Ezivivinyweni e-Afrika, amanethi ombhede enziweI-PYRETHROIDfuthiI-FIPRONILibonise imiphumela ethuthukisiwe ye-entomological kanye ne-epidemiological. Lokhu kuholele ekwandeni kwesidingo sale khosi entsha eku-inthanethi emazweni agcwele umalaleveva. I-PermaNet Dual iyi-deltamethrin entsha kanye ne-clofenac mesh eyakhiwe yi-Vestergaard Sàrl ukuze inikeze amakhono engeziwe ezinhlelweni zokulawula umalaleveva. Senze isivivinyo sokuhlola i-cockpit ukuhlola ukusebenza kwe-PermaNet Dual ngokumelene nomiyane basendle, abalwa ne-pyrethroid abandiza ngokukhululekile i-Anopheles gambiae eCove, eBenin. I-PermaNet Dual ibangele ukufa okuphezulu komiyane uma ingagezwanga uma kuqhathaniswa namanethe aqukethe i-pyrethroid yodwa kanye namanethe aqukethe i-pyrethroid kanye ne-PIPERONYL BUTOXIDE (77% ye-PermaNet Dual, 23% ye-PermaNet 2.0 kanye no-23% ye-PermaNet 3.0) 56% p < 0.001) ngemva kweminyaka engu-20. ukugeza okujwayelekile (75% kwe-PermaNet Dual, 14% kwe-PermaNet 2.0, 30% kwe-PermaNet 3.0, p < 0.001). Isebenzisa imingcele ephakathi nendawo engeyona ephansi echazwe yi-World Health Organisation, i-PermaNet Dual nayo yayingeyona ephansi ekufeni kwabathwali be-pyrethroid-clofenazoline, okubonise inani elithuthukisiwe lempilo yomphakathi (Interceptor G2) (79% vs 76). %, OR = 0.878, 95% CI 0.719–1.073), kodwa hhayi ukuvikela ekuhlinzekweni kwegazi (35% vs. 26%, OR = 1.424, 95% CI 1.177–1.723). I-PermaNet Dual iyindlela eyengeziwe kulolu hlobo lwenethi olusebenza kahle kakhulu ukuthuthukisa ukulawulwa kwe-malaria edluliselwa omiyane abamelana ne-pyrethroid.
Amanethi okulala aphathwa ngezibulala-zinambuzane (ama-ITN) ayizindlela zokuvimbela umalaleveva ezisebenza kahle kakhulu futhi ezisetshenziswa kabanzi. Aye abonakala ngokuphindaphindiwe ukuthi anciphisa ukugula nokufa komalaleveva ezimweni zokuhlola nezohlelo futhi enze umnikelo omkhulu kunanoma yikuphi ukungenelela kwamuva nje ukunciphisa ukwanda komalaleveva. Kodwa-ke, ukuthembela kwawo ekilasini elilodwa lama-insecticide (ama-pyrethroids) kunengcindezi ekhethiwe, okukhuthaza ukusabalala kokumelana nama-pyrethroid kuma-vectors kamalaleveva. Phakathi kuka-2010 no-2020, ukumelana nama-pyrethroid kwatholakala okungenani kohlobo olulodwa lwama-vector emazweni angama-88% agcwele umalaleveva. Nakuba izifundo zikhombisile ukuthi amanethi okulala aphathwa ngezibulala-zinambuzane avikela umalaleveva naphezu kokumelana nawo, kunobufakazi obuqinile bokuthi omiyane abavezwe kumanethi okulala aphathwa ngama-pyrethroid bathuthukise amandla okusinda nawokudla. Njengoba bebheka ukubaluleka kwawo ekuvimbeleni nasekulawuleni umalaleveva, noma yikuphi ukuncipha okwengeziwe ekusebenzeni kahle kwamanethi okulala aphathwa ngezibulala-zinambuzane kungaholela ekubuyeni kokugula nokufa.
Ngenxa yalolu songo, amanethi okulala aphathwe ngezibulala-zinambuzane asebenza kabili, ahlanganisa i-pyrethroid nenye inhlanganisela, akhiwe ukuze kubuyiselwe ukulawula izinambuzane ezimelana ne-pyrethroid. Uhlobo olusha lokuqala lwe-ITN luhlanganisa ama-pyrethroid nama-I-PIPERONYL BUTOXIDE (PBO), i-synergist ethuthukisa ukusebenza kahle kwama-pyrethroids ngokunciphisa ama-enzyme okususa ubuthi ahlobene nokumelana nama-pyrethroid10. Ezindlini zokuhlola kanye nezilingo ezilawulwa ngokungahleliwe zeqembu (cRCT) ama-ITN aqukethe ama-pyrethroids kanye nama-PBO abonise izinzuzo eziphezulu zezinambuzane uma kuqhathaniswa nama-ITN aqukethe ama-pyrethroids kuphela kanye nokusebenza kahle kwe-epidemiological. Kusukela lapho bathole isincomo se-WHO esinombandela sokusatshalaliswa ezindaweni lapho ama-vectors ebonisa ukumelana nama-pyrethroids, okuholela ekwandeni okukhulu kokusatshalaliswa kwawo emazweni atholakala kakhulu eminyakeni yamuva nje18. Kodwa-ke, i-pyrethroid-PBO ITN ayinayo imingcele. Okuphawulekayo ukuthi kukhona ukukhathazeka ngokuqina kwawo ngemva kokusetshenziswa ekhaya isikhathi eside. Izifundo zokuhlola eNtshonalanga Afrika ziphakamisa nokuthi amanethi omiyane e-pyrethroid-PBO anganikeza inzuzo elinganiselwe ezindaweni ezinokumelana okukhulu kwama-pyrethroid okubangelwa izindlela eziyinkimbinkimbi neziningi. Ngakho-ke, ukuze kulawulwe ama-vector okuphumelelayo nokuqhubekayo, kuyadingeka ukusebenzisa izinhlobo eziningi zamanethi ombhede aphathwe ngezibulala-zinambuzane, okungcono aqukethe ezinye izibulala-zinambuzane ezintsha lapho ama-vectors ezwela khona.
Muva nje, amanethi okulala aphathwe ngezibulala-zinambuzane aseyatholakala ahlanganisa ama-pyrethroids ne-fipronil, isibulala-zinambuzane se-azole esiphazamisa ukusebenza kwe-mitochondrial. I-Chlorfenopyr imelela indlela entsha yokulawula izinambuzane zezifo eziye zakha izindlela eziyinkimbinkimbi zokumelana nezibulala-zinambuzane ezikhona. I-pyrethroid-chlorphenopyr ITN (Interceptor G2), eyathuthukiswa yi-BASF, ibonise umalaleveva omelana ne-pyrethroid ezivivinyweni zokuhlola eBenin, eBurkina Faso, eCôte naseTanzania. Ukulawulwa kwama-vector kuthuthukile futhi manje sekuqinisekiswe yi-World Health Organisation. Izivivinyo ezinkulu kanye nezinhlelo zokusabalalisa ama-vector kwamanye amazwe nazo zibonise ubufakazi bomthelela we-epidemiological. Ngokukhethekile, ama-RCT eBenin naseTanzania abonise ukuthi i-Interceptor G2 inciphise ukwanda komalaleveva ebuntwaneni ngo-46% no-44% eminyakeni emi-2, ngokulandelana, uma kuqhathaniswa ne-ITN esebenzisa ama-pyrethroids ajwayelekile kuphela. Ngokusekelwe kule miphumela, i-World Health Organisation muva nje ikhiphe isincomo esinamandla sokusetshenziswa kwamanethi ombhede aphathwe nge-insecticide pyrethroid-chlorphenopyr kunemanethi ombhede aqukethe ama-pyrethroids kuphela ezindaweni lapho ama-vectors engamelana nama-pyrethroids. Amanethi ombhede aphathwe ngama-insecticide ukuvimbela umalaleveva. Lokhu kuholele ekwandeni okukhulu kwesidingo somhlaba wonke kanye nama-oda amanethi omiyane aphathwe ngama-pyrethroid afakwe emazweni avamile. Ukuthuthukiswa kwezinhlobo ezintsha kakhulu zamanethi ombhede e-pyrethroid kanye ne-fipronil asebenza kahle ngabakhiqizi abaningana abanamakhono okukhiqiza aqinile kuzosiza ekuthuthukiseni imakethe yamanethi ombhede aphathwe ngama-insecticide, kwandise ukuncintisana, futhi kuholele ekufinyeleleni kalula kwamanethi ombhede aphathwa ngama-insecticide angabizi kakhulu. Amanethi ombhede. Amanethi ombhede abulala izinambuzane okulawula i-vector kahle.
Isikhathi sokuthunyelwe: Okthoba-17-2023