Lilonke izinga lezehlakalo phakathi kwezingane ezineminyaka engu-6 kuya kweyi-10 lalingu-2.7 ngezinyanga zabantu eziyi-100 endaweni ye-IRS kanye no-6.8 ngezinyanga eziyi-100 zabantu endaweni yokulawula. Kodwa-ke, awubanga khona umehluko obalulekile ezenzakalweni zikamalaleveva phakathi kwalezi zindawo ezimbili phakathi nezinyanga ezimbili zokuqala (Julayi-August) nangemva kwesikhathi sezimvula (December–February) (bheka Umfanekiso 4).
Amajika okusinda e-Kaplan-Meier ezinganeni ezineminyaka engu-1 kuye kweyi-10 endaweni yocwaningo ngemva kwezinyanga eziyi-8 zokulandelela
Lolu cwaningo luqhathanise ukusabalala kwe-malaria kanye nezigameko ezifundeni ezimbili zisebenzisa amasu ahlanganisiwe okulawula umalaleveva ukuhlola umphumela owengeziwe we-IRS. Idatha yaqoqwa ezifundeni ezimbili ngokusebenzisa izinhlolovo ezimbili ezihlukene kanye nenhlolovo yezinyanga eziyisi-9 yokutholwa kwecala emitholampilo yezempilo. Imiphumela evela ezinhlolovo ezihlukene ekuqaleni nasekupheleni kwenkathi yokudluliswa kukamalaleveva ibonise ukuthi i-malaria parasitaemia yayiphansi kakhulu esifundeni se-IRS (LLTID+IRS) kunasesifundeni sokulawula (LLTIN kuphela). Njengoba lezi zifunda ezimbili ziqhathaniswa ngokuya ngesifo sikamalaleveva kanye nokungenelela, lo mehluko ungachazwa ngenani elengeziwe le-IRS esifundeni se-IRS. Eqinisweni, kokubili amanetha okubulala izinambuzane ahlala isikhathi eside kanye ne-IRS kwaziwa ngokuthi ehlisa kakhulu umthwalo kamalaleveva lapho esetshenziswa yedwa. Ngakho-ke, izifundo eziningi [7, 21, 23, 24, 25] zibikezela ukuthi ukuhlanganiswa kwazo kuzoholela ekunciphiseni okukhulu komthwalo we-malaria kunokwedwa. Ngaphandle kwe-IRS, i-Plasmodium parasitaemia iyanda kusukela ekuqaleni kuze kube sekupheleni kwenkathi yemvula ezindaweni ezisakazwa umalaleveva ngezikhathi ezithile zonyaka, futhi lo mkhuba kulindeleke ukuba ufinyelele umvuthwandaba ekupheleni kwenkathi yemvula . Kodwa-ke, ukwanda kwendawo ye-IRS (53.0%) kwakuphansi kakhulu kunalokho endaweni yokulawula (220.0%). Iminyaka eyisishiyagalolunye yemikhankaso ye-IRS elandelanayo ngokungangabazeki yasiza ukwehlisa noma ukucindezela ngisho neziqongo zokudluliswa kwegciwane ezindaweni ze-IRS. Ngaphezu kwalokho, kwakungekho umehluko kunkomba ye-gametophyte phakathi kwezindawo ezimbili ekuqaleni. Ekupheleni kwenkathi yemvula, yayiphezulu kakhulu endaweni yokulawula (11.5%) kunasendaweni ye-IRS (3.2%). Lokhu kuhlola ngokwengxenye kuchaza ukusabalala okuphansi kwe-malaria parasitemia esifundeni se-IRS, njengoba inkomba ye-gametocyte iwumthombo ongase ube umthombo wokutheleleka komiyane okuholela ekusakazekeni kukamalaleveva .
Imiphumela yokuhlaziywa kokuhlehla kwempahla ibonisa ubungozi bangempela obuhlobene nesifo sikamalaleveva endaweni yokulawula futhi igqamisa ukuthi ukuhlobana phakathi kwemfiva ne-parasitemia kulinganiselwa kakhulu nokuthi i-anemia iyisici esididayo.
Njenge-parasitaemia, isifo sikamalaleveva phakathi kwezingane ezineminyaka engu-0-10 sasiphansi kakhulu ku-IRS kunezindawo zokulawula. Iziqongo zokudlulisela kwendabuko zabonwa kuzo zombili izindawo, kodwa zaziphansi kakhulu ku-IRS kunasendaweni yokulawula (Umfanekiso 3). Eqinisweni, nakuba izibulala-zinambuzane zihlala cishe iminyaka emi-3 kuma-LLN, zihlala izinyanga ezifika kweziyisi-6 ku-IRS. Ngakho-ke, imikhankaso ye-IRS yenziwa minyaka yonke ukumboza iziqongo zokudlulisela. Njengoba kuboniswa amajika okusinda e-Kaplan–Meier (Umfanekiso 4), izingane ezihlala ezindaweni ze-IRS zinezigameko ezimbalwa zomtholampilo zomalaleveva kunalezo ezisezindaweni zokulawula. Lokhu kuhambisana nolunye ucwaningo olubike ukwehliswa okukhulu kwezehlakalo zikamalaleveva lapho i-IRS enwetshiwe ihlanganiswa nokunye ukungenelela . Kodwa-ke, isikhathi esilinganiselwe sokuvikela emiphumeleni eyinsalela ye-IRS siphakamisa ukuthi leli su kungase kudingeke lithuthukiswe ngokusebenzisa izibulala-zinambuzane ezihlala isikhathi eside noma ukwandisa imvamisa yonyaka yokusetshenziswa .
Umehluko wokuvama kwe-anemia phakathi kwe-IRS nezindawo zokulawula, phakathi kwamaqembu obudala obuhlukahlukene naphakathi kwabahlanganyeli abanomkhuhlane noma abangenawo umkhuhlane ungase usebenze njengenkomba enhle engaqondile yesu elisetshenzisiwe .
Lolu cwaningo lubonisa ukuthi i-pirimiphos-methyl IRS inganciphisa kakhulu ukusabalala kanye nesigameko se-malaria ezinganeni ezingaphansi kweminyaka engu-10 ubudala esifundeni sase-Koulikoro esingamelana ne-pyrethroid, nokuthi izingane ezihlala ezindaweni ze-IRS zinamathuba amaningi okuba zithole umalaleveva futhi zihlale zingenawo umalaleveva. isikhathi eside esifundeni. Ucwaningo luye lwabonisa ukuthi i-pirimiphos-methyl iyi-insecticide efanelekile yokulawula umalaleveva ezindaweni lapho ukumelana ne-pyrethroid kuvame.
Isikhathi sokuthumela: Dec-09-2024