amacala angu-22 okwelashwa kokubulala izibungu kwenzeka eqenjini le-LLIN+Bti.
Imiphumela emibi engaba khona (njengokulunywa, isiyezi noma impumulo egobhozayo) iqashwe ngokuhlola ngakunye kwama-nebulizer e-Bti biolarvicide kanye nezakhamuzi zasemakhaya ezihlanganyela eqenjini le-LIN + Bti.
Ucwaningo lwemindeni lwenziwa phakathi kwemindeni engu-400 (imindeni engu-200 eqenjini ngalinye locwaningo) ukuze kulinganiswe iphesenti lokusetshenziswa kwe-LLIN phakathi kwabantu. Lapho kuhlolisiswa imindeni, kusetshenziswa indlela yemibuzo yokulinganisa. Ukusabalala kokusetshenziswa kwe-LLIN kwahlukaniswa ngamaqembu amathathu eminyaka: iminyaka engu-15. Uhlu lwemibuzo lwaqedwa futhi lwachazwa ngolimi lwesiSenoufo lwendawo enhloko yomndeni noma komunye umuntu omdala oneminyaka engaphezu kwengu-18 ubudala.
Usayizi omncane womndeni ohloliwe wabalwa kusetshenziswa ifomula echazwe nguVaughan noMorrow [34].
u-n usayizi wesampula, u-e umkhawulo wephutha, u-t uyisici sokuphepha esithathwe ezingeni lokuzethemba, kanti u-p uyingxenye yabazali bomphakathi abanesici esinikeziwe. Ingxenye ngayinye yengxenye inenani elifanayo, ngakho-ke u-(t) = 1.96; Usayizi omncane womndeni kulesi simo ocwaningweni wawuyimindeni engu-384.
Ngaphambi kokuhlolwa kwamanje, izinhlobo ezahlukene zezindawo zokuhlala zezibungu ze-Anopheles emaqenjini e-LLIN+Bti kanye ne-LLIN zatholakala, zathathwa amasampula, zachazwa, zafakwa amalebula endaweni ethile futhi zafakwa amalebula. Sebenzisa itheyipu yokulinganisa ukulinganisa usayizi wekoloni lokuzalela. Ubuningi bezibungu zomiyane bahlolwa njalo ngenyanga izinyanga ezingu-12 ezindaweni ezingu-30 ezikhethwe ngokungahleliwe zokuzalela edolobhaneni ngalinye, ukuze kube nezindawo ezingu-60 zokuzalela eqenjini ngalinye locwaningo. Kwakukhona amasampula angu-12 ezibungu endaweni ngayinye yocwaningo, okuhambisana nokwelashwa okungu-22 kwe-Bti. Inhloso yokukhetha lezi zindawo ezingu-30 zokuzalela edolobhaneni ngalinye kwakuwukubamba inani elanele lezindawo zokuqoqwa kwezibungu emizini kanye nasezindaweni zocwaningo ukuze kuncishiswe ukuthambekela. Izibungu zaqoqwa ngokucwilisa ngesipuni esingu-60 ml [35]. Ngenxa yokuthi ezinye izindawo zokukhulisa izithombo zincane kakhulu futhi azijulile, kubalulekile ukusebenzisa ibhakede elincane ngaphandle kwebhakede elijwayelekile le-WHO (350 ml). Kwakhiwa ukucwila okungu-5, 10 noma 20 ezindaweni zokuzalela ezinomjikelezo ongu-10 m, ngokulandelana. Ukuhlonza ngokwesimo sezibungu eziqoqiwe (isib. i-Anopheles, i-Culex kanye ne-Aedes) kwenziwa ngqo ensimini [36]. Izibungu eziqoqiwe zahlukaniswa ngezigaba ezimbili ngokusekelwe esigabeni sokukhula: izibungu zokuqala (izigaba 1 kanye ne-2) kanye nezibungu ze-late instar (izigaba 3 kanye ne-4) [37]. Izibungu zabalwa ngokwezizukulwane kanye naso sonke isigaba sokukhula. Ngemva kokubala, izibungu zomiyane zibuyiselwa ezindaweni zazo zokuzalela futhi zigcwaliswe ngobuningi bazo bokuqala ngamanzi omthombo anezelwe ngamanzi emvula.
Indawo yokuzalela yayibhekwa njengenhle uma okungenani kukhona i-larva noma i-pupa eyodwa yanoma yiluphi uhlobo lomiyane. Ubuningi bezibungu banqunywa ngokuhlukanisa inani lezibungu zohlobo olufanayo ngenani lezibungu ezicwila emanzini.
Ucwaningo ngalunye lwathatha izinsuku ezimbili zilandelana, futhi njalo ezinyangeni ezimbili, omiyane abadala babeqoqwa emizini eyi-10 ekhethwe ngokungahleliwe edolobhaneni ngalinye. Kuyo yonke le nqubo, ithimba ngalinye locwaningo lenze ucwaningo lwesampula lwemizi engama-20 ezinsukwini ezintathu zilandelana. Omiyane babanjwa kusetshenziswa izicupho ezijwayelekile zamafasitela (WT) kanye nezicupho ze-pyrethrum spray (PSC) [38, 39]. Ekuqaleni, zonke izindlu edolobhaneni ngalinye zazibalwa. Izindlu ezine edolobhaneni ngalinye zabe sezikhethwa ngokungahleliwe njengezindawo zokuqoqa omiyane abadala. Endlini ngayinye ekhethwe ngokungahleliwe, omiyane baqoqwa ekamelweni lokulala elikhulu. Amakamelo okulala akhethiwe aneminyango namafasitela futhi ahlalwa ngobusuku obandulele. Amakamelo okulala ahlala evaliwe ngaphambi kokuqala umsebenzi nangesikhathi sokuqoqwa komiyane ukuvimbela omiyane ukuba bangandizi baphume ekamelweni. I-WT yafakwa efasiteleni ngalinye lekamelo lokulala ngalinye njengendawo yokuthatha isampula yomiyane. Ngosuku olulandelayo, omiyane ababengena endaweni yokusebenza bevela emakamelweni okulala baqoqwa phakathi kuka-06:00 no-08:00 ekuseni. Qoqa omiyane endaweni yakho yokusebenza usebenzisa umlomo bese ubagcina endebeni yephepha elahlwayo elimbozwe ngengxenye eluhlaza. Inethi yomiyane. Omiyane ababelele ekamelweni elifanayo babanjwa ngokushesha ngemva kokuqoqwa kwe-WT kusetshenziswa i-PSC esekelwe ku-pyrethroid. Ngemva kokusakaza amashidi amhlophe phansi ekamelweni lokulala, vala iminyango namafasitela bese ufafaza izinambuzane (izithako ezisebenzayo: 0.25% transfluthrin + 0.20% permethrin). Cishe imizuzu eyi-10 kuya kweyi-15 ngemva kokufafaza, susa isembozo sebhedi ekamelweni lokulala eliphathwe kahle, sebenzisa ama-tweezers ukuze uqoqe noma yibaphi omiyane abafike emashidini amhlophe, bese ubagcina esitsheni sePetri esigcwele uboya bekotini obucwiliswe emanzini. Inani labantu abachithe ubusuku emakamelweni okulala akhethiwe nalo labhalwa phansi. Omiyane abaqoqiwe badluliselwa ngokushesha elabhorethri yasendaweni ukuze baqhubeke nokucutshungulwa.
Elabhorethri, bonke omiyane abaqoqiwe bahlonzwa ngokwesimo sabo ngokohlobo kanye nohlobo [36]. Ama-ovari ka-Anna. gambiae SL kusetshenziswa i-binocular dissecting microscope eneconsi lamanzi acwengekile abekwe ku-slide yengilazi [35]. Isimo sokulingana sahlolwa ukuze kuhlukaniswe abesifazane abanezibeletho eziningi kwabesifazane abangenazo izibeletho ngokusekelwe kusimo se-ovari kanye ne-tracheal, kanye nokunquma izinga lokuzala kanye nobudala be-physiological [35].
Inkomba ehlobene inqunywa ngokuhlola umthombo wokudla kwegazi okuqoqwe kabusha. gambiae nge-enzyme-linked immunosorbent assay (ELISA) kusetshenziswa igazi elivela kubantu, emfuyweni (izinkomo, izimvu, izimbuzi) kanye nenkukhu ephethwe yizinkukhu [40]. Ukutheleleka kwe-Entomological (EIR) kubalwe kusetshenziswa i-An. Izilinganiso zabesifazane abane-SL eGambia [41] Ngaphezu kwalokho, i-An. Ukutheleleka nge-Plasmodium gambiae kunqunywa ngokuhlaziya ikhanda nesifuba sabesifazane abanezimpandla eziningi kusetshenziswa indlela ye-circumsporozoite antigen ELISA (CSP ELISA) [40]. Okokugcina, kukhona amalungu e-Ann. gambiae ahlonzwe ngokuhlaziya imilenze yayo, amaphiko kanye nesisu kusetshenziswa amasu e-polymerase chain reaction (PCR) [34].
Idatha yezokwelapha nge-malaria itholakale kurejista yokubonisana ngezokwelapha yeNapyeledugou Health Centre, ehlanganisa zonke izindawo ezine ezifakiwe kulolu cwaningo (okungukuthi iKakologo, iKolekaha, iLofinekaha kanye neNambatiurkaha). Ukubuyekezwa kokubhalisa kugxile kumarekhodi kusukela ngoMashi 2018 kuya kuFebhuwari 2019 kanye kusukela ngoMashi 2019 kuya kuFebhuwari 2020. Idatha yezokwelapha kusukela ngoMashi 2018 kuya kuFebhuwari 2019 imele idatha yokuqala noma yokungenelela kwe-Bti, kanti idatha yezokwelapha kusukela ngoMashi 2019 kuya kuFebhuwari 2020 imele idatha yokungenelela kwe-Bti. Idatha ngemva kokungenelela kwe-Bti. Ulwazi lwezokwelapha, ubudala kanye nedolobhana lesiguli ngasinye emaqenjini ocwaningo e-LLIN+Bti kanye ne-LLIN kwaqoqwa kurejista yezempilo. Kusiguli ngasinye, ulwazi olufana nemvelaphi yedolobhana, ubudala, ukuxilongwa, kanye nesifo kwaqoshwa. Ezimweni ezibukezwe kulolu cwaningo, i-malaria yaqinisekiswa ngokuhlolwa okusheshayo kokuxilonga (RDT) kanye/noma nge-microscopy ye-malaria ngemuva kokuphathwa kwe-artemisinin-based combination therapy (ACT) ngumhlinzeki wezempilo. Amacala kamalariya ahlukaniswe ngamaqembu amathathu eminyaka (okungukuthi iminyaka eyi-15). Ukusabalala komalariya minyaka yonke kubantu abayi-1000 kwalinganiselwa ngokuhlukanisa ukusabalala komalariya kubantu abayi-1000 ngabantu basemakhaya.
Idatha eqoqwe kulolu cwaningo ifakwe kabili kusizindalwazi se-Microsoft Excel yabe isingeniswa kusofthiwe yomthombo ovulekile i-R [42] inguqulo 3.6.3 ukuze kuhlaziywe izibalo. Iphakheji ye-ggplot2 isetshenziselwa ukudweba amagrafu. Amamodeli aqondile ajwayelekile asebenzisa i-Poisson regression asetshenziswa ukuqhathanisa ubuningi bezibungu kanye nenani eliphakathi lokulunywa komiyane ngomuntu ngamunye ubusuku ngabunye phakathi kwamaqembu ocwaningo. Izilinganiso zesilinganiso sokufaneleka (RR) zisetshenziswe ukuqhathanisa ubuningi bezibungu kanye namazinga okuluma komiyane be-Culex kanye ne-Anopheles. I-Gambia SL ibekwe phakathi kwamaqembu ocwaningo amabili kusetshenziswa iqembu le-LLIN + Bti njengesisekelo. Osayizi bomphumela bavezwe njengezilinganiso zokungalingani kanye nezikhawu zokuzethemba ezingama-95% (95% CI). Isilinganiso (RR) sokuhlolwa kwe-Poisson sisetshenziswe ukuqhathanisa izilinganiso kanye namazinga okusabalala kwe-malaria ngaphambi nangemva kokungenelela kwe-Bti eqenjini ngalinye locwaningo. Izinga lokubaluleka elisetshenzisiwe lalingu-5%.
Iphrothokholi yocwaningo yamukelwe yiKomidi Likazwelonke Lokuziphatha Kocwaningo loMnyango Wezempilo kanye Nempilo Yomphakathi waseCôte d'Ivoire (Akukho Ref: 001//MSHP/CNESVS-kp), kanye nesifunda sezempilo sesifunda kanye nokuphathwa kweKorhogo. Ngaphambi kokuqoqa izibungu zomiyane kanye nabantu abadala, kwatholakala imvume enolwazi evela kubahlanganyeli bocwaningo lwasekhaya, abanikazi, kanye/noma abahlala kulo. Imininingwane yomndeni neyezokwelapha ayiziwa futhi iyimfihlo futhi itholakala kuphela kubaphenyi abaqokiwe.
Kuvakashelwe izindawo zokuzalela ezingu-1198. Kulezi zindawo zokuzalela ezihlolwe endaweni yocwaningo, u-52.5% (n = 629) wayengoweqembu le-LLIN + Bti kanye no-47.5% (n = 569) owayengoweqembu le-LLIN kuphela (RR = 1.10 [95% CI 0 .98–1.24], P = 0.088). Ngokuvamile, izindawo zokuhlala zama-larval zasendaweni zahlukaniswa ngezinhlobo ezingu-12, phakathi kwazo ingxenye enkulu yezindawo zokuhlala zama-larval kwakuyizinsimu zerayisi (24.5%, n=294), kulandelwe ukugeleza kwamanzi esiphepho (21.0%, n=252) kanye nobumba (8.3). %, n = 99), usebe lomfula (8.2%, n = 100), ichibi (7.2%, n = 86), ichibi (7.0%, n = 84), ipompo yamanzi yasemakhaya (6.8 %, n = 81), izinti zezinselo (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, kuqoqwe izibungu zomiyane ezingu-47,274 endaweni yokucwaninga, kanye nengxenye engu-14.4% (n = 6,796) eqenjini le-LLIN + Bti uma kuqhathaniswa no-85.6% (n = 40,478) eqenjini le-LLIN kuphela ((RR = 5.96) [95% CI 5.80–6.11], P ≤ 0.001). Lezi zibungu zakhiwa izinhlobo ezintathu zomiyane, uhlobo oluyinhloko yi-Anopheles. (48.7%, n = 23,041), kulandelwe yi-Culex spp. (35.0%, n = 16,562) kanye ne-Aedes spp. (4.9%, n = 2340). Ama-Pupae aqukethe u-11.3% wezimpukane ezingakavuthwa (n = 5344).
Isilinganiso sobuningi bezibungu ze-Anopheles spp.. Kulolu cwaningo, inani lezibungu ngesipuni ngasinye lalingu-0.61 [95% CI 0.41–0.81] L/dip eqenjini le-LLIN + Bti kanye no-3.97 [95% CI 3.56–4.38] L/dive eqenjini le-LLIN kuphela (ongakukhetha). ifayela 1: Umfanekiso S1). Isilinganiso sobuningi be-Anopheles spp. Iqembu le-LLIN lodwa laliphakeme ngokuphindwe ka-6.5 kuneqembu le-LLIN + Bti (HR = 6.49; 95% CI 5.80–7.27; P < 0.001). Akukho miyane ye-Anopheles etholakele ngesikhathi sokwelashwa. Izibungu zaqoqwa eqenjini le-LLIN + Bti kusukela ngoJanuwari, okuhambisana nokwelashwa kwe-Bti yamashumi amabili. Eqenjini le-LLIN + Bti, kwaba nokwehla okukhulu kwesigaba sokuqala nesokugcina sobuningi bezibungu.
Ngaphambi kokuqala kokwelashwa nge-Bti (ngoMashi), isilinganiso sobuningi bomiyane be-Anopheles bokuqala abaqalayo sasilinganiselwa ku-1.28 [95% CI 0.22–2.35] L/dive eqenjini le-LLIN + Bti kanye no-1.37 [95% CI 0.36–2.36] l/dive eqenjini le-LLIN + Bti. l/dip. /dip kuphela ingalo ye-LLIN (Isithombe 2A). Ngemva kokusetshenziswa kokwelashwa nge-Bti, isilinganiso sobuningi bomiyane be-Anopheles bokuqala eqenjini le-LLIN + Bti ngokuvamile sehla kancane kancane kusuka ku-0.90 [95% CI 0.19–1.61] kuya ku-0.10 [95% CI – 0.03–0.18] l/dip. Ubuningi bezibungu ze-Anopheles zokuqala bahlala buphansi eqenjini le-LLIN + Bti. Eqenjini le-LLIN kuphela, ukuguquguquka kobuningi be-Anopheles spp. Izibungu zakuqala zabonakala ngobuningi obuphakathi kusukela ku-0.23 [95% CI 0.07–0.54] L/dive kuya ku-2.37 [95% CI 1.77–2.98] L/dive. Sekukonke, ubukhulu obuphakathi bezibungu zakuqala ze-Anopheles eqenjini le-LLIN kuphela babuphakeme ngokwezibalo ku-1.90 [95% CI 1.70–2.10] L/dive, kuyilapho ubukhulu obuphakathi bezibungu zakuqala ze-Anopheles eqenjini le-LLIN babungu-0.38 [95% CI 0.28–0.47]) l/dip. + Bti group (RR = 5.04; 95% CI 4.36–5.85; P < 0.001).
Izinguquko ekubuneni okumaphakathi kwezibungu ze-Anopheles. Amanethi omiyane okuqala (A) kanye nawakamuva (B) eqenjini locwaningo kusukela ngoMashi 2019 kuya kuFebhuwari 2020 esifundeni saseNapier, enyakatho yeCôte d'Ivoire. I-LLIN: inethi yokubulala izinambuzane ehlala isikhathi eside I-Bti: I-Bacillus thuringiensis, kwa-Israyeli I-TRT: ukwelashwa;
Ubuningi obumaphakathi bezibungu ze-Anopheles spp.. ubudala obusemuva eqenjini le-LLIN + Bti. Ubuningi be-Bti ngaphambi kokwelashwa babungu-2.98 [95% CI 0.26–5.60] L/dip, kanti ubuningi eqenjini le-LLIN lodwa babungu-1.46 [95% CI 0.26–2.65] l/ngosuku Ngemva kokusetshenziswa kwe-Bti, ubuningi bezibungu ze-Anopheles ezisanda kutholakala eqenjini le-LLIN + Bti behle kusukela ku-0.22 [95% CI 0.04–0.40] kuya ku-0.03 [95% CI 0.00–0.06] L/dip (Isithombe 2B). Eqenjini le-LLIN kuphela, ubuningi bezibungu ze-Anopheles ezisanda kuphuma bukhuphuke busuka ku-0.35 [95% CI - 0.15-0.76] kuya ku-2.77 [95% CI 1.13-4.40] l/dive kanye nokwehluka okuthile kobuningi bezibungu kuye ngosuku lokuthathwa kwesampula. Ubuningi obumaphakathi bezibungu ze-Anopheles ezisanda kuphuma eqenjini le-LLIN kuphela babungu-2.07 [95% CI 1.84–2.29] L/dive, obuphakeme ngokuphindwe kasishiyagalolunye kuno-0.23 [95% CI 0.11–0. 36] l/immersion ku-LLIN. + Bti group (RR = 8.80; 95% CI 7.40–10.57; P < 0.001).
Amanani aphakathi kwe-Culex spp. ayengu-0.33 [95% CI 0.21–0.45] L/dip eqenjini le-LLIN + Bti kanye no-2.67 [95% CI 2.23–3.10] L/dip eqenjini le-LLIN kuphela (ifayela elengeziwe 2: Umfanekiso S2). Ubuningi obuphakathi kwe-Culex spp. Iqembu le-LLIN lodwa laliphakeme kakhulu kuneqembu le-LLIN + Bti (HR = 8.00; 95% CI 6.90–9.34; P < 0.001).
Ubuningi obumaphakathi bohlobo lweCulex Culex spp. Ngaphambi kokwelashwa, i-Bti l/dip yayingu-1.26 [95% CI 0.10–2.42] l/dip eqenjini le-LLIN + Bti kanye no-1.28 [95% CI 0.37–2.36] eqenjini elilodwa kuphela le-LLIN (Isithombe 3A). Ngemva kokusetshenziswa kokwelashwa kwe-Bti, ubuningi bezibungu ze-Culex zakuqala behle 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 zokuhlala zezibungu ezaphathwa nge-Bti kusukela ngoDisemba. Ubuningi bezibungu zeCulex zakuqala behliswe baba ngu-0.21 [95% CI 0.14–0.28] L/dip eqenjini le-LLIN + Bti, kodwa bebuphakeme eqenjini le-LLIN kuphela ku-1.30 [95% CI 1.10– 1.50] l/immersion. drop/d. Ubuningi bezibungu zeCulex zakuqala eqenjini le-LLIN kuphela bebuphakeme ngokuphindwe kasithupha kuneqembu le-LLIN + Bti (RR = 6.17; 95% CI 5.11–7.52; P < 0.001).
Izinguquko ekubuneni okumaphakathi kwezibungu ze-Culex spp.. Ukuhlolwa kokuphila kwasekuqaleni (A) kanye nokuphila kwasekuqaleni (B) eqenjini locwaningo kusukela ngoMashi 2019 kuya kuFebhuwari 2020 esifundeni saseNapier, enyakatho yeCôte d'Ivoire. Inethi yokubulala izinambuzane ehlala isikhathi eside i-LLIN, i-Bti Bacillus thuringiensis Israel, ukwelashwa kwe-Trt
Ngaphambi kokwelashwa kwe-Bti, isilinganiso sobuningi bezibungu ze-instar Culex ezisekupheleni kwesikhathi eqenjini le-LLIN + Bti kanye neqembu le-LLIN sasingu-0.97 [95% CI 0.09–1.85] kanye no-1.60 [95% CI – 0.16–3.37] l/ukucwiliswa ngokufanele (Isithombe 3B) ). Isilinganiso sobuningi bezinhlobo ze-Culex ezisekupheleni kwesikhathi ngemuva kokuqala ukwelashwa kwe-Bti. Isilinganiso sobuningi eqenjini le-LLIN + Bti sehla kancane kancane futhi sasiphansi kunaleso eqenjini le-LLIN kuphela, esahlala siphezulu kakhulu. Isilinganiso sobuningi bezibungu ze-instar Culex ezisekupheleni kwesikhathi sasingu-0.12 [95% CI 0.07–0.15] L/ukucwila eqenjini le-LLIN + Bti kanye no-1.36 [95% CI 1.11–1.61] L/ukucwila eqenjini le-LLIN kuphela. Ubuningi obumaphakathi bezibungu ze-Culex ezisanda kutholakala babuphezulu kakhulu eqenjini le-LLIN kuphela kunaseqenjini le-LLIN + Bti (RR = 11.19; 95% CI 8.83–14.43; P < 0.001).
Ngaphambi kokwelashwa kwe-Bti, isilinganiso sobuningi be-pupae nge-ladybug sasingu-0.59 [95% CI 0.24–0.94] eqenjini le-LLIN + Bti kanye no-0.38 [95% CI 0.13–0.63] eqenjini le-LLIN kuphela (Isithombe 4). Ubuningi be-pupal buphelele babungu-0.10 [95% CI 0.06–0.14] eqenjini le-LLIN + Bti kanye no-0.84 [95% CI 0.75–0.92] eqenjini le-LLIN kuphela. Ukwelashwa kwe-Bti kunciphisa kakhulu isilinganiso sobuningi be-pupal eqenjini le-LLIN + Bti uma kuqhathaniswa neqembu le-LLIN kuphela (OR = 8.30; 95% CI 6.37–11.02; P < 0.001). Eqenjini le-LLIN + Bti, azikho izimbotshana ezaqoqwa ngemva kukaNovemba.
Izinguquko ekubuneni okumaphakathi kwama-pupae. Ucwaningo lwenziwe kusukela ngoMashi 2019 kuya kuFebhuwari 2020 esifundeni saseNapier enyakatho yeCôte d'Ivoire. Inethi yokubulala izinambuzane ehlala isikhathi eside i-LLIN, i-Bti Bacillus thuringiensis Israel, ukwelashwa kwe-Trt
Kuqoqwe omiyane abadala abangu-3456 endaweni yocwaningo. Omiyane bangaphansi kwezinhlobo ezingu-17 zezizukulwane ezi-5 (i-Anopheles, i-Culex, i-Aedes, i-Eretmapodites) (Ithebula 1). Kuma-vectors e-malaria i-An. gambiae sl yayiyizinhlobo eziningi kakhulu ezinesilinganiso esingu-74.9% (n = 2587), kulandelwe yi-An. gambiae sl. funestus (2.5%, n = 86) kanye ne-An null (0.7%, n = 24). Ingcebo ka-Anna. gambiae sl eqenjini le-LLIN + Bti (10.9%, n = 375) yayiphansi kunaseqenjini le-LLIN kuphela (64%, n = 2212). Akukho ukuthula. abantu ngabanye be-nli baqoqwa nge-LLIN kuphela. Kodwa-ke, i-An. gambiae kanye ne-An. funestus babekhona kokubili eqenjini le-LLIN + Bti kanye neqembu le-LLIN kuphela.
Ezifundweni eziqale ngaphambi kokusetshenziswa kwe-Bti endaweni yokuzalela (izinyanga ezi-3), inani elijwayelekile lomiyane basebusuku ngomuntu ngamunye (b/p/n) eqenjini le-LLIN + Bti kulinganiselwa ukuthi lingu-0.83 [95% CI 0.50–1.17], kanti eqenjini le-LLIN + Bti lalingu-0.72 eqenjini le-LLIN kuphela [95% CI 0.41–1.02] (Isithombe 5). Eqenjini le-LLIN + Bti, umonakalo womiyane we-Culex wehlile futhi wahlala uphansi naphezu kokuphakama kwe-1.95 [95% CI 1.35–2.54] bpp ngoSepthemba ngemuva kokusetshenziswa kwe-Bti yesi-12. Kodwa-ke, eqenjini le-LLIN kuphela, izinga lokulunywa komiyane elimaphakathi landa kancane kancane ngaphambi kokuphakama kwe-11.33 [95% CI 7.15–15.50] bp/n. Isilinganiso sokulunywa omiyane sasiphansi kakhulu eqenjini le-LLIN + Bti uma kuqhathaniswa neqembu le-LLIN lodwa nganoma yisiphi isikhathi ngesikhathi socwaningo (HR = 3.66; 95% CI 3.01–4.49; P < 0.001).
Amazinga okuluma kwezilwane ezincelisayo endaweni yokucwaninga yesifunda saseNapier enyakatho yeCôte d'Ivoire kusukela ngoMashi 2019 kuya kuFebhuwari 2020 LLIN Inethi yokubulala izinambuzane ehlala isikhathi eside, i-Bti Bacillus thuringiensis Israel, Ukwelashwa kwe-Trt, ukulunywa b/p/night/human/night
I-Anopheles gambiae iyona vector evame kakhulu ye-malaria endaweni yocwaningo. Isivinini sokuluma se-An. Ekuqaleni, abesifazane baseGambia babene-b/p/n values engu-0.64 [95% CI 0.27–1.00] eqenjini le-LLIN + Bti kanye no-0.74 [95% CI 0.30–1.17] eqenjini le-LLIN kuphela (Isithombe 6). Ngesikhathi sokungenelela kwe-Bti, umsebenzi omkhulu wokuluma wabonwa ngoSepthemba, okuhambisana nenkambo yeshumi nambili yokwelashwa kwe-Bti, enesilinganiso esiphezulu esingu-1.46 [95% CI 0.87–2.05] b/p/n eqenjini le-LLIN + Bti kanye nesilinganiso esiphezulu esingu-9 .65 [95% CI 0.87–2.05] w/n 5.23–14.07] iqembu le-LLIN kuphela. Isivinini sokuluma esiphelele se-An. Izinga lokutheleleka eGambia laliphansi kakhulu eqenjini le-LLIN + Bti (0.59 [95% CI 0.43–0.75] b/p/n) kunaseqenjini le-LLIN lodwa (2.97 [95% CI 2, 02–3.93] b/p/no). (RR = 3.66; 95% CI 3.01–4.49; P < 0.001).
Isivinini sokuluma sika-Anna. gambiae sl, iyunithi yocwaningo esifundeni saseNapier, enyakatho yeCote d'Ivoire, kusukela ngoMashi 2019 kuya kuFebhuwari 2020 Inethi yokulala ehlala isikhathi eside elashwe ngezibulala-zinambuzane i-LLIN, i-Bti Bacillus thuringiensis Israel, Ukwelashwa kwe-Trt, ukulunywa b/p/night/ person/night
Ingqikithi yama-amps angu-646. IGambia inqunyiwe. Sekukonke, iphesenti lokuphepha kwendawo. Amanani okulingana eGambia ngokuvamile ayengu->70% phakathi nesikhathi socwaningo, ngaphandle kukaJulayi, lapho kusetshenziswa iqembu le-LLIN kuphela (Ifayela elengeziwe 3: Umfanekiso S3). Kodwa-ke, isilinganiso sokuzala endaweni yocwaningo sasingu-74.5% (n = 481). Eqenjini le-LLIN+Bti, isilinganiso sokuzala sahlala sisezingeni eliphezulu, ngaphezu kuka-80%, ngaphandle kukaSepthemba, lapho izinga lokulingana lehla laya ku-77.5%. Kodwa-ke, ukwehluka kwamazinga okuzala aphakathi kwabonwa eqenjini le-LLIN kuphela, kanti isilinganiso sokuzala esiphansi kakhulu sasingu-64.5%.
Kusukela ku-389 Ann. Ucwaningo lwamayunithi egazi ngamanye avela eGambia luthole ukuthi ama-80.5% (n = 313) ayevela kubantu, ama-6.2% (n = 24) abesifazane badla igazi elixubile (lomuntu nelasekhaya) kanye nama-5.1% (n = 20) badla igazi. Ukudla okuvela emfuyweni (izinkomo, izimvu nezimbuzi) kanye nama-8.2% (n = 32) amasampula ahlaziyiwe ayenegative ekudleni kwegazi. Eqenjini le-LLIN + Bti, ingxenye yabesifazane abathola igazi lomuntu yayingu-25.7% (n = 100) uma kuqhathaniswa nama-54.8% (n = 213) eqenjini le-LLIN kuphela (Ifayela elingeziwe 5: Ithebula S5).
Ama-amps angu-308. I-P. gambiae ihlolwe ukuze kutholakale amalungu e-species complex kanye nokutheleleka kwe-P. falciparum (Ifayela elengeziwe 4: Ithebula S4). "Izinhlobo ezimbili ezihlobene" zihlala ndawonye endaweni yokucwaninga, okuyi-An. gambiae ss (95.1%, n = 293) kanye ne-An. coluzzii (4.9%, n = 15). Ama-Anopheles gambiae ss ayephansi kakhulu eqenjini le-LLIN + Bti kunaseqenjini le-LLIN lodwa (66.2%, n = 204) (RR = 2.29 [95% CI 1.78–2.97], P < 0.001). Ingxenye efanayo yomiyane i-Anopheles itholakale 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 kwe-Plasmodium falciparum phakathi kwe-An. SL eGambia kwakungu-11.4% (n = 35). Amazinga okutheleleka kwe-Plasmodium falciparum. Izinga lokutheleleka eGambia laliphansi kakhulu eqenjini le-LLIN + Bti (2.9%, n = 9) kunaseqenjini le-LLIN kuphela (8.4%, n = 26) (RR = 2.89 [95% CI 1. 31–7.01], P = 0.006). ). Uma kuqhathaniswa nomiyane be-Anopheles, omiyane be-Anopheles gambiae babenesilinganiso esiphezulu sokutheleleka kwe-Plasmodium ku-94.3% (n=32). I-coluzzii ingu-5.7% kuphela (n = 5) (RR = 6.4 [95% CI 2.47–21.04], P < 0.001).
Kuhlolwe abantu abangu-2,435 abavela emindenini engu-400. Isilinganiso sabantu singabantu abangu-6.1 ngomndeni ngamunye. Izinga lobunikazi be-LLIN phakathi kwemindeni lalingu-85% (n = 340), uma kuqhathaniswa no-15% (n = 60) emindenini engenayo 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-LLIN + Bti uma kuqhathaniswa no-36.2% (n = 882) eqenjini le-LLIN kuphela (RR = 1.12 [95% CI 1.02–1.23], P = 0.013). Izinga lokusetshenziswa kwe-net elijwayelekile endaweni yokucwaninga lalingu-38.4% (n = 1842). Ingxenye yabantwana abangaphansi kweminyaka emihlanu ubudala abasebenzisa i-inthanethi yayifana kuwo womabili amaqembu okufunda, ngamazinga okusetshenziswa aphelele angu-41.2% (n = 195) eqenjini le-LLIN + Bti kanye no-43.2% (n = 186) eqenjini le-LLIN kuphela. (HR = 1.05 [95% CI 0.85–1.29], P = 0.682). Phakathi kwezingane ezineminyaka engu-5 kuya kwengu-15, bekungekho mehluko emazingeni okusetshenziswa aphelele 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 abaneminyaka engaphezu kwengu-15 ubudala basebenzise amanethi ombhede angu-42.7% (n = 554) kancane eqenjini le-LLIN + Bti kunangu-33.4% (n = 439) eqenjini le-LLIN kuphela (RR = 1.26 [95% CI 1.11–1.43], P <0.001).
Isibalo samacala omtholampilo angu-2,484 aqoshwe eNapier Health Center phakathi kukaMashi 2018 noFebhuwari 2020. Ukusabalala komalaleveva emtholampilo kubantu bonke kwakungu-82.0% wazo zonke izimo ze-pathology yezokwelapha (n = 2038). Amanani onyaka okusabalala komalaleveva kule ndawo yocwaningo ayengu-479.8‰ kanye no-297.5‰ ngaphambi nangemva kokwelashwa kwe-Bti (Ithebula 2).
Isikhathi sokuthunyelwe: Julayi-01-2024