Amanetha emibhede aqukethe i-pyrethroid clofenpyr (CFP) kanye ne-pyrethroid piperonyl butoxide (PBO) ayakhuthazwa emazweni atholakala kalula ukuze kuthuthukiswe ukulawulwa kukamalaleveva osakazwa omiyane abangamelana ne-pyrethroid.I-CFP iyi-proinsecticide edinga ukwenziwa kusebenze ngomiyane i-cytochrome P450 monooxygenase (P450), futhi i-PBO ithuthukisa ukusebenza kahle kwe-pyrethroids ngokuvimbela ukusebenza kwalawa ma-enzyme komiyane abangamelana ne-pyrethroid.Ngakho, ukuvinjelwa kwe-P450 nge-PBO kungase kunciphise ukusebenza kwamanethi e-pyrethroid-CFP lapho esetshenziswa ekhaya elifanayo namanetha e-pyrethroid-PBO.
Ukuhlolwa kwe-cockpit okubili kwenziwa ukuze kuhlolwe izinhlobo ezimbili ezihlukene ze-pyrethroid-CFP ITN (Interceptor® G2, PermaNet® Dual) iyodwa futhi kuhlanganiswe ne-pyrethroid-PBO ITN (DuraNet® Plus, PermaNet® 3.0).Imithelela ye-Entomological yokusetshenziswa kwe-Pyrethroid resistance Vector labantu eningizimu ye-Benin.Kuzo zombili izifundo, zonke izinhlobo zemeshi zahlolwa ekwelashweni kwe-mesh eyodwa kanye nekabili.Ama-Bioassays nawo aqhutshwa ukuze kuhlolwe ukumelana nezidakamizwa kwezibalo zezilwane eqhugwaneni kanye nokucwaninga ukusebenzisana phakathi kwe-CFP ne-PBO.
Inani lama-vector lalizwela ku-CFP kodwa lalibonisa amazinga aphezulu okumelana nama-pyrethroids, kodwa lokhu kumelana kwanqotshwa ukuchayeka ngaphambilini ku-PBO.Ukufa kwezilwane kwehliswe kakhulu emaqhugwaneni kusetshenziswa inhlanganisela yamanethi e-pyrethroid-CFP kanye namanethi e-pyrethroid-PBO uma kuqhathaniswa namaqhugwane asebenzisa amanethi e-pyrethroid-CFP (74% we-Interceptor® G2 vs. 85%, PermaNet® Dual 57% vs. 83 % ), p <0.001).Ukuchayeka ngaphambilini ku-PBO kwehlise ubuthi be-CFP ekuhlolweni kwe-bioassay yamabhodlela, okuphakamisa ukuthi lo mphumela ungase ubangelwe ngokwengxenye ukungqubuzana phakathi kwe-CFP ne-PBO.Ukufa kwezilwane kwakuphezulu emaqhugwaneni kusetshenziswa inhlanganisela yamanethi aqukethe amanethi e-pyrethroid-CFP uma kuqhathaniswa namaqhugwane angenawo amanethi e-pyrethroid-CFP, nalapho amanetha e-pyrethroid-CFP esetshenziswa yedwa njengamanethi amabili.Uma kusetshenziswa ndawonye, ukufa kuphezulu kakhulu (83-85%).
Lolu cwaningo lubonise ukuthi ukusebenza kahle kwe-pyrethroid-CFP meshes kwehlisiwe uma isetshenziswa kuhlanganiswe ne-pyrethroid-PBO ITN uma kuqhathaniswa nokusetshenziswa iyodwa, kuyilapho ukusebenza kahle kwezinhlanganisela zemeshi eziqukethe amameshi e-pyrethroid-CFP kwakuphakeme.Le miphumela iphakamisa ukuthi ukubeka phambili ukusatshalaliswa kwamanethiwekhi e-pyrethroid-CFP ngaphezu kwezinye izinhlobo zamanethiwekhi kuzokhulisa imiphumela yokulawula i-vector ezimeni ezifanayo.
Amanethi alahlwe ngama-insecticide-treated bed (ITNs) aqukethe izibulala-zinambuzane ze-pyrethroid asephenduke insika yokulawula umalaleveva kule minyaka engamashumi amabili edlule.Kusukela ngo-2004, cishe ayizigidi eziyizinkulungwane ezingu-2.5 amanethi afakwe izibulala-zinambuzane ahlinzekwe e-Afrika eseningizimu yeSahara [1], okubangele ukwanda kwenani labantu abalala ngaphansi kwamanethi afakwe izibulala-zinambuzane ukusuka ku-4% kuya ku-47% [2].Umphumela walokhu kuqaliswa wawubalulekile.Kulinganiselwa ukuthi cishe izigameko ze-malaria eziyizigidi eziyizinkulungwane ezingu-2 kanye nokufa kwezigidi ezingu-6.2 kwagwenywa emhlabeni wonke phakathi kuka-2000 no-2021, ngokuhlaziywa kwemodeli ephakamisa ukuthi amanetha aphethwe yizinambuzane ayengumshayeli omkhulu wale nzuzo [2, 3].Kodwa-ke, le ntuthuko iza ngentengo: ukuvela okusheshisiwe kokumelana ne-pyrethroid kubantu be-malaria.Nakuba amanetha ombhede alashwe ngezinambuzane ze-pyrethroid asenganikeza ukuvikeleka komuntu ngamunye ngokumelene nomalaleveva ezindaweni lapho ama-vectors abonisa ukumelana ne-pyrethroid [4], izifundo zokumodela zibikezela ukuthi emazingeni aphezulu okumelana, amanetha ombhede aphethwe yizinambuzane azonciphisa umthelela we-epidemiological [5]..Ngakho-ke, ukumelana ne-pyrethroids kungenye yezinsongo ezibaluleke kakhulu ekuqhubekeleni phambili okuqhubekayo ekulawuleni umalaleveva.
Phakathi neminyaka embalwa edlule, kuye kwasungulwa isizukulwane esisha samanetha afakwe izibulala-zinambuzane, ahlanganisa i-pyrethroids nekhemikhali yesibili, ukuze kuthuthukiswe indlela yokulawula umalaleveva osakazwa omiyane abamelana ne-pyrethroid.Ikilasi elisha lokuqala le-ITN liqukethe i-synergist piperonyl butoxide (PBO), eyenza i-pyrethroids ngokushintsha ama-enzyme aqeda ubuthi ahlobene nokuphikiswa kwe-pyrethroid, ikakhulukazi ukuphumelela kwe-cytochrome P450 monooxygenases (P450s) [6].Amanethi ombhede alashwe nge-fluprone (CFP), isibulala-zinambuzane se-azole esinendlela entsha yokusebenza eqondise ukuphefumula kwamaselula, nawo asanda kutholakala.Ukulandela ukuboniswa komthelela othuthukisiwe we-entomological ekuhlolweni komshayeli we-hut [7, 8], uchungechunge lwezilingo ezilawulwa ngokungahleliwe (cRCT) zenziwa ukuze kuhlolwe izinzuzo zezempilo zomphakathi zalawa manetha uma kuqhathaniswa namanetha aphethwe yizinambuzane kusetshenziswa ama-pyrethroids kuphela futhi anikeze ubufakazi obudingekayo ukuze bazise izincomo zenqubomgomo ezivela ku-World Health Organization (WHO) [9].Ngokusekelwe ebufakazini bomthelela othuthukisiwe we-epidemiological kusuka kuma-CRCTs e-Uganda [11] naseTanzania [12], i-WHO igunyaze amanethi aphethwe ngesibulala-zinambuzane e-pyrethroid-PBO [10].I-pyrethroid-CFP ITN nayo isanda kushicilelwa ngemva kwama-RCT afanayo e-Benin [13] naseTanzania [14] ibonise ukuthi i-prototype ye-ITN (Interceptor® G2) yehlisa izehlakalo zikamalaleveva wezingane ngama-46% nama-44% ngokulandelana.10].].
Kulandela imizamo evuselelwe ye-Global Fund kanye nabanye abanikeli bakamalaleveva abakhulu yokubhekana nokumelana nezibulala-zinambuzane ngokusheshisa ukwethulwa kwamanethi amasha wokulala [15], amanethi e-pyrethroid-PBO kanye ne-pyrethroid-CFP asesetshenziswa ezindaweni eziwugwadule.Ithatha indawo yezibulala-zinambuzane zendabuko.amanetha alashiwe asebenzisa ama-pyrethroids kuphela.Phakathi kuka-2019 no-2022, ingxenye yamanethi omiyane e-PBO pyrethroid ahlinzekwa e-sub-Saharan Africa inyuke isuka ku-8% yaya ku-51% [1], kuyilapho amanethi omiyane e-PBO pyrethroid, okuhlanganisa amanethi omiyane e-CFP pyrethroid, amanethi “akabili” alindeleke ukuba adle omiyane. ibalwa ku-56% wempahla.Ngena emakethe yase-Afrika ngo-2025[16].Njengobufakazi bokusebenza kwamanethi omiyane e-pyrethroid-PBO kanye ne-pyrethroid-CFP ayaqhubeka nokukhula, la manetha kulindeleke ukuthi atholakale kabanzi eminyakeni ezayo.Ngakho-ke, kunesidingo esikhulayo sokugcwalisa izikhala zolwazi mayelana nokusetshenziswa kahle kwamanethi esizukulwane esisha afakwe isibulala-zinambuzane ukuze kuzuzwe umphumela omkhulu uma esenyuswa ukuze asetshenziswe ngokugcwele.
Uma kubhekwa ukwanda okuhambisanayo kwe-pyrethroid CFP kanye ne-pyrethroid PBO mosquito nets, Uhlelo Lukazwelonke Lokulawula Umalaleveva (NMCP) lunombuzo owodwa wocwaningo olusebenzayo: Ingabe ukusebenza kwawo kuzoncishiswa - PBO ITN?Isizathu salokhu kukhathazeka ukuthi i-PBO yenza ngokuvimbela ama-enzyme e-mosquito P450 [6], kanti i-CFP iyi-proinsecticide edinga ukusebenza nge-P450s [17].Ngakho-ke, kucatshangelwa ukuthi uma i-pyrethroid-CFP ITN ne-pyrethroid-CFP ITN kusetshenziswa ekhaya elifanayo, umphumela ovimbelayo we-PBO ku-P450 ungase wehlise ukusebenza kwe-pyrethroid-CFP ITN.Ucwaningo oluningi lwaselabhorethri luye lwabonisa ukuthi ukuchayeka kwangaphambili ku-PBO kunciphisa ubuthi obukhulu be-CFP kuma-vector omiyane ekuchayekeni okuqondile kwe-bioassays [18,19,20,21,22].Kodwa-ke, lapho kwenziwa izifundo phakathi kwamanethiwekhi ahlukene emkhakheni, ukusebenzisana phakathi kwalawa makhemikhali kuzoba nzima kakhulu.Ucwaningo olungashicilelwe luhlole imiphumela yokusebenzisa izinhlobo ezahlukene zamanethi afakwe izibulala-zinambuzane ndawonye.Ngakho-ke, ucwaningo lwasensimini oluhlola umthelela wokusebenzisa inhlanganisela yamanethi emibhede afakwe isibulala-zinambuzane e-pyrethroid-CFP kanye ne-pyrethroid-PBO endlini eyodwa kuzosiza ekunqumeni ukuthi ngabe ukuphikiswa okungaba khona phakathi kwalezi zinhlobo zamanethi kubangela inkinga yokusebenza futhi kusize ekunqumeni ukuthunyelwa kwesu elingcono kakhulu. .ezifundeni zayo ezisatshalaliswe ngokulinganayo.
Isikhathi sokuthumela: Sep-21-2023