Izinga lokwanda kwesifo phakathi kwezingane ezineminyaka ephakathi kwezinyanga eziyi-6 kuya kweziyi-10 lalingu-2.7 kubantu abayi-100 ezinyangeni endaweni ye-IRS kanye no-6.8 kubantu abayi-100 ezinyangeni endaweni yokulawula. Kodwa-ke, bekungekho mehluko omkhulu ekusabalaleni kwesifo sikamalaleveva phakathi kwezindawo ezimbili phakathi nezinyanga ezimbili zokuqala (Julayi-Agasti) kanye nangemva kwesizini yemvula (Disemba-Febhuwari) (bheka Umfanekiso 4).
Izindlela zokusinda zeKaplan-Meier zezingane ezineminyaka engu-1 kuya kwengu-10 endaweni yocwaningo ngemuva kwezinyanga ezingu-8 zokulandelela
Lolu cwaningo luqhathanise ukusabalala kwe-malaria kanye nokwanda kwayo ezifundeni ezimbili kusetshenziswa amasu okulawula i-malaria ahlanganisiwe ukuhlola umphumela owengeziwe we-IRS. Idatha yaqoqwa ezifundeni ezimbili ngokusebenzisa izinhlolovo ezimbili ezihlanganisa izingxenye kanye nocwaningo lwezinyanga ezingu-9 lokuthola amacala emitholampilo yezempilo. Imiphumela evela ezinhlolovo ezihlanganisa izingxenye ekuqaleni nasekupheleni kwesizini yokudluliswa kwe-malaria ibonise ukuthi i-malaria parasitaemia yayiphansi kakhulu esifundeni se-IRS (LLTID+IRS) kunasesifundeni sokulawula (LLTIN kuphela). Njengoba lezi zifunda ezimbili zifana ngokwe-epidemiology ye-malaria kanye nokungenelela, lo mehluko ungachazwa ngenani elengeziwe le-IRS esifundeni se-IRS. Eqinisweni, womabili amanethi okubulala izinambuzane ahlala isikhathi eside kanye ne-IRS aziwa ngokunciphisa kakhulu umthwalo we-malaria uma esetshenziswa wodwa. Ngakho-ke, izifundo eziningi [7, 21, 23, 24, 25] zibikezela ukuthi ukuhlanganiswa kwazo kuzoholela ekunciphiseni okukhulu umthwalo we-malaria kunanoma yikuphi kokubili. Naphezu kwe-IRS, i-Plasmodium parasitaemia iyanda kusukela ekuqaleni kuze kube sekupheleni kwesizini yemvula ezindaweni ezidluliswa yi-malaria yonyaka, futhi lo mkhuba kulindeleke ukuthi ufinyelele phezulu ekupheleni kwesizini yemvula. Kodwa-ke, ukwanda endaweni ye-IRS (53.0%) kwakuphansi kakhulu kunalokho endaweni yokulawula (220.0%). Iminyaka eyisishiyagalolunye yemikhankaso ye-IRS elandelanayo ngokungangabazeki yasiza ekunciphiseni noma ngisho nasekucindezeleni iziqongo zokudluliswa kwegciwane ezindaweni ze-IRS. Ngaphezu kwalokho, kwakungekho mehluko ku-index ye-gametophyte phakathi kwezindawo ezimbili ekuqaleni. Ekupheleni kwesizini yemvula, kwakuphakeme kakhulu endaweni yokulawula (11.5%) kunasendaweni ye-IRS (3.2%). Lokhu kuqaphela kuchaza ngokwengxenye ukusabalala okuphansi kakhulu kwe-malaria parasitemia esifundeni se-IRS, njengoba i-index ye-gametocyte ingumthombo ongaba khona wokutheleleka komiyane okuholela ekudlulisweni kwe-malaria.
Imiphumela yokuhlaziywa kokuhlehla kwempahla ikhombisa ingozi yangempela ehlotshaniswa nokutheleleka kwe-malaria endaweni yokulawula futhi igcizelela ukuthi ubudlelwano phakathi komkhuhlane kanye ne-parasitemia buqikelelwe ngokweqile nokuthi i-anemia iyisici esididayo.
Njengasezinhlayiyeni, ukwanda kwesifo sikamalaleveva ezinganeni ezineminyaka engu-0-10 kwakuphansi kakhulu ku-IRS kunasezindaweni zokulawula. Ukuphakama kokutheleleka kwendabuko kwabonwa kuzo zombili izindawo, kodwa kwakuphansi kakhulu ku-IRS kunasezindaweni zokulawula (Isithombe 3). Eqinisweni, ngenkathi izibulala-zinambuzane zihlala iminyaka engaba ngu-3 kuma-LLIN, zihlala izinyanga ezifika kweziyisithupha ku-IRS. Ngakho-ke, imikhankaso ye-IRS yenziwa minyaka yonke ukuze imboze ukwehla kokutheleleka. Njengoba kuboniswe yi-Kaplan-Meier survival curves (Isithombe 4), izingane ezihlala ezindaweni ze-IRS zazinamacala ambalwa omtholampilo we-malaleveva kunalawo asezindaweni zokulawula. Lokhu kuhambisana nezinye izifundo ezibike ukwehla okukhulu kokwanda kwesifo sikamalaleveva lapho i-IRS enwetshiwe ihlanganiswa nezinye izindlela zokungenelela. Kodwa-ke, isikhathi esilinganiselwe sokuvikelwa emiphumeleni eseleyo ye-IRS sibonisa ukuthi leli cebo lingadinga ukuthuthukiswa ngokusebenzisa izibulala-zinambuzane ezihlala isikhathi eside noma ukwandisa imvamisa yokusetshenziswa yonyaka.
Umehluko ekusabalaleni kwe-anemia phakathi kwe-IRS nezindawo zokulawula, phakathi kwamaqembu eminyaka ahlukene kanye naphakathi kwabahlanganyeli abanomkhuhlane nabangenawo ungase ube uphawu oluhle olungaqondile lwesu elisetshenzisiwe.
Lolu cwaningo lubonisa ukuthi i-pirimiphos-methyl IRS inganciphisa kakhulu ukusabalala kanye nokwanda komalaleveva ezinganeni ezingaphansi kweminyaka eyi-10 ubudala esifundeni saseKoulikoro esingamelani ne-pyrethroid, nokuthi izingane ezihlala ezindaweni ze-IRS zinamathuba amaningi okuthola umaleveva futhi zihlale zingenawo umaleveva isikhathi eside esifundeni. Izifundo zibonise ukuthi i-pirimiphos-methyl iyisibulala-zinambuzane esifanelekile sokulawula umaleveva ezindaweni lapho ukumelana ne-pyrethroid kuvame khona.
Isikhathi sokuthunyelwe: Disemba-09-2024