Izibulala-zinambuzane zidlala indima ebalulekile kwezolimo zasemakhaya, kodwa ukusetshenziswa kwazo ngokweqile noma ukusetshenziswa kabi kwazo kungathinta kabi izinqubomgomo zokulawula i-malaria vector; Lolu cwaningo lwenziwe phakathi kwemiphakathi yabalimi eningizimu yeCôte d'Ivoire ukuze kutholakale ukuthi yiziphi izibulala-zinambuzane ezisetshenziswa abalimi bendawo nokuthi lokhu kuhlobana kanjani nemibono yabalimi ngemalariya. Ukuqonda ukusetshenziswa kwezibulala-zinambuzane kungasiza ekuthuthukiseni izinhlelo zokuqwashisa mayelana nokulawulwa komiyane kanye nokusetshenziswa kwezibulala-zinambuzane.
Ucwaningo lwenziwe phakathi kwemindeni engu-1,399 emadolobhaneni ayi-10. Abalimi bahlolwe ngemfundo yabo, imikhuba yokulima (isib. ukukhiqizwa kwezitshalo, ukusetshenziswa kwezibulala-zinambuzane), imibono nge-malaria, kanye namasu ahlukahlukene okulawula omiyane basekhaya abawasebenzisile. Isimo sezomnotho nezomnotho (i-SES) somndeni ngamunye sihlolwa ngokusekelwe kwezinye izimpahla zasekhaya ezinqunyiwe. Ubudlelwano bezibalo phakathi kwezinguquko ezahlukene buyabalwa, okubonisa izici ezibalulekile zengozi.
Izinga lemfundo labalimi lihlotshaniswa kakhulu nesimo sabo sezomnotho (p < 0.0001). Iningi lemindeni (88.82%) likholelwa ukuthi omiyane bayimbangela eyinhloko ye-malaria futhi ulwazi lwe-malaria lwaluhlotshaniswa kahle nezinga lemfundo ephakeme (OR = 2.04; 95% CI: 1.35, 3.10). Ukusetshenziswa kwamakhemikhali ngaphakathi kwakuhlotshaniswa kakhulu nesimo sezomnotho semindeni, izinga lemfundo, ukusetshenziswa kwamanethi okulala aphathwe ngezibulala-zinambuzane kanye nezibulala-zinambuzane zezolimo (p < 0.0001). Abalimi bathole ukuthi basebenzisa izibulala-zinambuzane ze-pyrethroid ngaphakathi futhi basebenzisa lezi zibulala-zinambuzane ukuvikela izitshalo.
Ucwaningo lwethu lubonisa ukuthi izinga lemfundo lihlala liyisici esibalulekile esithonya ukuqwashisa kwabalimi ngokusetshenziswa kwezibulala-zinambuzane kanye nokulawulwa komalaleveva. Sincoma ukuthi ukuxhumana okuthuthukisiwe okuhlose ukufinyeleleka kwezemfundo, okuhlanganisa isimo sezenhlalo nezomnotho, ukutholakala, kanye nokufinyelela emikhiqizweni yamakhemikhali elawulwayo kucatshangelwe lapho kuthuthukiswa ukuphathwa kwezibulala-zinambuzane kanye nokungenelela kokuphathwa kwezifo ezithwalwa yizinambuzane emiphakathini yendawo.
Ezolimo ziwumthombo oyinhloko wezomnotho emazweni amaningi aseNtshonalanga Afrika. Ngo-2018 nango-2019, iCôte d'Ivoire yayingumkhiqizi ohamba phambili emhlabeni we-cocoa kanye ne-cashew nuts kanye nomkhiqizi wesithathu ngobukhulu wekhofi e-Afrika [1], lapho izinsizakalo zezolimo kanye nemikhiqizo zibalwa ku-22% womkhiqizo wasekhaya (i-GDP) [2]. Njengabanikazi bomhlaba omningi wezolimo, abalimi abancane ezindaweni zasemakhaya yibona abanegalelo elikhulu ekuthuthukisweni komnotho walo mkhakha [3]. Izwe linamandla amakhulu ezolimo, ngamahektha ayizigidi ezingu-17 okulima kanye nokushintshashintsha kwezinkathi zonyaka okukhuthaza ukuhlukahluka kwezitshalo kanye nokutshalwa kwekhofi, i-cocoa, ama-cashew nuts, irabha, ukotini, ama-yam, isundu, i-cassava, ilayisi kanye nemifino [2]. Ezolimo ezijulile zinegalelo ekusabalaleni kwezinambuzane, ikakhulukazi ngokusetshenziswa kakhulu kwezibulala-zinambuzane zokulawula izinambuzane [4], ikakhulukazi phakathi kwabalimi basemakhaya, ukuvikela izitshalo nokwandisa isivuno sezitshalo [5], kanye nokulawula omiyane [6]. Kodwa-ke, ukusetshenziswa okungafanele kwezibulala-zinambuzane kungenye yezimbangela eziyinhloko zokumelana nezibulala-zinambuzane ezifweni, ikakhulukazi ezindaweni zezolimo lapho omiyane nezinambuzane zezitshalo zingase zibe ngaphansi kwengcindezi yokukhetha evela kuzibulala-zinambuzane ezifanayo [7,8,9,10]. Ukusetshenziswa kwezibulala-zinambuzane kungabangela ukungcola okuthinta amasu okulawula izibulala-zinambuzane kanye nemvelo ngakho-ke kudinga ukunakwa [11, 12, 13, 14, 15].
Ukusetshenziswa kwezibulala-zinambuzane ngabalimi kuye kwafundwa esikhathini esidlule [5, 16]. Izinga lemfundo liboniswe njengesici esibalulekile ekusetshenzisweni kahle kwezibulala-zinambuzane [17, 18], yize ukusetshenziswa kwezibulala-zinambuzane ngabalimi kuvame ukuthonywa ulwazi oluvela kubathengisi [5, 19, 20]. Imingcele yezezimali ingenye yezithiyo ezivame kakhulu ezivimbela ukufinyelela kwezibulala-zinambuzane noma izibulala-zinambuzane, okuholela abalimi ekuthengeni imikhiqizo engekho emthethweni noma esiphelelwe yisikhathi, evame ukubiza kancane kunemikhiqizo esemthethweni [21, 22]. Imikhuba efanayo iyabonakala kwamanye amazwe aseNtshonalanga Afrika, lapho imali engenayo ephansi iyimbangela yokuthenga nokusebenzisa izibulala-zinambuzane ezingafanele [23, 24].
ECôte d'Ivoire, izibulala-zinambuzane zisetshenziswa kakhulu ezitshalweni [25, 26], okuthinta imikhuba yezolimo kanye nenani labantu abathwala i-malaria [27, 28, 29, 30]. Izifundo ezindaweni ezivame ukuba khona kwe-malaria zibonise ubudlelwano phakathi kwesimo sezomnotho kanye nemibono ye-malaria kanye nezingozi zokutheleleka, kanye nokusetshenziswa kwamanethi okulala aphathwe ngezinambuzane (i-ITN) [31,32,33,34,35,36,37]. Naphezu kwalezi zifundo, imizamo yokuthuthukisa izinqubomgomo ezithile zokulawula omiyane incishiswa ukuntuleka kolwazi mayelana nokusetshenziswa kwezibulala-zinambuzane ezindaweni zasemakhaya kanye nezici ezifaka isandla ekusetshenzisweni okufanele kwezibulala-zinambuzane. Lolu cwaningo luhlole izinkolelo ze-malaria kanye namasu okulawula omiyane phakathi kwemindeni yezolimo e-Abeauville, eningizimu yeCôte d'Ivoire.
Ucwaningo lwenziwe emadolobhaneni ayi-10 emnyangweni wase-Abeauville eningizimu yeCôte d'Ivoire (Isithombe 1). Isifundazwe sase-Agbowell sinabantu abangu-292,109 endaweni engamakhilomitha-skwele angu-3,850 futhi yisona sifundazwe esinabantu abaningi esifundeni sase-Anyebi-Tiasa [38]. Sinesimo sezulu esishisayo esinezinkathi ezimbili zemvula (Ephreli kuya kuJulayi kanye no-Okthoba kuya kuNovemba) [39, 40]. Ezolimo ziwumsebenzi oyinhloko esifundeni futhi zenziwa abalimi abancane kanye nezinkampani ezinkulu zezolimo. Lezi zindawo eziyi-10 zifaka u-Aboud Boa Vincent (323,729.62 E, 651,821.62 N), Aboud Kuassikro (326,413.09 E, 651,573.06 N), Aboud Mandek (326,413.09 E , 6515073,3073,3073,3073,651573. 652372.90N), Amengbeu (348477.76N), 664971.70N, Damojiang (374,039.75 E, 661,579.59 N), Gesigie 1 (363,140.15 E, 634,357 (351.456), Love. 642, 062.37 N), I-Ofa (350 924.31 E, 654 607.17 N), i-Ofonbo (338 578.5) 1 E, 657 302.17 N ) kanye ne-Oji (i-longitude 363,990.74 empumalanga, i-latitude 648,587.44 enyakatho).
Ucwaningo lwenziwe phakathi kuka-Agasti 2018 noMashi 2019 kanye nokubamba iqhaza kwemindeni yabalimi. Inani eliphelele lezakhamuzi edolobhaneni ngalinye latholakala emnyangweni wezinsizakalo wendawo, futhi abantu abayi-1,500 bakhethwa ngokungahleliwe kulolu hlu. Abahlanganyeli abaqokiwe bamele phakathi kuka-6% no-16% wabantu basemakhaya. Imindeni efakiwe ocwaningweni kwakuyileyo mindeni yabalimi evumile ukubamba iqhaza. Ucwaningo lokuqala lwenziwa phakathi kwabalimi abangu-20 ukuze kuhlolwe ukuthi ngabe eminye imibuzo idinga ukubhalwa kabusha. Imibuzo yabe isigcwaliswa ngabaqoqi bedatha abaqeqeshwe nabakhokhelwayo edolobhaneni ngalinye, okungenani oyedwa kubo owayeqashwe edolobhaneni uqobo. Lokhu kukhetha kwaqinisekisa ukuthi idolobhana ngalinye linomqoqi wedatha okungenani oyedwa owayejwayelene nendawo futhi ekhuluma ulimi lwendawo. Ekhaya ngalinye, ingxoxo yobuso nobuso yenziwa nenhloko yomndeni (ubaba noma umama) noma, uma inhloko yomndeni ingekho, omunye umuntu omdala oneminyaka engaphezu kwengu-18 ubudala. Uhlu lwemibuzo lwalunemibuzo engu-36 ehlukaniswe ngezigaba ezintathu: (1) Isimo sabantu kanye nesomphakathi kanye nezomnotho zomndeni (2) Imikhuba yezolimo kanye nokusetshenziswa kwezibulala-zinambuzane (3) Ulwazi ngomalaleveva kanye nokusetshenziswa kwezibulala-zinambuzane zokulawula omiyane [bheka iSithasiselo 1].
Izibulala-zinambuzane ezishiwo abalimi zabhalwa ngamakhodi ngamagama azo ezentengiselwano futhi zahlukaniswa ngezithako ezisebenzayo namaqembu amakhemikhali kusetshenziswa i-Ivory Coast Phytosanitary Index [41]. Isimo sezomnotho somndeni ngamunye sahlolwa ngokubala inkomba yempahla [42]. Impahla yasekhaya yaguqulwa yaba yiziguquguquko ezihlukene [43]. Izilinganiso zezici ezingezinhle zihlotshaniswa nesimo sezomnotho esiphansi (i-SES), kanti izilinganiso zezici ezinhle zihlotshaniswa ne-SES ephezulu. Izilinganiso zempahla zihlanganiswa ukuze kukhiqizwe amaphuzu aphelele omndeni ngamunye [35]. Ngokusekelwe kumaphuzu aphelele, imindeni yahlukaniswa yaba ama-quintile amahlanu esimo sezomnotho, kusukela kwabampofu kakhulu kuya kwabacebile kakhulu [bheka ifayela elingeziwe 4].
Ukuze kutholakale ukuthi i-variable ihluke kakhulu ngesimo sezomnotho, idolobhana, noma izinga lemfundo lamakhanda emindeni, ukuhlolwa kwe-chi-square noma ukuhlolwa okuqondile kukaFisher kungasetshenziswa, njengoba kufanele. Amamodeli okubuyela emuva kwe-Logistic afakwe lezi ziguquguquko ezilandelayo zokubikezela: izinga lemfundo, isimo sezomnotho (konke kuguqulwe kwaba yiziguquguquko ezihlukene), idolobhana (kufakwe njengeziguquguquko zesigaba), izinga eliphezulu lolwazi mayelana nomalaleveva nokusetshenziswa kwezibulala-zinambuzane kwezolimo, kanye nokusetshenziswa kwezibulala-zinambuzane ngaphakathi endlini (okukhiphayo ngebhodlela lokufafaza). noma ikhoyili); izinga lemfundo, isimo sezomnotho nezenhlalo kanye nedolobhana, okuholele ekuqwashisweni okuphezulu komalaleveva. Kwenziwe imodeli yokubuyela emuva okuxubile kwe-logistic kusetshenziswa iphakheji ye-R lme4 (umsebenzi we-Glmer). Ukuhlaziywa kwezibalo kwenziwe ku-R 4.1.3 (https://www.r-project.org) kanye ne-Stata 16.0 (StataCorp, College Station, TX).
Ezingxoxweni ezingu-1,500 ezenziwe, ezingu-101 azizange zifakwe ekuhlaziyweni ngoba uhlu lwemibuzo aluzange luqedwe. Ingxenye ephezulu kakhulu yemindeni ehlolwayo yayiseGrande Maury (18.87%) kanti ephansi kakhulu e-Ouanghi (2.29%). Imindeni engu-1,399 ehlolwayo efakiwe ekuhlaziyweni imele inani labantu abangu-9,023. Njengoba kuboniswe kuThebula 1, ama-91.71% ezinhloko zemindeni ngabesilisa kanti ama-8.29% ngabesifazane.
Cishe u-8.86% wezinhloko zemindeni zivela emazweni angomakhelwane njengeBenin, iMali, iBurkina Faso neGhana. Izinhlanga ezimelelwe kakhulu yi-Abi (60.26%), iMalinke (10.01%), iKrobu (5.29%) kanye neBaulai (4.72%). Njengoba bekulindelekile kusampula yabalimi, ezolimo ziwukuphela komthombo wemali engenayo kubalimi abaningi (89.35%), kanti i-cocoa iyisitshalo esivame ukutshalwa emindenini ehlolisisiwe; Imifino, izilimo zokudla, ilayisi, irabha kanye ne-plantain nakho kutshalwa endaweni encane yomhlaba. Izinhloko zemindeni ezisele zingabosomabhizinisi, abaculi kanye nabadobi (Ithebula 1). Isifinyezo sezimpawu zemindeni ngokwedolobhana sivezwa kufayela Lokwengeza [bheka ifayela Lokwengeza 3].
Isigaba semfundo asizange sehluke ngobulili (p = 0.4672). Iningi labaphenduli lalinemfundo yesikole samabanga aphansi (40.80%), kulandele imfundo yamabanga aphezulu (33.41%) kanye nokungafundi (17.97%). Bangu-4.64% kuphela abangene eyunivesithi (Ithebula 1). Kwabesifazane abangu-116 abahloliwe, abangaphezu kuka-75% babenemfundo yamabanga aphansi okungenani, kanti abanye babengakaze baye esikoleni. Izinga lemfundo labalimi liyahlukahluka kakhulu kuzo zonke izindawo (ukuhlolwa okuqondile kukaFisher, p < 0.0001), kanti izinga lemfundo lezinhloko zemindeni lihlobene kakhulu nesimo sabo sezomnotho (ukuhlolwa okuqondile kukaFisher, p < 0.0001). Eqinisweni, amazinga aphezulu ezomnotho aphethwe abalimi abafundile kakhulu, futhi ngokuphambene nalokho, amazinga aphansi ezomnotho akhiwa abalimi abangafundile; Ngokusekelwe kwimpahla iyonke, imindeni eyisampula ihlukaniswe ngama-quintile amahlanu engcebo: kusukela kwabampofu kakhulu (Q1) kuya kwabacebile kakhulu (Q5) [bheka ifayela elingeziwe 4].
Kukhona umehluko omkhulu esimweni somshado sezinhloko zemindeni yezigaba ezahlukene zengcebo (p < 0.0001): 83.62% banomfazi oyedwa, 16.38% banomfazi oyedwa (kuze kufike kwabangu-3). Akukho mehluko omkhulu otholakale phakathi kwesigaba sengcebo nenani labashadile.
Iningi labaphenduli (88.82%) likholelwa ukuthi omiyane bangenye yezimbangela ze-malaria. Abangu-1.65% kuphela abaphendule ngokuthi abazi ukuthi yini ebangela i-malaria. Ezinye izimbangela ezitholakele zifaka phakathi ukuphuza amanzi angcolile, ukuchayeka elangeni, ukudla okungenamsoco kanye nokukhathala (Ithebula 2). Ezingeni ledolobhana eGrande Maury, iningi lemindeni libheka ukuphuza amanzi angcolile njengembangela eyinhloko ye-malaria (umehluko wezibalo phakathi kwemizi, p < 0.0001). Izimpawu ezimbili eziyinhloko ze-malaria ukushisa komzimba okuphezulu (78.38%) kanye nokuphuzi kwamehlo (72.07%). Abalimi bakhulume nokuhlanza, i-anemia kanye nokukhanya kwesikhumba (bheka Ithebula 2 ngezansi).
Phakathi kwamasu okuvimbela umalaleveva, abaphenduli bakhulume ngokusetshenziswa kwemithi yendabuko; nokho, lapho begula, kokubili ukwelashwa kwe-biomedical kanye ne-malaria yendabuko kwakubhekwa njengezinketho ezisebenzayo (80.01%), kanye nezinketho ezihlobene nesimo sezenhlalo nezomnotho. Ubudlelwano obubalulekile (p < 0.0001). ): Abalimi abanesimo senhlalo nezomnotho esiphezulu bakhetha futhi bangakwazi ukukhokhela ukwelashwa kwezokwelapha abanesimo senhlalo nezomnotho esiphansi, abalimi bakhetha ukwelashwa kwemithi yendabuko kakhulu; Cishe ingxenye yemindeni isebenzisa isilinganiso esingaphezu kuka-30,000 XOF ngonyaka ekwelashweni komalaleveva (okuhlobene kabi ne-SES; p < 0.0001). Ngokusekelwe ekulinganisweni kwezindleko eziqondile ezibikiwe, imindeni enesimo senhlalo nezomnotho esiphansi kakhulu yayinamathuba amaningi okusebenzisa i-XOF engu-30,000 (cishe ama-US$50) ngaphezulu ekwelashweni komalaleveva kunemindeni enesimo senhlalo nezomnotho esiphezulu. Ngaphezu kwalokho, iningi labaphenduli lalikholelwa ukuthi izingane (49.11%) zisengozini enkulu yokuthola umalaleveva kunabantu abadala (6.55%) (Ithebula 2), kanti lo mbono uvame kakhulu phakathi kwemindeni esesigabeni esimpofu kakhulu (p < 0.01).
Ngokulunywa omiyane, iningi labahlanganyeli (85.20%) libike ukuthi basebenzisa amanethi ombhede aphathwe ngezinambuzane, abawathola kakhulu ngesikhathi sokusatshalaliswa kuzwelonke ngo-2017. Abantu abadala nezingane babike ukuthi balala ngaphansi kwamanethi ombhede aphathwe ngezinambuzane emindenini engu-90.99%. Imvamisa yokusetshenziswa kwamanethi ombhede aphathwe ngezinambuzane emakhaya yayingaphezu kuka-70% kuzo zonke izindawo ngaphandle kwedolobhana laseGessigye, lapho imindeni engu-40% kuphela ebike ukuthi isebenzisa amanethi ombhede aphathwe ngezinambuzane. Inani elimaphakathi lamanethi ombhede aphathwe ngezinambuzane ephethwe yikhaya lalihlobene kakhulu nosayizi wekhaya (i-Pearson's correlation coefficient r = 0.41, p < 0.0001). Imiphumela yethu iphinde yabonisa ukuthi imindeni enezingane ezingaphansi konyaka owodwa ubudala yayinamathuba amaningi okusebenzisa amanethi ombhede aphathwe ngezinambuzane emakhaya uma kuqhathaniswa nemindeni engenazo izingane noma enezingane ezindala (isilinganiso samathuba (OR) = 2.08, 95% CI : 1.25–3.47).
Ngaphezu kokusebenzisa amanethi okulala aphathwe ngezibulala-zinambuzane, abalimi baphinde babuzwa ngezinye izindlela zokulawula omiyane emakhaya abo kanye nasemikhiqizo yezolimo esetshenziselwa ukulawula izinambuzane zezitshalo. Abangu-36.24% kuphela babahlanganyeli bakhulume ngokufafaza izibulala-zinambuzane emakhaya abo (ukuxhumana okubalulekile nokuhle ne-SES p < 0.0001). Izithako zamakhemikhali ezibikiwe zazivela ezinhlotsheni eziyisishiyagalolunye zezentengiselwano futhi zazinikezwa kakhulu ezimakethe zendawo kanye nakwabanye abathengisi ngendlela yama-fumigating coils (16.10%) kanye nama-insecticide spray (83.90%). Ikhono labalimi lokubiza amagama ezibulala-zinambuzane ezifuthwe ezindlini zabo landa ngezinga labo lemfundo (12.43%; p < 0.05). Imikhiqizo ye-agrochemical esetshenzisiwe yathengwa ekuqaleni ngama-canister futhi yaxutshwa kuma-sprayer ngaphambi kokusetshenziswa, kanti ingxenye enkulu kakhulu ivame ukusetshenziselwa izitshalo (78.84%) (Ithebula 2). Idolobhana lase-Amangbeu linenani eliphansi kakhulu labalimi abasebenzisa izibulala-zinambuzane emakhaya abo (0.93%) kanye nezitshalo (16.67%).
Inani eliphezulu lemikhiqizo yokubulala izinambuzane (izifutho noma amakhoyili) elafunwa ngomndeni ngamunye lalingu-3, kanti i-SES yayihlobene kahle nenani lemikhiqizo esetshenzisiwe (ukuhlolwa okuqondile kukaFisher p < 0.0001, nokho kwezinye izimo imikhiqizo itholakale iqukethe into efanayo); izithako ezisebenzayo ngaphansi kwamagama okuhweba ahlukene. Ithebula 2 libonisa imvamisa yamasonto onke yokusetshenziswa kwezibulala-zinambuzane phakathi kwabalimi ngokwesimo sabo sezenhlalo nezomnotho.
Ama-pyrethroids ayizinhlobo zamakhemikhali ezimelelwe kakhulu ekhaya (48.74%) kanye nezolimo (54.74%) zokufutha izinambuzane. Imikhiqizo yenziwa ngesibulala-zinambuzane ngasinye noma ihlanganiswe nezinye izibulala-zinambuzane. Inhlanganisela evamile yezibulala-zinambuzane zasekhaya yi-carbamates, i-organophosphates kanye ne-pyrethroids, kuyilapho ama-neonicotinoids kanye ne-pyrethroids evame kakhulu phakathi kwezibulala-zinambuzane zezolimo (Isithasiselo 5). Isithombe 2 sibonisa isilinganiso semindeni ehlukene yezibulala-zinambuzane ezisetshenziswa abalimi, zonke ezihlukaniswe njengeSigaba II (ingozi ephakathi) noma IsiGaba III (ingozi encane) ngokusho kwesigaba sezibulala-zinambuzane se-World Health Organisation [44]. Ngesinye isikhathi, kwavela ukuthi izwe lalisebenzisa i-deltamethrin yezinambuzane, ehloselwe izinjongo zezolimo.
Ngokuphathelene nezithako ezisebenzayo, i-propoxur ne-deltamethrin yimikhiqizo evame ukusetshenziswa kakhulu ekhaya nasensimini, ngokulandelana. Ifayela elengeziwe 5 liqukethe ulwazi oluningiliziwe ngemikhiqizo yamakhemikhali esetshenziswa abalimi ekhaya nasezitshalweni zabo.
Abalimi bakhulume ngezinye izindlela zokulawula omiyane, okuhlanganisa abalandeli bamaqabunga (i-pêpê ngolimi lwendawo lwe-Abbey), ukushisa amaqabunga, ukuhlanza indawo, ukususa amanzi amile, ukusebenzisa imithi yokuxosha omiyane, noma ukusebenzisa amashidi ukuxosha omiyane.
Izici ezihambisana nolwazi lwabalimi nge-malaria kanye nokufuthwa kwezibulala-zinambuzane endlini (ukuhlaziywa kokuhlehla kwempahla).
Idatha ikhombise ubudlelwano obubalulekile phakathi kokusetshenziswa kwezibulala-zinambuzane zasekhaya kanye nezibikezelo ezinhlanu: izinga lemfundo, i-SES, ulwazi ngomiyane njengembangela enkulu ye-malaria, ukusetshenziswa kwe-ITN, kanye nokusetshenziswa kwezibulala-zinambuzane zezolimo. Isibalo 3 sibonisa ama-OR ahlukene okuguquguquka ngakunye kokubikezela. Uma ziqoqwe ngokwedolobhana, zonke izibikezelo zibonise ubudlelwano obuhle nokusetshenziswa kwezifutho zezibulala-zinambuzane emakhaya (ngaphandle kolwazi lwezimbangela eziyinhloko ze-malaria, olwaluhlotshaniswa ngokuphambene nokusetshenziswa kwezibulala-zinambuzane (OR = 0.07, 95% CI: 0.03, 0.13) . )) (Isibalo 3). Phakathi kwalezi zibikezelo ezinhle, esithakazelisayo ukusetshenziswa kwezibulala-zinambuzane kwezolimo. Abalimi abasebenzise izibulala-zinambuzane ezitshalweni babenamathuba angu-188% okusebenzisa izibulala-zinambuzane ekhaya (95% CI: 1.12, 8.26). Kodwa-ke, imindeni enolwazi oluphezulu mayelana nokudluliswa kwe-malaria yayinamathuba amancane okusebenzisa izibulala-zinambuzane ekhaya. Abantu abanezinga eliphezulu lemfundo babenamathuba amaningi okwazi ukuthi omiyane bayimbangela eyinhloko ye-malaria (OR = 2.04; 95% CI: 1.35, 3.10), kodwa bekungekho ukuhlangana kwezibalo ne-SES ephezulu (OR = 1.51; 95% CI: 0.93, 2.46).
Ngokusho kwenhloko yomndeni, inani lomiyane likhuphuka ngesikhathi semvula kanti ebusuku yisikhathi lapho kulunywa khona omiyane kakhulu (85.79%). Lapho abalimi bebuzwa ngombono wabo ngomthelela wokufuthwa kwezinambuzane ezibulala izinambuzane ezithwala umalaleveva, ama-86.59% aqinisekisile ukuthi omiyane babonakala bekhula ukumelana nemithi yokubulala izinambuzane. Ukungakwazi ukusebenzisa imikhiqizo yamakhemikhali eyanele ngenxa yokungatholakali kwayo kubhekwa njengesizathu esiyinhloko sokungasebenzi kahle noma ukusetshenziswa kabi kwemikhiqizo, okubhekwa njengezinye izici ezinqumayo. Ikakhulukazi, lokhu kokugcina kwakuhlotshaniswa nesimo semfundo esiphansi (p < 0.01), ngisho nalapho kulawulwa i-SES (p < 0.0001). Ama-12.41% kuphela abaphendulile abheka ukumelana nomiyane njengenye yezimbangela ezingaba khona zokumelana nemithi yokubulala izinambuzane.
Kwakukhona ukuhlobana okuhle phakathi kokuvama kokusetshenziswa kwezibulala-zinambuzane ekhaya kanye nemibono yokumelana komiyane nezibulala-zinambuzane (p < 0.0001): imibiko yokumelana komiyane nezibulala-zinambuzane yayisekelwe kakhulu ekusetshenzisweni kwezibulala-zinambuzane ekhaya izikhathi ezingu-3-3 ngesonto. Izikhathi ezingu-4 (90.34%). Ngaphezu kokuvama, inani lezibulala-zinambuzane ezisetshenzisiwe nalo lalihlobene kahle nemibono yabalimi yokumelana nezibulala-zinambuzane (p < 0.0001).
Lolu cwaningo lugxile emibonweni yabalimi ngokusetshenziswa kwe-malaria kanye nezibulala-zinambuzane. Imiphumela yethu ikhombisa ukuthi imfundo kanye nesimo sezomnotho nezenhlalo kudlala indima ebalulekile emikhubeni yokuziphatha kanye nolwazi mayelana ne-malaria. Nakuba iningi lezinhloko zemindeni lafunda esikoleni samabanga aphansi, njengakwezinye izindawo, inani labalimi abangafundile libalulekile [35, 45]. Lesi simo singachazwa iqiniso lokuthi noma ngabe abalimi abaningi baqala ukuthola imfundo, iningi labo kufanele liyeke isikole ukuze londle imindeni yabo ngemisebenzi yezolimo [26]. Kunalokho, lesi simo sigcizelela ukuthi ubudlelwano phakathi kwesimo sezomnotho nezenhlalo nemfundo bubalulekile ekuchazeni ubudlelwano phakathi kwesimo sezomnotho nezenhlalo kanye nekhono lokwenza okuthile ngolwazi.
Ezindaweni eziningi ezivame ukuba khona umalaleveva, ababambiqhaza bajwayelene nezimbangela nezimpawu zomalaleveva [33,46,47,48,49]. Ngokuvamile kuyamukelwa ukuthi izingane zisengozini yokuthola umalaleveva [31, 34]. Lokhu kuqashelwa kungase kuhlobane nokuthambekela kwezingane kanye nobunzima bezimpawu zomalaleveva [50, 51].
Abahlanganyeli babike ukuthi basebenzise imali elinganiselwa ku-30,000. Izici ezifana nokulahlekelwa umkhiqizo kanye nezokuthutha azixoxwa ngazo.
Ukuqhathaniswa kwesimo sezomnotho sabalimi kubonisa ukuthi abalimi abanesimo sezomnotho esiphansi kakhulu basebenzisa imali eningi kunabalimi abacebe kakhulu. Lokhu kungenzeka ngoba imindeni enesimo sezomnotho esiphansi kakhulu ibona izindleko ziphezulu (ngenxa yomthwalo wayo omkhulu kwezezimali zemindeni iyonke) noma ngenxa yezinzuzo ezihambisanayo zokuqashwa komphakathi kanye nomkhakha ozimele (njengoba kunjalo ngemindeni ecebile). ): Ngenxa yokutholakala komshuwalense wezempilo, uxhaso lokwelashwa komalaleveva (uma kuqhathaniswa nezindleko eziphelele) lungase lube luphansi kakhulu kunezindleko zemindeni engazuzi ngomshuwalense [52]. Eqinisweni, kwabikwa ukuthi imindeni ecebile kakhulu isebenzisa kakhulu ukwelashwa kwezokwelapha uma kuqhathaniswa nemindeni empofu kakhulu.
Nakuba abalimi abaningi bebheka omiyane njengembangela eyinhloko ye-malaria, bambalwa kuphela abasebenzisa izibulala-zinambuzane (ngokufafaza nokubulala izinambuzane) emakhaya abo, okufana nokutholakele eCameroon nase-Equatorial Guinea [48, 53]. Ukuntuleka kokukhathazeka ngomiyane uma kuqhathaniswa nezinambuzane zezitshalo kungenxa yenani lezomnotho lezitshalo. Ukuze kuncishiswe izindleko, izindlela ezingabizi njengokushisa amaqabunga ekhaya noma ukuxosha omiyane ngesandla ziyathandwa. Ubuthi obubonakalayo bungaba yimbangela: iphunga lemikhiqizo ethile yamakhemikhali kanye nokungakhululeki ngemva kokusebenzisa kubangela abanye abasebenzisi ukuthi bagweme ukuyisebenzisa [54]. Ukusetshenziswa okuphezulu kwezibulala-zinambuzane emakhaya (85.20% yemindeni ebikwe ukuthi iyayisebenzisa) nakho kunegalelo ekusetshenzisweni okuphansi kwezibulala-zinambuzane ezilwa nomiyane. Ukuba khona kwamanethi ombhede aphathwe ngezibulala-zinambuzane ekhaya nakho kuhlotshaniswa kakhulu nokuba khona kwezingane ezingaphansi konyaka owodwa ubudala, mhlawumbe ngenxa yokusekelwa kwekliniki yabesifazane abakhulelwe abathola amanethi ombhede aphathwe ngezibulala-zinambuzane ngesikhathi sokubonisana nodokotela ngaphambi kokubeletha [6].
Ama-pyrethroids yiwona ama-insecticide ayinhloko asetshenziswa emanethini ombhede aphathwe ngama-insecticide [55] futhi asetshenziswa abalimi ukulawula izinambuzane kanye nomiyane, okuphakamisa ukukhathazeka ngokwanda kokumelana nama-insecticide [55, 56, 57,58,59]. Lesi simo singachaza ukwehla kokuzwela kwama-insecticide kuma-insecticide abonwa abalimi.
Isimo sezomnotho esiphezulu asizange sihlotshaniswe nokuqwashisa okukhulu nge-malaria kanye nomiyane njengembangela yayo. Ngokungafani nokutholakele kwangaphambilini kuka-Ouattara kanye nozakwabo ngo-2011, abantu abacebile bavame ukukwazi kangcono ukubona izimbangela ze-malaria ngoba banokufinyelela okulula kolwazi ngethelevishini kanye nomsakazo [35]. Ukuhlaziywa kwethu kukhombisa ukuthi izinga lemfundo ephakeme liyisibikezelo sokuqonda kangcono i-malaria. Lokhu okubonwe kuqinisekisa ukuthi imfundo isalokhu iyisici esibalulekile solwazi lwabalimi mayelana ne-malaria. Isizathu sokuthi isimo sezomnotho kanye nomnotho sinomthelela omncane ukuthi amadolobhana avame ukwabelana ngethelevishini kanye nomsakazo. Kodwa-ke, isimo sezomnotho kanye nomnotho kufanele sicatshangelwe lapho kusetshenziswa ulwazi mayelana namasu okuvimbela i-malaria yasekhaya.
Isimo esiphezulu sezomnotho kanye nezinga lemfundo ephakeme kuhlotshaniswa kahle nokusetshenziswa kwezibulala-zinambuzane zasekhaya (isifutho noma isifutho). Ngokumangazayo, ikhono labalimi lokubona omiyane njengembangela eyinhloko yomalaleveva lathinta kabi imodeli. Lesi sibikezeli sahlotshaniswa kahle nokusetshenziswa kwezibulala-zinambuzane lapho sihlanganiswa kuwo wonke umphakathi, kodwa sahlotshaniswa kabi nokusetshenziswa kwezibulala-zinambuzane lapho sihlanganiswa ngokwedolobhana. Lo mphumela ubonisa ukubaluleka kwethonya lokudla abantu ekuziphatheni kwabantu kanye nesidingo sokufaka imiphumela engahleliwe ekuhlaziyweni. Ucwaningo lwethu lubonisa okokuqala ukuthi abalimi abanolwazi lokusebenzisa izibulala-zinambuzane kwezolimo banamathuba amaningi kunabanye okusebenzisa izifutho nezinsila zokubulala izinambuzane njengezindlela zangaphakathi zokulawula umaleveva.
Njengoba kushiwo izifundo zangaphambilini mayelana nethonya lesimo sezenhlalo nezomnotho emibonweni yabalimi mayelana nezibulala-zinambuzane [16, 60, 61, 62, 63], imindeni ecebile ibike ukuguquguquka okuphezulu kanye nokuvama kokusetshenziswa kwezibulala-zinambuzane. Abaphenduli babekholelwa ukuthi ukufafaza inani elikhulu lezibulala-zinambuzane kuyindlela engcono kakhulu yokugwema ukumelana nomiyane, okuhambisana nokukhathazeka okuvezwe kwezinye izindawo [64]. Ngakho-ke, imikhiqizo yasekhaya esetshenziswa abalimi inokwakheka kwamakhemikhali okufanayo ngaphansi kwamagama ahlukene ezentengiselwano, okusho ukuthi abalimi kufanele babeke phambili ulwazi lobuchwepheshe lomkhiqizo kanye nezithako zawo ezisebenzayo. Kufanele futhi kunakwe ukuqwashisa kwabathengisi, njengoba bengomunye wamaphuzu ayinhloko okubhekisela kuwo abathengi bezibulala-zinambuzane [17, 24, 65, 66, 67].
Ukuze kube nomthelela omuhle ekusetshenzisweni kwezibulala-zinambuzane emiphakathini yasemakhaya, izinqubomgomo kanye nokungenelela kufanele kugxile ekuthuthukiseni amasu okuxhumana, kucatshangelwa amazinga emfundo kanye nemikhuba yokuziphatha ngokwesimo sokuzivumelanisa namasiko kanye nemvelo, kanye nokuhlinzekwa kwezibulala-zinambuzane eziphephile. Abantu bazothenga ngokusekelwe ezindleleni (ukuthi bangakwazi ukukhokhela malini) kanye nekhwalithi yomkhiqizo. Uma ikhwalithi isitholakala ngentengo engabizi, isidingo sokushintsha kokuziphatha ekuthengeni imikhiqizo emihle kulindeleke ukuthi sikhule kakhulu; Fundisa abalimi ngokushintsha izibulala-zinambuzane ukuze baphule uchungechunge lokumelana nezibulala-zinambuzane futhi bakwenze kucace ukuthi ukushintsha akusho ushintsho ekufakweni komkhiqizo (ngoba izinhlobo ezahlukene zinenhlanganisela efanayo esebenzayo), kodwa kunalokho umehluko ezithakweni ezisebenzayo. Le mfundo ingasekelwa futhi ngokulebula okungcono komkhiqizo ngokusebenzisa izethulo ezilula nezicacile.
Njengoba izibulala-zinambuzane zisetshenziswa kakhulu ngabalimi basemakhaya eSifundazweni sase-Abbotville, ukuqonda izikhala zolwazi lwabalimi kanye nesimo sengqondo ngokusetshenziswa kwezibulala-zinambuzane emvelweni kubonakala kuyinto ebalulekile ekuthuthukiseni izinhlelo zokuqwashisa eziphumelelayo. Ucwaningo lwethu luqinisekisa ukuthi imfundo isalokhu iyisici esibalulekile ekusetshenzisweni kahle kwezibulala-zinambuzane kanye nolwazi mayelana nomalaleveva. Isimo sezomnotho somndeni naso sasibhekwa njengethuluzi elibalulekile okufanele silicabangele. Ngaphezu kwesimo sezomnotho somphakathi kanye nezinga lemfundo lenhloko yekhaya, ezinye izici ezifana nolwazi mayelana nomalaleveva, ukusetshenziswa kwezibulala-zinambuzane ukulawula izinambuzane, kanye nemibono yokumelana nomiyane nezibulala-zinambuzane kuthonya isimo sengqondo sabalimi mayelana nokusetshenziswa kwezibulala-zinambuzane.
Izindlela ezixhomeke kubaphenduli njengemibuzo zingase zikhunjulwe futhi zibandlululwe ngokwezenhlalo. Kulula kakhulu ukusebenzisa izici zomndeni ukuhlola isimo sezenhlalo nezomnotho, yize lezi zindlela zingase ziqondene nesikhathi kanye nesimo sendawo lapho zakhiwe khona futhi zingase zingabonisi ngokufanayo iqiniso lesimanje lezinto ezithile ezibalulekile ngokwesiko, okwenza ukuqhathanisa phakathi kwezifundo kube nzima. Ngempela, kungase kube nezinguquko ezibalulekile ekuphathweni kwemindeni kwezingxenye zezinkomba ezingeke ziholele ekunciphiseni ubumpofu bezinto ezibonakalayo.
Abanye abalimi abakhumbuli amagama emikhiqizo yezibulala-zinambuzane, ngakho-ke inani lezibulala-zinambuzane ezisetshenziswa abalimi lingase lithathwe kancane noma lilinganiswe ngokweqile. Ucwaningo lwethu aluzange lucabangele isimo sengqondo sabalimi ngokufafaza izibulala-zinambuzane noma imibono yabo ngemiphumela yezenzo zabo empilweni yabo kanye nemvelo. Ucwaningo aluzange luhlanganise nabathengisi. Womabili amaphuzu angahlolwa ezifundweni ezizayo.
Isikhathi sokuthunyelwe: Agasti-13-2024