Ukufafaza ngesibulali zinambuzane kwangaphakathi (IRS) kuyindlela eyinhloko yokunciphisa ukudluliswa kwe-Trypanosoma cruzi ethwalwa yizilwane, okubangela isifo se-Chagas engxenyeni enkulu yaseNingizimu Melika.Kodwa-ke, impumelelo ye-IRS esifundeni iGrand Chaco, ehlanganisa iBolivia, Argentina kanye neParaguay, ayikwazi ukuncintisana neyamanye amazwe aseSouthern Cone.
Lolu cwaningo luhlole izinqubo ze-IRS ezivamile nokulawulwa kwekhwalithi yezibulala-zinambuzane emphakathini ovamile ovamile e-Chaco, e-Bolivia.
Isithako esisebenzayo i-alpha-cypermethrin (ai) sithwetshulwe ephepheni lesihlungi elibekwe phezu kodonga lwesifutho futhi likalwa ngezixazululo zethangi lesifutho elilungisiwe kusetshenziswa i-Insecticide Quantitative Kit (IQK™) eqinisekisiwe ngezindlela ze-HPLC zobuningi.Idatha yahlaziywa kusetshenziswa imodeli ye-binomial exubekile yokuhlehla yemiphumela engemihle ukuze kuhlolwe ubudlelwano phakathi kokugxiliswa kwesibulala-zinambuzane esisetshenziswa ephepheni lesihlungi nobude bodonga lwesifutho, ukumbozwa kwesifutho (indawo yokufafaza/isikhathi sokufutha [m2/min]), kanye nesifutho esibonwa/esilindelwe.isilinganiso sesilinganiso.Umehluko phakathi kokuthobela kwabahlinzeki bezempilo kanye nokuthobela kwabanikazi bezindlu nezimfuneko zekhaya ezingenamuntu ze-IRS nazo zahlolwa.Izinga lokumisa i-alpha-cypermethrin ngemva kokuxuba emathangeni okufutha alungisiwe lalinganiswa elabhorethri.
Ukuhluka okuphawulekayo kubonwe ekugxilweni kwe-alpha-cypermethrin AI, kanye no-10.4% (50/480) kuphela wezihlungi kanye no-8.8% (5/57) wamakhaya athola ukuhlushwa okuhlosiwe okungu-50 mg ± 20% AI/m2.Ukugxila okubonisiwe akuxhomekile ekugxiliseni okutholakala ezixazululweni zesifutho.Ngemva kokuxuba i-alpha-cypermethrin ai esixazululweni esiphezulu esilungisiwe sethangi lesifutho yahlala ngokushesha, okuholele ekulahlekelweni okuqondile kwe-alpha-cypermethrin ai ngomzuzu nokulahlekelwa okungama-49% ngemva kwemizuzu engu-15.Kuphela u-7.5% (6/80) wezindlu ezilashwe ngesilinganiso sokufutha esituswa yi-WHO esingu-19 m2/min (±10%), kuyilapho u-77.5% (62/80) wezindlu eselashwe ngenani eliphansi kunalokho obekulindelekile.Isilinganiso esimaphakathi sesithako esisebenzayo esilethwe ekhaya sasingahlobene kakhulu nokumbozwa kwesifutho.Ukuthobelana nomkhaya akuzange kuthinte kakhulu ukumbozwa kwesifutho noma isilinganiso sokugxiliswa kwe-cypermethrin esilethwa emakhaya.
Ukulethwa kwe-IRS esezingeni eliphansi kungase kubangelwe ngokwengxenye yezakhiwo ezingokoqobo zezibulala-zinambuzane kanye nesidingo sokubuyekeza izindlela zokulethwa kwezibulala-zinambuzane, okuhlanganisa ukuqeqeshwa kwamaqembu e-IRS kanye nemfundo yomphakathi ukuze kugqugquzelwe ukuthobela umthetho.I-IQK™ iyithuluzi elibalulekile elisebenziseka kalula elenza ngcono ikhwalithi ye-IRS futhi lenze kube lula ukuqeqeshwa kwabahlinzeki bezempilo kanye nokuthatha izinqumo kwabaphathi ekulawuleni ivekhtha ye-Chagas.
Isifo se-Chagas sibangelwa ukutheleleka nge-parasite i-Trypanosoma cruzi (kinetoplastid: Trypanosomatidae), ebangela uchungechunge lwezifo kubantu nakwezinye izilwane.Kubantu, ukutheleleka ngezimpawu ezinzima kwenzeka emasontweni kuya ezinyangeni ngemva kokutheleleka futhi kubonakala ngemfiva, ukugula, kanye ne-hepatosplenomegaly.Izibalo ezilinganiselwa ku-20-30% zezifo ziqhubekela phambili zibe uhlobo olungapheli, ngokuvamile i-cardiomyopathy, ebonakala ngokukhubazeka kwesistimu yokuqhuba, i-cardiac arrhythmias, ukungasebenzi kahle kwe-ventricular yesokunxele, futhi ekugcineni ukuhluleka kwenhliziyo kanye, kancane kancane, isifo sesisu.Lezi zimo zingaqhubeka amashumi eminyaka futhi kunzima ukuzelapha [1].Awukho umgomo.
Umthwalo womhlaba wonke wesifo se-Chagas ngo-2017 ulinganiselwa kubantu abayizigidi ezingu-6.2, okubangele ukufa kwe-7900 kanye neminyaka engu-232,000 yokuphila yokukhubazeka (DALYs) kuyo yonke iminyaka [2,3,4].I-Triatominus cruzi isakazwa kulo lonke elase-Central naseNingizimu Melika, futhi ezingxenyeni eziseningizimu yeNyakatho Melika, nge-Triatominus cruzi (Hemiptera: Reduviidae), ibalwa ku-30,000 (77%) yenani eliphelele lamacala amasha eLatin America ngo-2010 [5] .Eminye imizila yokutheleleka ezindaweni ezinganqamuki njengase-Europe nase-United States ihlanganisa ukudluliselwa kokuzalwa kanye nokumpontshelwa igazi elinegciwane.Isibonelo, eSpain, kunezimo ezibalelwa ku-67,500 zokutheleleka phakathi kwabokufika baseLatin America [6], okuholela ezindlekweni zonyaka zohlelo lokunakekelwa kwezempilo zama-US$9.3 wezigidi [7].Phakathi kuka-2004 no-2007, u-3.4% wabesifazane bokufika baseLatin America abakhulelwe abahlolwe esibhedlela sase-Barcelona babene-seropositive ye-Trypanosoma cruzi [8].Ngakho-ke, imizamo yokulawula ukudluliswa kwe-vector emazweni ahlala njalo ibalulekile ukunciphisa umthwalo wezifo emazweni angenayo i-triatomine vector [9].Izindlela zamanje zokulawula zihlanganisa ukufafaza kwangaphakathi (IRS) ukunciphisa isibalo sama-vector emakhaya nasezindlini ezizungezile, ukuhlolwa komama ukukhomba nokuqeda ukutheleleka kokuzalwa, ukuhlolwa kwegazi kanye namabhange okufakelwa kwezitho, nezinhlelo zemfundo [5,10,11,12].
E-Southern Cone yaseNingizimu Melika, i-vector eyinhloko yi-pathogenic triatomine bug.Lolu hlobo ngokuyinhloko alunasiphelo futhi luyaphela futhi luzalanisa kabanzi ezindlini nasemashedeni ezilwane.Ezakhiweni ezingakhiwe kahle, imifantu ezindongeni kanye nosilingi kunezimbungulu ze-triatomine, futhi ukuhlasela kwemindeni kubi kakhulu [13, 14].I-Southern Cone Initiative (INCOSUR) ikhuthaza imizamo ehlanganisiwe yamazwe ngamazwe yokulwa nezifo zasekhaya e-Tri.Sebenzisa i-IRS ukuthola amagciwane e-pathogenic namanye ama-agent aqondene nesayithi [15, 16].Lokhu kwaholela ekwehleni okukhulu kwezehlakalo zesifo se-Chagas kanye nokuqinisekiswa okwalandela yi-World Health Organization ukuthi ukudluliswa kwe-vector-borne kuqediwe kwamanye amazwe (Uruguay, Chile, izingxenye ze-Argentina neBrazil) [10, 15].
Naphezu kwempumelelo ye-INCOSUR, i-vector Trypanosoma cruzi isaqhubeka esifundeni sase-Gran Chaco e-USA, indawo yehlathi elomile ngezikhathi ezithile zonyaka elihlanganisa amakhilomitha-skwele ayizigidi ezingu-1.3 ngaphesheya kwemingcele ye-Bolivia, Argentina kanye neParaguay [10].Izakhamizi zakulesi sifunda ziphakathi kwamaqembu ancishwe amathuba kakhulu futhi ziphila ngobumpofu obudlulele ngokufinyelela okulinganiselwe ekunakekelweni kwezempilo [17].Isigameko sokutheleleka kwe-T. cruzi kanye nokudluliswa kwe-vector kule miphakathi siphakathi kweziphakeme kakhulu emhlabeni [5,18,19,20] nge-26-72% yamakhaya ahlaselwe ama-trypanosomatids.infestans [13, 21] kanye 40-56% Tri.Amagciwane e-Pathogenic ahlasela i-Trypanosoma cruzi [22, 23].Iningi (>93%) lazo zonke izehlakalo ze-Chagas ezithwalwa yizilwane esifundeni sase-Southern Cone zenzeka e-Bolivia [5].
I-IRS okwamanje ukuphela kwendlela eyamukelwa kabanzi yokunciphisa i-triacine kubantu.ama-infestans isu elifakazelwe ngokomlando lokunciphisa umthwalo wezifo eziningana ezithwalwa yizilwane [24, 25].Izindlu e- Tri.ama-infestans (inkomba yokutheleleka) iyinkomba eyinhloko esetshenziswa iziphathimandla zezempilo ukwenza izinqumo mayelana nokuthunyelwa kwe-IRS futhi, okubalulekile, ukuthethelela ukwelashwa kwezingane ezinegciwane elingapheli ngaphandle kwengozi yokuphinda batheleleke [16,26,27,28,29].Ukusebenza kwe-IRS kanye nokuphikelela kokudluliswa kwe-vector esifundeni sase-Chaco kuthonywa izici eziningana: izinga eliphansi lokwakhiwa kwesakhiwo [19, 21], ukuqaliswa kwe-IRS ephansi kanye nezindlela zokuqapha ukuhlaselwa kwe-infestation [30], ukungaqiniseki komphakathi mayelana nezidingo ze-IRS Ukuhambisana okuphansi [ 31], umsebenzi omfushane osele wokubunjwa kwezibulala-zinambuzane [32, 33] kanye ne-Tri.ama-infestans anciphise ukumelana kanye / noma ukuzwela kuma-insecticides [22, 34].
Izibulala-zinambuzane ze-synthetic pyrethroid zivame ukusetshenziswa ku-IRS ngenxa yokubulala kwazo izimbungulu ze-triatomine ezisengozini.Emazingeni aphansi, ama-insecticide e-pyrethroid nawo asetshenzisiwe njengama-irritants ukukhipha ama-vector emifantwini yodonga ngezinjongo zokuqapha [35].Ucwaningo lokulawulwa kwekhwalithi yezinqubo ze-IRS lunqunyelwe, kodwa kwezinye izindawo kuye kwaboniswa ukuthi kukhona ukuhluka okuphawulekayo ekugxilweni kwezithako ezisebenzayo zezibulala-zinambuzane (ama-AI) ezilethwa emakhaya, namazinga avame ukuwela ngaphansi kwebanga lokuhlushwa okuhlosiwe elisebenzayo [33,36], 37,38].Isizathu esisodwa sokuntuleka kocwaningo lokulawulwa kwekhwalithi ukuthi i-high-performance liquid chromatography (HPLC), indinganiso yegolide yokulinganisa ukuhlangana kwezithako ezisebenzayo kuzibulala-zinambuzane, iyinkimbinkimbi ngokobuchwepheshe, iyabiza, futhi ngokuvamile ayifaneleki izimo ezisabalele emphakathini.Intuthuko yakamuva ekuhlolweni kwaselabhorethri manje ihlinzeka ngezindlela ezihlukile nezingabizi kakhulu zokuhlola ukulethwa kwezibulala-zinambuzane kanye nezinqubo ze-IRS [39, 40].
Lolu cwaningo lwenzelwe ukukala izinguquko ekugxilweni kwezibulala-zinambuzane phakathi nemikhankaso ye-IRS evamile eqondise i-Tri.I-Phytophthora infestans yamazambane esifundeni saseChaco, eBolivia.Ukugxiliswa kwezithako ezisebenzayo zezibulala-zinambuzane kukalwa ngokwenziwa okulungiselelwe emathangeni okufutha nasemasampula ephepha lokuhlunga aqoqwe egunjini lokufutha.Izinto ezingase zibe nomthelela ekulethweni kwezibulala-zinambuzane ezindlini nazo zahlolwa.Kulokhu, sisebenzise ikhemikhali ye-colorimetric assay ukuze silinganise ukugcwala kwama-pyrethroids kulawa masampuli.
Ucwaningo lwenziwe e-Itanambicua, kumasipala waseCamili, umnyango wase-Santa Cruz, eBolivia (20°1′5.94″ S; 63°30′41″ W) (Fig. 1).Lesi sifunda siyingxenye yesifunda saseGran Chaco e-USA futhi sibonakala ngamahlathi omile ngezikhathi ezithile zonyaka namazinga okushisa angu-0–49 °C kanye nemvula engu-500–1000 mm/ngonyaka [41].I-Itanambicua ingomunye wemiphakathi engu-19 yaseGuaraní edolobheni, lapho izakhamuzi ezingaba ngu-1,200 zihlala ezindlini ezingama-220 ezakhiwe ngokuyinhloko ngezitini zelanga (i-adobe), uthango lwendabuko kanye nama-tabique (ezaziwa endaweni ngokuthi tabique), ukhuni, noma izingxube zalezi zinto.Ezinye izakhiwo nezakhiwo eziseduze nendlu zihlanganisa amashedi ezilwane, izindawo zokugcina izimpahla, amakhishi nezindlu zangasese, ezakhiwe ngezinto ezifanayo.Umnotho wendawo usekelwe kwezolimo ukuziphilisa, ikakhulukazi ummbila namantongomane, kanye nezinkukhu ezincane, izingulube, izimbuzi, amadada nezinhlanzi, kanye nensalela yemikhiqizo yasekhaya ethengiswa edolobheni lezimakethe zendawo laseKamili (cishe amakhilomitha ayi-12).Idolobhana laseKamili liphinde linikeze inqwaba yamathuba emisebenzi kubantu, ikakhulukazi emkhakheni wezokwakha kanye nezinkonzo zasekhaya.
Ocwaningweni lwamanje, izinga lokutheleleka kwe-T. cruzi phakathi kwezingane zase-Itanambiqua (iminyaka engu-2-15) lalingu-20% [20].Lokhu kufana nokwanda kokutheleleka kwezingane okubikwa emphakathini ongumakhelwane waseGuarani, okuphinde kwabona ukwanda kwesibalo sabantu abaneminyaka engaphezu kwengama-30 ubudala.Ukudluliswa kwe-Vector kuthathwa njengomzila omkhulu wokutheleleka kule miphakathi, kanti i-Tri iyona ehamba phambili.Ama-infestan angena ezindlini nasezindaweni ezingaphandle [21, 22].
Isiphathimandla sezempilo sikamasipala esisanda kukhethwa asikwazanga ukuhlinzeka ngemibiko ngemisebenzi ye-IRS e-Itanambicua ngaphambi kwalolu cwaningo, nokho imibiko evela emiphakathini eseduze ikhombisa ngokusobala ukuthi ukusebenza kwe-IRS kumasipala bekwenzeka ngezikhathi ezithile kusukela ngo-2000 kanye nokufuthwa okuvamile kwe-beta cypermethrin engu-20%;kwenziwa ngo-2003, kwalandelwa ukufafazwa okugxilile kwezindlu ezigcwele kusukela ngo-2005 kuya ku-2009 [22] kanye nokufuthwa okuhlelekile kusukela ngo-2009 kuya ku-2011 [19].
Kulo mphakathi, i-IRS yenziwa ochwepheshe abathathu bezempilo abaqeqeshwe ngumphakathi basebenzisa ukwakheka okungama-20% kwe-alpha-cypermethrin suspension concentrate [SC] (Alphamost®, Hockley International Ltd., Manchester, UK).Isibulala-zinambuzane sakhiwe ngokugxilisa okuhlosiwe kokulethwa okungu-50 mg ai/m2 ngokuvumelana nezidingo Zohlelo Lokulawula Izifo lwe-Chagas loMnyango Wokuphatha wase-Santa Cruz (Servicio Departamental de Salud-SEDES).Izibulala-zinambuzane zasetshenziswa kusetshenziswa isifutha sikajosaka se-Guarany® (Guarany Indústria e Comércio Ltda, Itu, São Paulo, Brazil) esinamandla omthamo angu-8.5 l (ikhodi yethangi: 0441.20), efakwe umbhobho wesifutho esiyisicaba kanye nezinga lokugeleza elivamile lika- 757 ml/min, ikhiqiza umfudlana we-engeli engu-80° ngomfutho we-cylinder ojwayelekile ongu-280 kPa.Abasebenzi bezindlu zangasese baphinde baxuba amathini e-aerosol nezindlu ezifuthwayo.Ngaphambili izisebenzi zaziqeqeshwe umnyango wezempilo wedolobha lendawo ukuze zilungiselele futhi zilethe izibulala-zinambuzane, zifafaze izibulala-zinambuzane ngaphakathi nangaphandle kwezindonga zemizi.Baphinde belulekwe ukuthi bafune ukuthi abahlali basuse zonke izinto endlini, okuhlanganisa nefenisha (ngaphandle kwamafreyimu emibhede), okungenani amahora angu-24 ngaphambi kokuba i-IRS ithathe isinyathelo sokuvumela ukufinyelela okugcwele ngaphakathi kwekhaya ukuze kufuthwe.Ukuhambisana nale mfuneko kukalwa njengoba kuchazwe ngezansi.Izakhamuzi nazo ziyelulekwa ukuthi zilinde kuze kube yilapho izindonga ezipendiwe zomile ngaphambi kokungena kabusha ekhaya, njengoba kunconyiwe [42].
Ukulinganisa ukuhlushwa kwe-lambda-cypermethrin AI ethunyelwe ezindlini, abacwaningi bafaka iphepha lokuhlunga (Whatman No. 1; 55 mm ububanzi) ezindaweni ezibolile zezindlu ze-57 phambi kwe-IRS.Wonke amakhaya athola i-IRS ngaleso sikhathi ayehilelekile (amakhaya angama-25/25 ngoNovemba 2016 kanye namakhaya angama-32/32 ngoJanuwari-Februwari 2017).Lezi zihlanganisa izindlu ze-adobe ezingu-52 kanye nezindlu ze-tabik ezi-5.Kwafakwa izingcezu zephepha lokuhlunga eziyisishiyagalombili kuya kweziyisishiyagalolunye endlini ngayinye, zahlukaniswa zaba ubude bodonga obuthathu (amamitha angu-0,2, 1.2 no-2 ukusuka phansi), udonga ngalunye kwezintathu lukhethwe ngokuphambene newashi, luqala ngomnyango omkhulu.Lokhu kuhlinzeke ngokuphindaphinda okuthathu ekuphakameni kodonga ngalunye, njengoba kunconyiwe ukuze kuqashwe ukulethwa kwezibulala-zinambuzane ezisebenzayo [43].Ngokushesha ngemva kokufaka isibulala-zinambuzane, abacwaningi baqoqa iphepha lokuhlunga futhi balomisa lingangeni elangeni eliqondile.Uma lomile, iphepha lokuhlunga laligoqwa ngetheyiphu ecacile ukuze kuvikelwe futhi kubambe isibulala-zinambuzane endaweni emboziwe, bese sigoqwa ngephepha le-aluminium futhi ligcinwe ku-7°C kuze kube yilapho lihlolwa.Emaphepheni okuhlunga angama-513 aqoqiwe, izindlu ezingama-480 kwezingama-57 bezitholakala ukuthi zihlolwe, okungukuthi amaphepha okuhlunga ayi-8-9 ikhaya ngalinye.Amasampula okuhlola afaka amaphepha okuhlunga angama-437 avela ezindlini ezingama-52 ze-adobe kanye namaphepha okuhlunga angama-43 aphuma ezindlini ezi-5 zama-tabik.Isampula lilingana nokuvama okuhlobene kwezinhlobo zezindlu emphakathini (76.2% [138/181] adobe kanye no-11.6% [21/181] tabika) okurekhodwe ocwaningweni lwendlu ngendlu lwalolu cwaningo.Ukuhlaziywa kwephepha lokuhlunga kusetshenziswa i-Insecticide Quantification Kit (IQK™) kanye nokuqinisekiswa kwayo kusetshenziswa i-HPLC kuchazwe Efayeleni Lokwengeza 1. Ingqikithi yesibulala-zinambuzane okuhlosiwe ingu-50 mg ai/m2, okuvumela ukubekezelela okungu-± 20% (okungukuthi 40–60 mg ai /m2).
Ukugxila komthamo we-AI kwanqunywa kumathini angama-29 alungiswe ngabasebenzi bezokwelapha.Sathatha amathangi alungisiwe angu-1-4 ngosuku, ngesilinganiso samathangi angu-1.5 (ububanzi: 1-4) alungiswa ngosuku esikhathini esiyizinsuku ezingu-18.Ukulandelana kwamasampula kulandele ukulandelana kwamasampula okusetshenziswa ngabasebenzi bezempilo ngoNovemba 2016 nangoJanuwari 2017. Inqubekela phambili yansuku zonke kusukela;January February.Ngokushesha ngemva kokuxuba okuphelele kokubunjwa, i-2 ml yesisombululo iqoqwe ebusweni bokuqukethwe.Isampula engu-2 mL yabe isixutshwa elabhorethri ngokuvuthwa imizuzu emi-5 ngaphambi kokuthi amasampula amancane angu-5.2 μL aqoqwe futhi ahlolwe kusetshenziswa i-IQK™ njengoba kuchaziwe (bona ifayela Lokwengeza 1).
Amazinga okubekwa kwesithako esisebenzayo sesibulala-zinambuzane akalwe emathangeni amane okufuthwa akhethwe ngokukhethekile ukuze amele ukugxiliswa kwezithako ezisebenzayo zokuqala (eziro) ngaphakathi kwebanga eliphezulu, eliphansi, neliqondiwe.Ngemva kokuxuba imizuzu engu-15 elandelanayo, susa amasampula amathathu angu-5.2 µL kusukela kungqimba engaphezulu yesampula ngayinye ye-vortex engu-2 mL ngezikhathi ezithile zeminithi elingu-1.Ukugxila kwesixazululo okuhlosiwe ku-tank ngu-1.2 mg ai/ml ± 20% (okungukuthi 0.96–1.44 mg ai/ml), okulingana nokuzuza ukugxila okuhlosiwe okulethwe ephepheni lokuhlunga, njengoba kuchazwe ngenhla.
Ukuqonda ubudlelwano phakathi kwemisebenzi yokufafaza izibulala-zinambuzane kanye nokulethwa kwezibulala-zinambuzane, umcwaningi (RG) uphelezele abasebenzi bezempilo be-IRS ababili bendawo ngesikhathi sokuthunyelwa kwe-IRS ezindlini ezingama-87 (amakhaya angama-57 athathwe ngenhla kanye namakhaya angama-30 kwangu-43 afuthwe ngezibulala-zinambuzane).Mashi 2016).Ishumi nantathu kule mizi engama-43 ayifakwanga ekuhlaziyweni: abanikazi abayisithupha benqaba, futhi amakhaya ayisikhombisa aphathwa kancane.Ingqikithi yendawo okufanele ifuthwe (ama-square metres) ngaphakathi nangaphandle kwendlu ikalwe ngokuningiliziwe, futhi isikhathi esichithwa abasebenzi bezempilo befutha (imizuzu) sabhalwa ngasese.Le datha yokufaka isetshenziselwa ukubala izinga lokufafaza, elichazwa njengendawo engaphezulu efuthwe ngomzuzu (m2/min).Kusukela kule datha, isilinganiso sokufafaza esibonwayo/esilindelwe singabalwa njengesilinganiso esihlobene, nezinga lokufuthwa elituswayo elilindelekile libe ngu-19 m2/min ± 10% ekucacisweni kwemishini yesifutho [44].Ngesilinganiso esibhekiwe/esilindelwe, ububanzi bokubekezelela bungu-1 ± 10% (0.8–1.2).
Njengoba kushiwo ngenhla, izindlu ezingu-57 zazifakwe amaphepha okuhlunga ezindongeni zazo.Ukuhlola ukuthi ingabe ukubonakala kwephepha lokuhlunga kuthinte izinga lokufafaza kwabasebenzi bezokuthuthwa kwendle, amazinga okufuthwa kulawa makhaya angama-57 aqhathaniswe namazinga okufuthwa ezindlini ezingama-30 ezilashwe ngoNdasa wezi-2016 ngaphandle kokufakwa kwephepha lokuhlunga.Izibulala-zinambuzane zikalwa kuphela ezindlini ezinephepha lokuhlunga.
Izakhamuzi zemizi engama-55 zabhalwa ukuthi zithobela izidingo zangaphambilini zokuhlanza izindlu ze-IRS, okuhlanganisa izindlu ezingama-30 ezafuthwa ngoMashi 2016 kanye nezindlu ezingama-25 ezafuthwa ngoNovemba 2016. 0–2 (0 = zonke noma izinto eziningi zisala endlini; 1 = izinto eziningi ezisusiwe 2 = indlu ayinalutho ngokuphelele).Umthelela wokuthobela umnikazi emazingeni okufuthwa kanye nokugxiliswa kwesibulala-zinambuzane se-moxa wacwaningwa.
Amandla ezibalo abalwa ukuze kutholwe ukuchezuka okubalulekile ekugxilweni okulindelekile kwe-alpha-cypermethrin esetshenziswa ephepheni lokuhlunga, kanye nokuthola umehluko omkhulu ekugxilweni kwezibulala-zinambuzane kanye namazinga okufutha phakathi kwamaqembu abhanqiwe ngokwezigaba ezindlu.Amandla ezibalo amancane (α = 0.05) abalwe ngenani eliphansi lamakhaya athathwe isampula kunoma yiliphi iqembu lesigaba (okungukuthi, usayizi wesampula ongashintshi) onqunywe ekuqaleni.Kafushane, ukuqhathaniswa kokugxiliswa kwesibulala-zinambuzane kusampula eyodwa kuzo zonke izindawo ezikhethiwe ezingu-17 (ezithathwa njengabanikazi abangathobeli imithetho) kube namandla angu-98.5% okuthola ukuchezuka okungama-20% kusukela ekugxilweni kwesilinganiso okulindelekile kuka-50 mg ai/m2, lapho ukuhluka (SD = 10) kulinganiselwa ngokweqile ngokusekelwe kokuphawuliwe okushicilelwe kwenye indawo [37, 38].Ukuqhathaniswa kokugxilwa kwezibulala-zinambuzane emathini e-aerosol akhethiwe ekhaya ukuze asebenze ngokulinganayo (n = 21) > 90%.
Ukuqhathaniswa kwamasampula amabili esilinganiso sokugxiliswa kwezibulala-zinambuzane ku-n = 10 kanye no-n = ezindlini ezingu-12 noma isilinganiso sokufafaza isilinganiso ku-n = 12 kanye no-n = 23 izindlu kunikeze amandla ezibalo angu-66.2% kanye nama-86.2% okutholwa.Amanani alindelwe umehluko ongu-20% angu-50 mg ai/m2 kanye no-19 m2/min, ngokulandelanayo.Ngokweqile, kwakucatshangwa ukuthi kuzoba nokuhlukahluka okukhulu eqenjini ngalinye ngezinga lokufuthwa (SD = 3.5) kanye nokuhlushwa kwezinambuzane (SD = 10).Amandla ezibalo ayengu->90% ekuqhathaniseni okulinganayo kwamazinga okufuthwa phakathi kwezindlu ezinephepha lokuhlunga (n = 57) nezindlu ezingenalo iphepha lokuhlunga (n = 30).Zonke izibalo zamandla zenziwe kusetshenziswa uhlelo lwe-SAMPSI kusofthiwe ye-STATA v15.0 [45]).
Amaphepha okuhlunga aqoqwe endlini ahlolwe ngokufaka idatha kumodeli ye-multivariate negative binomial mix-effects (uhlelo lwe-MENBREG ku-STATA v.15.0) ngendawo yezindonga ngaphakathi kwendlu (amazinga amathathu) njengomphumela ongahleliwe.Ukugxiliswa kwemisebe ye-Beta.Amamodeli we-cypermethrin io asetshenziselwa ukuhlola izinguquko ezihlotshaniswa nobude bodonga lwe-nebulizer (amazinga amathathu), isilinganiso se-nebulization (m2/min), idethi yokufaka ye-IRS, kanye nesimo somhlinzeki wezempilo (amazinga amabili).Imodeli yomugqa ojwayelekile (i-GLM) yasetshenziswa ukuhlola ubudlelwano phakathi kwesilinganiso esimaphakathi se-alpha-cypermethrin ephepheni lesihlungi elilethwe ekhaya ngalinye kanye nokugxiliswa kwesisombululo esihambisanayo kuthangi lesifutho.Ukucwiliswa kwezibulala-zinambuzane esixazululweni sethangi lesifutho ngokuhamba kwesikhathi kwahlolwa ngendlela efanayo ngokufaka inani lokuqala (isikhathi esiyiziro) njengemodeli yokulinganisa, ukuhlola isikhathi sokusebenzisana se-ID yethangi × isikhathi (izinsuku).Amaphoyinti edatha engaphandle x akhonjwa ngokusebenzisa umthetho ojwayelekile womngcele we-Tukey, lapho x
Ukunemba kwe-ai IQK™ chemical quantification ye-alpha-cypermethrin concentration kwaqinisekiswa ngokuqhathanisa amanani amasampula ephepha lesihlungi angama-27 aphuma ezindlini zenkukhu ezintathu ezihlolwe yi-IQK™ kanye ne-HPLC (izinga legolide), futhi imiphumela yabonisa ukuhlobana okuqinile ( r = 0.93; p <0.001) (Fig. 2).
Ukuhlotshaniswa kokugxilwa kwe-alpha-cypermethrin kumasampula ephepha okuhlunga aqoqwe ezindlini zezinkukhu ze-post-IRS, okulinganiswa yi-HPLC kanye ne-IQK™ (n = 27 amaphepha okuhlunga avela ezindlini zezinkukhu ezintathu)
I-IQK™ ihlolwe emaphepheni okuhlunga angama-480 aqoqwe ezindlini zezinkukhu ezingama-57.Ephepheni lokuhlunga, okuqukethwe kwe-alpha-cypermethrin kwakusukela ku-0.19 kuya ku-105.0 mg ai/m2 (i-median 17.6, IQR: 11.06-29.78).Kulokhu, i-10.4% kuphela (50/480) yayingaphakathi kwebanga lokuhlushwa elihlosiwe lika-40-60 mg ai/m2 (Fig. 3).Iningi lamasampula (84.0% (403/480)) libe no-<40 mg ai/m2 kanye no-5.6% (27/480) libe>>60 mg ai/m2.Umehluko ekugxilweni okulinganiselwe kwe-median ngekhaya lezihlungi zokuhlola ezingu-8-9 eziqoqwe ngekhaya ngalinye kwakuyi-oda lobukhulu, ngenani elingu-19.6 mg ai/m2 (IQR: 11.76-28.32, ububanzi: 0. 60-67.45).Amaphesenti angu-8.8 kuphela (5/57) ezindawo athole ukugxiliswa kwezibulala-zinambuzane okulindelekile;Ama-89.5% (51/57) abengaphansi kwemikhawulo yebanga eliqondiwe, kanti u-1.8% (1/57) ubengaphezu kwemikhawulo yebanga eliqondiwe (Fig. 4).
Ukusatshalaliswa kwemvamisa kokugxiliswa kwe-alpha-cypermethrin kuzihlungi eziqoqwe ezindlini eziphathwe nge-IRS (n = 57 amakhaya).Ulayini oqondile umelela uhla lokuhlushwa oluqondiwe lwe-cypermethrin ai (50 mg ± 20% ai/m2).
Ukuhlushwa okumaphakathi kwe-beta-cypermethrin av kumaphepha okuhlunga angu-8-9 ekhaya ngalinye, aqoqwe kumakhaya acutshungulwe yi-IRS (n = 57 amakhaya).Ulayini ovundlile umelela uhla lokuhlushwa oluqondiwe lwe-alpha-cypermethrin ai (50 mg ± 20% ai/m2).Amabha wephutha amelela imikhawulo ephansi nengaphezulu yamanani asondelene we-median.
Ukugxilisa okumaphakathi okulethwe kuzihlungi ezinobude bebonda obungu-0.2, 1.2 kanye no-2.0 m obungu-17.7 mg ai/m2 (IQR: 10.70–34.26), 17.3 mg a .i./m2 (IQR: 11.43–26.91) kanye ne-17m2 mg .ngokulandelana (IQR: 10.85–31.37) (eboniswe efayeleni Lokwengeza 2).Ilawula idethi ye-IRS, imodeli yemiphumela exubile ayizange iveze umehluko obalulekile ekugxiliseni phakathi kobude bodonga (z <1.83, p > 0.067) noma izinguquko ezibalulekile ngedethi yesifutho (z = 1.84 p = 0.070).Ukugxiliswa okumaphakathi okulethwe ezindlini ze-adobe ezi-5 kwakungehlukile ekugxiliseni okumaphakathi okulethwa ezindlini ezingama-52 ze-adobe (z = 0.13; p = 0.89).
Ukugxila kwe-AI kumathini angama-29 e-aerosol alungiselelwe ngokuzimela e-Guarany® athathwe ngaphambi kokufakwa kwe-IRS ahluka ngo-12.1, ukusuka ku-0.16 mg AI/mL kuya ku-1.9 mg AI/mL ngekani (Umfanekiso 5).Kuphela u-6.9% (2/29) wamakani e-aerosol aqukethe ukugxila kwe-AI ngaphakathi kwebanga lethamo elihlosiwe lika-0.96–1.44 mg AI/ml, kanye no-3.5% (1/29) wamakani e-aerosol aqukethe ukugxila kwe-AI>1.44 mg AI/ml..
Ukugxila okumaphakathi kwe-alpha-cypermethrin ai kukalwe ekwakhekeni kwezifutho ezingama-29.Ulayini ovundlile umelela ukugxiliswa kwe-AI okunconyiwe kwamathini e-aerosol (0.96–1.44 mg/ml) ukuze kuzuzwe ububanzi obuhlosiwe be-AI obungu-40–60 mg/m2 endlini yezinkukhu.
Emathini e-aerosol angu-29 ahloliwe, angu-21 ahambisana nezindlu ezingu-21.Ukugxiliswa okumaphakathi kwe-ai elethwe endlini akuzange kuhlotshaniswe nokugxilisa ingqondo emathangeni okufafaza ngamanye asetshenziselwa ukwelapha indlu (z = -0.94, p = 0.345), okuboniswe ekuxhumaneni okuphansi (rSp2 = -0.02) ( Umfanekiso .6).).
Ukuxhumana phakathi kokugxiliswa kwe-beta-cypermethrin AI emaphepheni okuhlunga angu-8-9 aqoqwe ezindlini ezilashwe nge-IRS kanye nokugxila kwe-AI ezixazululweni zesifutho ezilungiselelwe ekhaya ezisetshenziselwa ukwelapha indlu ngayinye (n = 21)
Ukuhlushwa kwe-AI kuzixazululo ezingaphezulu kwezifutho ezine eziqoqwe ngokushesha ngemva kokuzamazama (isikhathi esingu-0) kuhluka ngo-3.3 (0.68-2.22 mg AI / ml) (Fig. 7).Ethangini elilodwa amanani angaphakathi kwebanga eliqondiwe, ithangi elilodwa amanani angaphezulu kwethagethi, kwamanye amathangi amabili amanani angaphansi kwethagethi;Ukugxiliswa kwezibulala-zinambuzane kube sekwehla kakhulu kuwo wonke amachibi amane phakathi nesampula yokulandela eyi-15-min elandelayo (b = -0.018 kuya ku- -0.084; z > 5.58; p <0.001).Uma kucatshangelwa amanani okuqala ethangi ngalinye, ithemu le-Tank ID x Isikhathi (amaminithi) lalingabalulekanga (z = -1.52; p = 0.127).Emachibini amane, isilinganiso sokulahlekelwa kwe-mg ai/ml insecticide sasingu-3.3% ngomzuzu (95% CL 5.25, 1.71), sifinyelela ku-49.0% (95% CL 25.69, 78.68) ngemva kwemizuzu engu-15 (Fig. 7).
Ngemva kokuxuba kahle izixazululo emathangini, izinga lokuna kwe-alpha-cypermethrin ai lalinganiswa.emathangini amane okufutha ngomzuzu ongu-1 ngezikhathi ezithile imizuzu eyi-15.Ulayini omelela ukulingana okuhle kwedatha uyaboniswa endaweni yokugcina amanzi.Okubhekwayo (amaphuzu) kumele i-median yamasampuli amathathu.
Indawo emaphakathi yodonga ngekhaya ngalinye lokwelashwa kwe-IRS okungenzeka yayiyi-128 m2 (IQR: 99.0–210.0, ububanzi: 49.1–480.0) futhi isikhathi esimaphakathi esichithwe abasebenzi bezokunakekelwa kwempilo kwakuyimizuzu engu-12 (IQR: 8. 2–17.5, ububanzi: 1.5) -36.6).) indlu ngayinye yafuthwa (n = 87).Ukufakwa kwesifutho okubonwa kulezi zindlu zezinkukhu kwakusukela ku-3.0 kuya ku-72.7 m2/min (imaphakathi: 11.1; IQR: 7.90–18.00) (Umfanekiso 8).Izinto ezingaphandle azifakwanga futhi amazinga okufuthwa aqhathaniswa nebanga lesilinganiso sokufuthwa esinconyiwe se-WHO esingu-19 m2/min ± 10% (17.1–20.9 m2/min).Amakhaya angu-7.5% (6/80) kuphela abekulolu hlu;Ama-77.5% (62/80) abekwibanga eliphansi kanti u-15.0% (12/80) abekwibanga eliphezulu.Abukho ubuhlobo obutholakele phakathi kokugxilisa okumaphakathi kwe-AI okulethwe ezindlini nokubonwa kokufakwa kwesifutho (z = -1.59, p = 0.111, n = 52 amakhaya).
Izinga lokufuthwa elibhekiwe (min/m2) ezindlini zezinkukhu eziphathwe nge-IRS (n = 87).Ulayini wereferensi umele uhla olulindelekile lokubekezelela izinga lokufafaza elingu-19 m2/min (±10%) olutuswe ngokucaciswa kwempahla yethangi lesifutho.
U-80% wezindlu ezingu-80 ube nesilinganiso esibonwayo/esilindelekile sokufafazwa kwesifutho ngaphandle kwebanga lokubekezelela i-1 ± 10%. ububanzi bokubekezelelana phakathi kwebanga.Ukusatshalaliswa kwemvamisa kwamanani esilinganiso esiboniwe/okulindelekile kuboniswa Efayelini Eyengeziwe 3.
Kube nomehluko obalulekile esilinganisweni esimaphakathi se-nebulization phakathi kwabasebenzi ababili bezempilo abenza i-IRS njalo: 9.7 m2/min (IQR: 6.58–14.85, n = 68) uma kuqhathaniswa no-15.5 m2/min (IQR: 13.07–21.17, n = 12) ).(z = 2.45, p = 0.014, n = 80) (njengoba kubonisiwe kokuthi Ifayela Eyengeziwe 4A) kanye nesilinganiso sesilinganiso sokufuthwa esibonwayo/esilindelwe (z = 2.58, p = 0.010) (njengoba kuboniswe kokuthi Ifayela Lengeziwe Lombukiso 4B) .
Ngaphandle kwezimo ezingajwayelekile, munye kuphela umsebenzi wezempilo owafafaza ezindlini ezingama-54 lapho kwakufakwa khona iphepha lokuhlunga.Izinga lokufutha elimaphakathi kulezi zindlu lalingu-9.23 m2/min (IQR: 6.57–13.80) uma kuqhathaniswa no-15.4 m2/min (IQR: 10.40–18.67) ezindlini ezingu-26 ezingenalo iphepha lokuhlunga (z = -2.38, p = 0.017).).
Ukuthobelana komkhaya nemfuneko yokushiya amakhaya abo ukuze kuthunyelwe i-IRS kuyehluka: 30.9% (17/55) awazange ashiye amakhaya awo kancane futhi ama-27.3% (15/55) awazange awashiye ngokuphelele;bacekela phansi imizi yabo.
Amazinga okufafaza aqashelwe ezindlini ezingenakho (17.5 m2/min, IQR: 11.00–22.50) ngokuvamile ayephakeme kunezindlu ezingenalutho (14.8 m2/min, IQR: 10.29–18 .00) kanye nezindlu ezingenalutho ngokuphelele (11.7 m2) )./min, IQR: 7.86–15.36), kodwa umehluko wawungabalulekile (z > -1.58; p > 0.114, n = 48) (kuboniswe kufayela Lokwengeza 5A).Imiphumela efanayo yatholwa lapho kucatshangelwa izinguquko ezihambisana nokuba khona noma ukungabikho kwephepha lokuhlunga, elingatholakalanga njenge-covariate ebalulekile kumodeli.
Kula maqembu amathathu, isikhathi esiphelele esidingekayo sokufutha izindlu asihlukanga phakathi kwezindlu (z < -1.90, p > 0.057), kuyilapho indawo ephakathi nendawo ihlukile: izindlu ezingenalutho ngokuphelele (104 m2 [IQR: 60.0–169, 0 m2) ]) ngokwezibalo zincane kunezindlu ezingenalutho (224 m2 [IQR: 174.0–284.0 m2]) kanye nezindlu ezingenalutho (132 m2 [IQR: 108.0–384.0 m2]) (z > 2 .17; p < 0.031, n = 48).Amakhaya angenamuntu ngokuphelele acishe abe uhhafu wosayizi (indawo) yamakhaya angenamuntu noma angenamuntu.
Ngenani elincane ngokuqhathaniswa lamakhaya (n = 25) anakho kokubili idatha ye-AI yokuthobela kanye nesibulala-zinambuzane, kwakungekho mehluko ekugxilweni kwe-AI okulinganiselwe okulethwe emakhaya phakathi kwalezi zigaba zokuthobela (z <0.93, p > 0.351) , njengoba kucaciswe kokuthi Ifayela Elingeziwe 5B.Imiphumela efanayo yatholwa lapho kulawulwa ukuba khona/ukungabikho kwephepha lokuhlunga futhi kubhekwe ukumbozwa kwesifutho (n = 22).
Lolu cwaningo luhlola izinqubo nezinqubo ze-IRS endaweni evamile yasemaphandleni esifundeni saseGran Chaco eBolivia, indawo enomlando omude wokudluliswa kwe-vector [20].Ukugxiliswa kwe-alpha-cypermethrin ai elawulwa ngesikhathi se-IRS evamile kwahlukahluka kakhulu phakathi kwezindlu, phakathi kwezihlungi ngazinye ngaphakathi kwendlu, naphakathi kwamathangi okufutha ngamanye alungiselelwe ukuzuza ukuhlushwa okufanayo okulethwayo okungu-50 mg ai/m2.Amakhaya angu-8.8% kuphela (u-10.4% wezihlungi) abe nokugxila ngaphakathi kwebanga eliqondiwe lika-40–60 mg ai/m2, iningi (89.5% kanye nama-84% ngokulandelanayo) libe nokugxilisa ingqondo ngaphansi komkhawulo ophansi ovunyelwe.
Esinye isici esingaba khona sokulethwa kwe-alpha-cypermethrin ekhaya ukuhlanjululwa okungalungile kwezibulala-zinambuzane kanye namazinga angahambisani wokumiswa okulungiselelwe emathangini okufutha [38, 46].Ocwaningweni lwamanje, ukubonwa kwabacwaningi kwabasebenzi bezokunakekelwa kwempilo kuqinisekisile ukuthi balandela izindlela zokupheka zokulungiselela izibulala-zinambuzane futhi baqeqeshwa yi-SEDES ukuze bavuse ngamandla ikhambi ngemva kokuhlanjululwa ethangini lokufutha.Kodwa-ke, ukuhlaziywa kokuqukethwe kwedamu kubonise ukuthi ukugxila kwe-AI kwahluka nge-factory ye-12, kanye no-6.9% (2/29) kuphela wezixazululo zechibi lokuhlola elingaphakathi kwebanga eliqondiwe;Ukuze kwenziwe olunye uphenyo, izixazululo ezingaphezulu kwethangi lokufafaza zilinganiselwe ezimeni zaselabhorethri.Lokhu kubonisa ukwehla komugqa ku-alpha-cypermethrin ai ka-3.3% ngomzuzu ngemva kokuxutshwa kanye nokulahlekelwa okuhlanganisiwe kwe-ai ka-49% ngemva kwemizuzu engu-15 (95% CL 25.7, 78.7).Amazinga aphezulu okudilika ngenxa yokuhlanganiswa kokumiswa kwezibulala-zinambuzane okwakhiwa ekuxutshweni kwempushana emanzi (WP) akuvamile (isb, i-DDT [37, 47]), futhi ucwaningo lwamanje lubonisa lokhu ku-SA pyrethroid formulations.I-Suspension concentrates isetshenziswa kakhulu ku-IRS futhi, njengawo wonke amalungiselelo okubulala izinambuzane, ukuzinza kwawo ngokomzimba kuncike ezintweni eziningi, ikakhulukazi usayizi wezinhlayiyana zesithako esisebenzayo nezinye izithako.I-sedimentation ingase ithinteke ngobulukhuni bamanzi asetshenziselwa ukulungisa i-slurry, into okunzima ukuyilawula ensimini.Isibonelo, kulesi sizinda socwaningo, ukufinyelela kwamanzi kukhawulelwe emifuleni yendawo ebonisa ukuhluka kwesizini ekugelezeni kwayo kanye nezinhlayiya zenhlabathi ezilengisiwe.Izindlela zokuqapha ukuzinza komzimba kwezingoma zaseNingizimu Afrika zingaphansi kocwaningo [48].Kodwa-ke, izidakamizwa ezingaphansi kwesikhumba ziye zasetshenziswa ngempumelelo ukunciphisa izifo zasendlini e-Tri.amagciwane e-pathogenic kwezinye izingxenye zeLatin America [49].
Ukwakheka kwezibulala-zinambuzane okunganele kubikwe kwezinye izinhlelo zokulawula ama-vector.Isibonelo, ohlelweni lokulawula i-visceral leishmaniasis e-India, kuphela ama-29% wamaqembu ezifafazi angama-51 aqaphe izisombululo ze-DDT ezilungiswe kahle nezixutshwe, futhi alikho elagcwalisa amathangi okufutha njengoba kunconyiwe [50].Ukuhlolwa kwamadolobhana ase-Bangladesh kubonise ukuthambekela okufanayo: kuphela ama-42-43% weqembu le-IRS alungisa izibulala-zinambuzane futhi agcwalisa amathini njengomthethonqubo ngamunye, kuyilapho kwesinye isifunda esincane isibalo sasingu-7.7% [46] kuphela.
Izinguquko eziphawuliwe ekugxilweni kwe-AI ezilethwa ekhaya nazo azihlukile.E-India, kuphela ama-7.3% (41 kwangu-560) amakhaya aphathwayo athola ukugxiliswa okuhlosiwe kwe-DDT, nomehluko ngaphakathi naphakathi kwezindlu ube mkhulu ngokulinganayo [37].E-Nepal, iphepha lokuhlunga limunce isilinganiso se-1.74 mg ai/m2 (ububanzi: 0.0–17.5 mg/m2), okungamaphesenti angu-7 kuphela okugxiliswa okuhlosiwe (25 mg ai/m2) [38].Ukuhlaziywa kwe-HPLC kwephepha lokuhlunga kubonise umehluko omkhulu ekugxilweni kwe-deltamethrin ai ezindongeni zezindlu e-Chaco, eParaguay: kusuka ku-12.8-51.2 mg ai / m2 kuya ku-4.6-61.0 mg ai / m2 ophahleni [33].E-Tupiza, eBolivia, Uhlelo Lokulawula I-Chagas lubike ukulethwa kwe-deltamethrin ezindlini ezinhlanu ekugxilweni kuka-0.0-59.6 mg/m2, okulinganiselwe yi-HPLC [36].
Isikhathi sokuthumela: Apr-16-2024