Kupopera mankhwala otsala m'nyumba (IRS) ndiye njira yaikulu yoyendetsera ntchito zowongolera ma vector a visceral leishmaniasis (VL) ku India. Sizikudziwika zambiri za momwe ma control a IRS amakhudzira mitundu yosiyanasiyana ya mabanja. Pano tikuona ngati IRS yogwiritsa ntchito mankhwala ophera tizilombo ili ndi zotsatira zofanana komanso zotsutsana ndi mitundu yonse ya mabanja m'mudzi. Tinapanganso mamapu ophatikizana a zoopsa za malo ndi zitsanzo zowunikira kuchuluka kwa udzudzu kutengera mawonekedwe a m'nyumba, kukhudzidwa ndi mankhwala ophera tizilombo, komanso momwe IRS ilili kuti tiwone momwe ma vector amafalikira m'malo osiyanasiyana pamlingo wa microscale.
Kafukufukuyu adachitika m'midzi iwiri ya Mahnar block m'boma la Vaishali ku Bihar. IRS idayang'anira ma vector a VL (P. argentipes) pogwiritsa ntchito mankhwala awiri ophera tizilombo [dichlorodiphenyltrichloroethane (DDT 50%) ndi ma pyrethroids opangidwa (SP 5%)]. Kugwira ntchito kwa mankhwala ophera tizilombo pa makoma osiyanasiyana kunayesedwa pogwiritsa ntchito njira ya cone bioassay monga momwe bungwe la World Health Organization linanenera. Kuzindikira kwa nsomba zasiliva zakumaloko ku mankhwala ophera tizilombo kunayesedwa pogwiritsa ntchito in vitro bioassay. Kuchuluka kwa udzudzu wa IRS m'nyumba ndi m'malo osungira nyama kunayang'aniridwa pogwiritsa ntchito misampha yopepuka yomwe idayikidwa ndi Centers for Disease Control kuyambira 6:00 pm mpaka 6:00 am. Chitsanzo choyenera kwambiri chowunikira kuchuluka kwa udzudzu chinapangidwa pogwiritsa ntchito kusanthula kwambiri kwa logistic regression. Ukadaulo wofufuza malo wozikidwa pa GIS unagwiritsidwa ntchito poyesa kufalikira kwa kukhudzidwa kwa mankhwala ophera tizilombo malinga ndi mtundu wa nyumba, ndipo mkhalidwe wa IRS m'nyumba unagwiritsidwa ntchito kufotokoza kufalikira kwa siliva shrimp m'malo osiyanasiyana.
Udzudzu wasiliva umakhudzidwa kwambiri ndi SP (100%), koma umalimbana kwambiri ndi DDT, ndipo chiwerengero cha imfa ndi 49.1%. SP-IRS inanenedwa kuti imalandiridwa bwino ndi anthu kuposa DDT-IRS pakati pa mabanja osiyanasiyana. Mphamvu yotsalira imasiyanasiyana m'makoma osiyanasiyana; palibe mankhwala ophera tizilombo omwe adakwaniritsa nthawi yomwe bungwe la World Health Organization limalimbikitsa kuti agwire ntchito. Nthawi zonse pambuyo pa IRS, kuchepetsa kununkha kwa tizilombo chifukwa cha SP-IRS kunali kwakukulu pakati pa magulu a mabanja (monga opopera ndi oteteza) kuposa DDT-IRS. Mapu ophatikizana a chiopsezo cha malo akuwonetsa kuti SP-IRS ili ndi mphamvu yabwino yolamulira udzudzu kuposa DDT-IRS m'malo onse omwe ali pachiwopsezo cha mabanja. Kusanthula kwa regression ya logistic logistic kwapeza zinthu zisanu zomwe zimagwirizanitsidwa kwambiri ndi kuchuluka kwa shrimp yasiliva.
Zotsatirazi zithandiza kumvetsetsa bwino machitidwe a IRS polimbana ndi matenda a visceral leishmaniasis ku Bihar, zomwe zingathandize kutsogolera zoyesayesa zamtsogolo zokonzanso vutoli.
Visceral leishmaniasis (VL), yomwe imadziwikanso kuti kala-azar, ndi matenda ofala kwambiri m'madera otentha omwe amayambitsidwa ndi tizilombo toyambitsa matenda a protozoan a mtundu wa Leishmania. Mu Indian subcontinent (IS), komwe anthu ndi okhawo omwe amakhala m'malo osungiramo tizilombo toyambitsa matenda, tizilombo toyambitsa matenda (monga Leishmania donovani) timafalikira kwa anthu kudzera mu kulumidwa ndi udzudzu wachikazi womwe uli ndi kachilomboka (Phlebotomus argentipes) [1, 2]. Ku India, VL imapezeka kwambiri m'maiko anayi apakati ndi kum'mawa: Bihar, Jharkhand, West Bengal ndi Uttar Pradesh. Kufalikira kwina kwanenedwanso ku Madhya Pradesh (Central India), Gujarat (Western India), Tamil Nadu ndi Kerala (South India), komanso m'madera a kumadzulo kwa Himalaya kumpoto kwa India, kuphatikiza Himachal Pradesh ndi Jammu ndi Kashmir. 3]. Pakati pa mayiko omwe ali ndi kachilomboka, Bihar ndi matenda ofala kwambiri ndipo madera 33 omwe akhudzidwa ndi VL ndi oposa 70% ya milandu yonse ku India chaka chilichonse [4]. Anthu pafupifupi 99 miliyoni m'derali ali pachiwopsezo, ndipo chiwerengero cha anthu omwe ali ndi matendawa pachaka ndi 6,752 (2013-2017).
Ku Bihar ndi madera ena a India, khama loletsa matenda a VL limadalira njira zitatu zazikulu: kuzindikira msanga, chithandizo chogwira mtima, ndi kuletsa tizilombo toyambitsa matenda pogwiritsa ntchito kupopera mankhwala ophera tizilombo m'nyumba (IRS) m'nyumba ndi m'malo osungira nyama [4, 5]. Monga zotsatira zoyipa za kampeni yolimbana ndi malungo, IRS idathetsa bwino matenda a VL m'zaka za m'ma 1960 pogwiritsa ntchito dichlorodiphenyltrichloroethane (DDT 50% WP, 1 g ai/m2), ndipo kuletsa kwa pulogalamuyo kudathetsa bwino matenda a VL mu 1977 ndi 1992 [5, 6]. Komabe, kafukufuku waposachedwa watsimikizira kuti nkhono zasiliva zakhala zikukana kwambiri DDT [4,7,8]. Mu 2015, National Vector Borne Disease Control Program (NVBDCP, New Delhi) idasintha IRS kuchokera ku DDT kupita ku synthetic pyrethroids (SP; alpha-cypermethrin 5% WP, 25 mg ai/m2) [7, 9]. Bungwe la World Health Organization (WHO) lakhazikitsa cholinga chothetsa matenda a VL pofika chaka cha 2020 (monga <1 mwa anthu 10,000 pachaka pamlingo wa mumsewu/malo ozungulira) [10]. Kafukufuku wambiri wasonyeza kuti IRS ndi yothandiza kwambiri kuposa njira zina zowongolera tizilombo toyambitsa matenda pochepetsa kuchuluka kwa tizilombo toyambitsa matenda [11,12,13]. Chitsanzo chaposachedwapa chikuloseranso kuti m'malo omwe mliriwu unali waukulu (monga, kuchuluka kwa mliri woletsa wa 5/10,000), IRS yogwira ntchito yophimba 80% ya mabanja ikhoza kukwaniritsa zolinga zochotsera matendawa chaka chimodzi mpaka zitatu m'mbuyomu [14]. VL imakhudza madera osauka kwambiri akumidzi m'madera omwe ali ndi matendawa ndipo kuwongolera tizilombo toyambitsa matenda kumadalira IRS kokha, koma zotsatira zotsalira za njira yowongolera iyi pa mabanja osiyanasiyana sizinaphunzirepo m'munda m'madera olowererapo [15, 16]. Kuphatikiza apo, pambuyo pa ntchito yayikulu yolimbana ndi VL, mliriwu m'midzi ina unakhalapo kwa zaka zingapo ndipo unasanduka malo otentha [17]. Chifukwa chake, ndikofunikira kuwunika momwe IRS imakhudzira kuwunika kuchuluka kwa udzudzu m'mabanja osiyanasiyana. Kuphatikiza apo, mapu a zoopsa za geospatial a microscale athandiza kumvetsetsa bwino ndikulamulira kuchuluka kwa udzudzu ngakhale mutachitapo kanthu. Makina odziwitsa za malo (GIS) ndi kuphatikiza matekinoloje a digito omwe amathandiza kusunga, kuphimba, kusintha, kusanthula, kupeza ndi kuwona magulu osiyanasiyana a deta ya zachilengedwe ndi chikhalidwe cha anthu pazinthu zosiyanasiyana [18, 19, 20]. . Dongosolo loyika malo padziko lonse lapansi (GPS) limagwiritsidwa ntchito kuphunzira malo a zigawo za dziko lapansi [21, 22]. Zipangizo ndi njira zowonetsera malo zochokera ku GIS ndi GPS zagwiritsidwa ntchito pazinthu zingapo zokhudzana ndi matenda, monga kuwunika matenda a malo ndi nthawi komanso kulosera za mliri, kukhazikitsa ndi kuwunika njira zowongolera, kuyanjana kwa tizilombo toyambitsa matenda ndi zinthu zachilengedwe, ndi mapu a zoopsa za malo. [20,23,24,25,26]. Chidziwitso chosonkhanitsidwa ndikuchokera ku mapu a zoopsa za malo chingathandize njira zowongolera panthawi yake komanso moyenera.
Kafukufukuyu adawunika momwe DDT ndi SP-IRS zimagwirira ntchito komanso momwe zimakhudzira mabanja motsatira pulogalamu ya National VL Vector Control Program ku Bihar, India. Zolinga zina zinali kupanga mapu ophatikizana a chiopsezo cha malo ndi chitsanzo chowunikira kuchuluka kwa udzudzu kutengera mawonekedwe a nyumba, kuthekera kwa tizilombo toyambitsa matenda, komanso momwe IRS imagwirira ntchito m'nyumba kuti iwunikenso momwe udzudzu wa microscale umafalikira m'malo osiyanasiyana.
Kafukufukuyu adachitika ku Mahnar block ya chigawo cha Vaishali kumpoto kwa gombe la Ganga (Chithunzi 1). Makhnar ndi dera lomwe anthu ambiri amapezeka ndi matendawa, ndipo anthu pafupifupi 56.7 amadwala matenda a VL pachaka (170 mwa 2012-2014), kuchuluka kwa anthu omwe amapezeka ndi matendawa pachaka ndi 2.5–3.7 mwa anthu 10,000; Midzi iwiri idasankhidwa: Chakeso ngati malo owongolera matenda (Chithunzi 1d1; palibe milandu ya VL m'zaka zisanu zapitazi) ndi Lavapur Mahanar ngati malo omwe anthu ambiri amapezeka ndi matendawa (Chithunzi 1d2; omwe anthu ambiri amapezeka ndi matendawa, ndipo anthu 5 kapena kuposerapo pa anthu 1000 pachaka). M'zaka 5 zapitazi, midzi idasankhidwa kutengera mfundo zitatu zazikulu: malo ndi momwe anthu angafikire matendawa (monga omwe ali pamtsinje womwe anthu ambiri amawapeza mosavuta chaka chonse), makhalidwe a anthu ndi chiwerengero cha mabanja (monga mabanja osachepera 200; Chaqueso ili ndi mabanja 202 ndi 204 omwe ali ndi mabanja ambiri). Anthu 4.9 ndi 5.1) ndi Lavapur Mahanar motsatana) ndi mtundu wa nyumba (HT) ndi mtundu wa kufalikira kwawo (mwachitsanzo, HT yosakanikirana yogawidwa mwachisawawa). Midzi yonse yophunzirira ili mkati mwa 500 m kuchokera ku tawuni ya Makhnar ndi chipatala cha chigawo. Kafukufukuyu adawonetsa kuti anthu okhala m'midzi yophunzirira anali otanganidwa kwambiri ndi zochitika zofufuzira. Nyumba zomwe zili m'mudzi wophunzitsira [zokhala ndi chipinda chimodzi kapena ziwiri chokhala ndi khonde limodzi lolumikizidwa, khitchini imodzi, bafa limodzi ndi khola limodzi (lolumikizidwa kapena lopatukana)] zimakhala ndi makoma a njerwa/matope ndi pansi pa dothi, makoma a njerwa okhala ndi pulasitala wa simenti ya laimu. ndi pansi pa simenti, makoma a njerwa osapakidwa pulasitala komanso osapakidwa utoto, pansi pa dothi ndi denga lokhala ndi udzu. Chigawo chonse cha Vaishali chili ndi nyengo yonyowa ya subtropical yokhala ndi nyengo yamvula (Julayi mpaka Ogasiti) ndi nyengo youma (Novembala mpaka Disembala). Mvula yapakati pachaka ndi 720.4 mm (pakati pa 736.5-1076.7 mm), chinyezi chapakati ndi 65±5% (pakati pa 16-79%), kutentha kwapakati pamwezi ndi 17.2-32.4°C. Meyi ndi Juni ndi miyezi yotentha kwambiri (kutentha 39–44°C), pomwe Januwale ndi yozizira kwambiri (pakati pa 7–22°C).
Mapu a malo ophunzirirawa akuwonetsa komwe kuli Bihar pamapu a India (a) ndi komwe kuli chigawo cha Vaishali pamapu a Bihar (b). Malo a Makhnar Block (c) Midzi iwiri idasankhidwa kuti igwiritsidwe ntchito pa kafukufukuyu: Chakeso ngati malo owongolera ndi Lavapur Makhnar ngati malo olowererapo.
Monga gawo la National Kalaazar Control Programme, Bihar Society Health Board (SHSB) idachita maulendo awiri a IRS pachaka mu 2015 ndi 2016 (ulendo woyamba, February-March; ulendo wachiwiri, June-July)[4]. Pofuna kuonetsetsa kuti ntchito zonse za IRS zikuyenda bwino, Rajendra Memorial Medical Institute (RMRIMS; Bihar), Patna, kampani yothandizira ya Indian Council of Medical Research (ICMR; New Delhi). Midzi ya IRS idasankhidwa kutengera mfundo ziwiri zazikulu: mbiri ya milandu ya VL ndi retrodermal kala-azar (RPKDL) m'mudzimo (monga midzi yokhala ndi milandu 1 kapena kuposerapo nthawi iliyonse m'zaka 3 zapitazi, kuphatikiza chaka chokhazikitsidwa). , midzi yomwe siili yopezeka m'madera ozungulira "malo otentha" (monga midzi yomwe yakhala ikunena za milandu kwa zaka ≥ 2 kapena ≥ milandu 2 pa anthu 1000) ndi midzi yatsopano yopezeka m'madera opezeka (palibe milandu m'zaka 3 zapitazi) midzi m'chaka chomaliza cha chaka chokhazikitsidwa chomwe chidanenedwa mu [17]. Midzi yoyandikana nayo yomwe ikukhazikitsa gawo loyamba la misonkho ya dziko, midzi yatsopano ikuphatikizidwanso mu gawo lachiwiri la dongosolo la msonkho wa dziko. Mu 2015, maulendo awiri a IRS pogwiritsa ntchito DDT (DDT 50% WP, 1 g ai/m2) adachitika m'midzi yophunzirira. Kuyambira 2016, IRS yakhala ikugwiritsidwa ntchito pogwiritsa ntchito pyrethroids zopangidwa (SP; alpha-cypermethrin 5% VP, 25 mg ai/m2). Kupopera kunachitika pogwiritsa ntchito pampu ya Hudson Xpert (13.4 L) yokhala ndi chinsalu chopondereza, valavu yosinthasintha yoyenda (1.5 bar) ndi nozzle ya 8002 flat jet pamalo obowoka [27]. ICMR-RMRIMS, Patna (Bihar) idayang'anira IRS pamlingo wa mabanja ndi mudzi ndipo idapereka chidziwitso choyambirira chokhudza IRS kwa anthu akumudzi kudzera m'ma maikolofoni mkati mwa masiku 1-2 oyamba. Gulu lililonse la IRS lili ndi chowunikira (choperekedwa ndi RMRIMS) kuti chiyang'anire momwe gulu la IRS likuyendera. Oweruza milandu, pamodzi ndi magulu a IRS, amatumizidwa m'mabanja onse kuti akadziwitse ndikutsimikizira atsogoleri a mabanja za ubwino wa IRS. Pa nthawi ziwiri za kafukufuku wa IRS, kuchuluka kwa mabanja m'midzi yofufuza kunafika pa 80% [4]. Kupopera mankhwala (monga, kusapopera mankhwala, kupopera pang'ono, ndi kupopera mankhwala kwathunthu; tafotokozedwa mu fayilo yowonjezera 1: Table S1) kunalembedwa m'mabanja onse m'mudzi wolowererapo panthawi zonse za IRS.
Kafukufukuyu adachitika kuyambira mu June 2015 mpaka Julayi 2016. IRS idagwiritsa ntchito malo opezera matenda poyesa kulowererapo (monga, masabata awiri asanayambe kulowererapo; kafukufuku woyambira) ndi pambuyo pake (monga, masabata awiri, anayi, ndi khumi ndi awiri atatha kulowererapo; kafukufuku wotsatira) kuyang'anira, kuwongolera kuchulukana kwa anthu, ndi kupewa ntchentche zam'mphepete mwa mchenga mu gawo lililonse la IRS. m'nyumba iliyonse Usiku umodzi (monga kuyambira 18:00 mpaka 6:00) msampha wopepuka [28]. Misampha yopepuka yayikidwa m'zipinda zogona ndi m'malo osungira nyama. M'mudzi momwe kafukufukuyu adachitikira, mabanja 48 adayesedwa kuchulukana kwa ntchentche zam'mphepete mwa mchenga IRS isanakwane (mabanja 12 patsiku kwa masiku anayi otsatizana mpaka tsiku lisanafike tsiku la IRS). 12 adasankhidwa pa gulu lililonse la mabanja anayi akuluakulu (monga pulasitala wosalala wa dongo (PMP), pulasitala wa simenti ndi laimu (CPLC), nyumba zopanda pulasitala ndi zosapakidwa utoto (BUU) ndi nyumba za denga la udzu (TH). Pambuyo pake, mabanja 12 okha (mwa mabanja 48 asanafike IRS) adasankhidwa kuti apitirize kusonkhanitsa deta ya kuchuluka kwa udzudzu pambuyo pa msonkhano wa IRS. Malinga ndi malangizo a WHO, mabanja 6 adasankhidwa kuchokera ku gulu lothandizira (mabanja omwe akulandira chithandizo cha IRS) ndi gulu la alonda (mabanja omwe ali m'midzi yothandiza, eni ake omwe adakana chilolezo cha IRS) [28]. Pakati pa gulu lolamulira (mabanja omwe ali m'midzi yoyandikana nawo omwe sanalandire IRS chifukwa chosowa VL), mabanja 6 okha ndi omwe adasankhidwa kuti ayang'anire kuchuluka kwa udzudzu asanayambe komanso atalandira magawo awiri a IRS. Pa magulu onse atatu owunikira kuchuluka kwa udzudzu (monga kulowererapo, alonda ndi oyang'anira), mabanja adasankhidwa kuchokera m'magulu atatu omwe ali pachiwopsezo (monga otsika, apakati ndi apamwamba; mabanja awiri ochokera pamlingo uliwonse wa chiopsezo) ndipo makhalidwe a chiopsezo cha HT adagawidwa m'magulu (magawo ndi kapangidwe kake akuwonetsedwa mu Table 1 ndi Table 2, motsatana) [29, 30]. Mabanja awiri pamlingo uliwonse wa chiopsezo adasankhidwa kuti apewe kuyerekezera kopanda tsankho kwa kuchuluka kwa udzudzu ndi kufananiza pakati pa magulu. Mu gulu lothandizira, kuchulukana kwa udzudzu pambuyo pa IRS kunayang'aniridwa m'mabanja awiri a IRS: kuchiritsidwa kwathunthu (n = 3; banja limodzi pa gulu lililonse la anthu omwe ali pachiwopsezo) ndi kuchiritsidwa pang'ono (n = 3; banja limodzi pa gulu lililonse la anthu omwe ali pachiwopsezo). ). gulu la anthu omwe ali pachiwopsezo).
Udzudzu wonse womwe unagwidwa m'munda womwe unasonkhanitsidwa m'machubu oyesera unasamutsidwira ku labotale, ndipo machubu oyeserawo anaphedwa pogwiritsa ntchito ubweya wa thonje wonyowa mu chloroform. Ntchentche zasiliva zinasanduka zachiwerewere ndikulekanitsidwa ndi tizilombo tina ndi udzudzu kutengera mawonekedwe a thupi pogwiritsa ntchito ma code odziwika bwino [31]. Nsomba zonse zasiliva zazimuna ndi zazikazi zinayikidwa m'zitini padera mu mowa wa 80%. Kuchuluka kwa udzudzu pa msampha/usiku kunawerengedwa pogwiritsa ntchito njira iyi: chiwerengero chonse cha udzudzu chomwe chinasonkhanitsidwa/chiwerengero cha misampha yowala yomwe inayikidwa usiku uliwonse. Kusintha kwa kuchuluka kwa udzudzu (SFC) chifukwa cha IRS pogwiritsa ntchito DDT ndi SP kunayesedwa pogwiritsa ntchito njira iyi [32]:
pomwe A ndiye apakati pa SFC ya mabanja olowererapo, B ndiye apakati pa SFC ya IRS ya mabanja olowererapo, C ndiye apakati pa SFC ya mabanja owongolera/a sentinel, ndipo D ndiye apakati pa SFC ya mabanja owongolera/a sentinel a IRS.
Zotsatira za zotsatira za kulowererapo, zolembedwa ngati zabwino ndi zoipa, zimasonyeza kuchepa ndi kuwonjezeka kwa SFC pambuyo pa IRS, motsatana. Ngati SFC pambuyo pa IRS ikhalabe yofanana ndi SFC yoyambira, zotsatira za kulowererapo zidawerengedwa ngati zero.
Malinga ndi World Health Organization Pesticide Evaluation Scheme (WHOPES), kukhudzidwa kwa nkhanu za silverleg zakuthengo ku mankhwala ophera tizilombo a DDT ndi SP kunayesedwa pogwiritsa ntchito njira zoyesera za in vitro bioassays [33]. Nkhanu zazikazi zathanzi komanso zosadyetsedwa (18–25 SF pagulu lililonse) zinakumana ndi mankhwala ophera tizilombo ochokera ku Universiti Sains Malaysia (USM, Malaysia; yoyendetsedwa ndi World Health Organization) pogwiritsa ntchito World Health Organization Pesticide Sensitivity Test Kit [4,9, 33,34]. Seti iliyonse ya mayeso ophera tizilombo inayesedwa kasanu ndi katatu (mayeso anayi obwerezabwereza, iliyonse imayendetsedwa nthawi imodzi ndi oyang'anira). Mayeso owongolera anachitika pogwiritsa ntchito pepala lodzazidwa kale ndi risella (ya DDT) ndi mafuta a silicone (ya SP) operekedwa ndi USM. Pambuyo pa mphindi 60 zowonekera, udzudzu unayikidwa m'machubu a WHO ndipo unapatsidwa thonje lonyowa lomwe linanyowa mu yankho la shuga la 10%. Chiwerengero cha udzudzu womwe unaphedwa pambuyo pa ola limodzi ndi imfa yomaliza pambuyo pa maola 24 chinawonedwa. Mkhalidwe wa kukana umafotokozedwa motsatira malangizo a World Health Organization: imfa ya 98–100% imasonyeza kukana, 90–98% imasonyeza kukana komwe kumafunika kutsimikiziridwa, ndipo <90% imasonyeza kukana [33, 34]. Popeza imfa m'gulu lolamulira zinali kuyambira 0 mpaka 5%, palibe kusintha kwa imfa komwe kunachitika.
Kugwira ntchito kwa tizilombo toyambitsa matenda komanso zotsatira zotsalira za mankhwala ophera tizilombo pa nsabwe zachilengedwe m'munda zinayesedwa. M'mabanja atatu olowererapo (limodzi lililonse lili ndi pulasitala wadothi wamba kapena PMP, pulasitala wa simenti ndi laimu kapena CPLC, njerwa zosapakidwa pulasitala komanso zosapakidwa utoto kapena BUU) patatha milungu 2, 4 ndi 12 mutapopera. Kuyesa kwa WHO kwa bioassay kunachitika pa ma cones okhala ndi misampha yowala. [27, 32]. Kutentha kwapakhomo sikunachotsedwe chifukwa cha makoma osafanana. Mu kusanthula kulikonse, ma cones 12 adagwiritsidwa ntchito m'nyumba zonse zoyesera (ma cones anayi panyumba, imodzi pamtundu uliwonse wa khoma). Mangani ma cones pakhoma lililonse la chipindacho kutalika kosiyana: limodzi pamlingo wa mutu (kuchokera pa 1.7 mpaka 1.8 m), awiri pamlingo wa m'chiuno (kuchokera pa 0.9 mpaka 1 m) ndi limodzi pansi pa bondo (kuchokera pa 0.3 mpaka 0.5 m). Udzudzu khumi wa akazi wosadyetsedwa (10 pa koni; wosonkhanitsidwa kuchokera ku malo owongolera pogwiritsa ntchito aspirator) unayikidwa m'chipinda chilichonse cha pulasitiki cha WHO (koni imodzi pamtundu uliwonse wa banja) ngati zowongolera. Pambuyo pa mphindi 30 mutakumana ndi udzudzu, chotsani mosamala udzudzuwo; sungani chipinda chozungulira pogwiritsa ntchito chotsukira chigongono ndikuchiyika m'machubu a WHO okhala ndi 10% shuga kuti mudyetse. Imfa yomaliza pambuyo pa maola 24 inalembedwa pa 27 ± 2°C ndi 80 ± 10% chinyezi. Chiŵerengero cha imfa ndi zigoli pakati pa 5% ndi 20% chimasinthidwa pogwiritsa ntchito njira ya Abbott [27] motere:
pomwe P ndiye chiwerengero cha imfa chosinthidwa, P1 ndiye chiwerengero cha imfa chomwe chawonedwa, ndipo C ndiye chiwerengero cha imfa chowongolera. Mayeso okhala ndi chiwerengero cha imfa >20% adachotsedwa ndipo adachitidwanso [27, 33].
Kafukufuku wathunthu wa mabanja unachitika mumudzi wothandiza anthu. Malo a GPS a banja lililonse adalembedwa pamodzi ndi kapangidwe kake ndi mtundu wa zinthu, malo okhala, ndi momwe zinthu zilili. Pulatifomu ya GIS yapanga database ya digito yomwe imaphatikizapo zigawo za malire pamlingo wa mudzi, chigawo, chigawo ndi boma. Malo onse a m'banja amalembedwa pogwiritsa ntchito zigawo za mfundo za GIS pamlingo wa mudzi, ndipo zambiri za makhalidwe awo zimalumikizidwa ndikusinthidwa. Pamalo aliwonse a m'banja, chiopsezo chinayesedwa kutengera HT, kuthekera kwa tizilombo toyambitsa matenda, ndi momwe zinthu zilili mu IRS (Table 1) [11, 26, 29, 30]. Malo onse a m'banja adasinthidwa kukhala mamapu amutu pogwiritsa ntchito kulemera kwa mtunda wozungulira (IDW; resolution kutengera avareji ya malo a m'banja a 6 m2, mphamvu 2, chiwerengero chokhazikika cha mfundo zozungulira = 10, pogwiritsa ntchito variable search radius, low pass filter). ndi cubic convolution mapping) spatial interpolation technology [35]. Mitundu iwiri ya mamapu amutu amutu adapangidwa: mamapu amutu amutu a HT ndi pesticides vector sensitivity ndi IRS status (ISV ndi IRSS). Mamapu awiri owopsa omwe ali ndi mitu iwiri adaphatikizidwa pogwiritsa ntchito kusanthula kwa overlay kolemera [36]. Panthawiyi, zigawo za raster zidasinthidwa kukhala magulu okondedwa ambiri pamlingo wosiyana wa chiopsezo (monga, chiopsezo chapamwamba, chapakati, ndi chotsika/chopanda). Gawo lililonse la raster lomwe linasinthidwanso linachulukitsidwa ndi kulemera komwe linapatsidwa kutengera kufunika kwa magawo omwe amathandizira kuchuluka kwa udzudzu (kutengera kufalikira kwa midzi yophunzirira, malo oberekera udzudzu, ndi khalidwe lopumula ndi kudyetsa) [26, 29]. , 30, 37]. Mamapu onse awiri owopsa omwe ali ndi mitu adayesedwa 50:50 chifukwa adathandizira mofanana kuchuluka kwa udzudzu (Fayilo Yowonjezera 1: Gome S2). Mwa kufotokozera mamapu olemera omwe ali ndi mitu yambiri, mapu omaliza owopsa amapangidwa ndikuwonetsedwa pa nsanja ya GIS. Mamapu omaliza owopsa amaperekedwa ndikufotokozedwa motsatira miyezo ya Sand Fly Risk Index (SFRI) yowerengedwa pogwiritsa ntchito njira iyi:
Mu fomula iyi, P ndiye chizindikiro cha chiopsezo, L ndiye chiwerengero chonse cha chiopsezo pa malo omwe banja lililonse lili, ndipo H ndiye chiwerengero chachikulu kwambiri cha chiopsezo pa banja lililonse m'dera lofufuza. Tinakonza ndikuchita zigawo za GIS ndi kusanthula pogwiritsa ntchito ESRI ArcGIS v.9.3 (Redlands, CA, USA) kuti tipange mamapu a chiopsezo.
Tinachita kafukufuku wobwerezabwereza kambirimbiri kuti tione zotsatira za HT, ISV, ndi IRSS (monga tafotokozera mu Table 1) pa kuchuluka kwa udzudzu m'nyumba (n = 24). Makhalidwe a nyumba ndi zinthu zoopsa kutengera njira ya IRS yomwe yalembedwa mu kafukufukuyu zinaonedwa ngati zosintha zofotokozera, ndipo kuchuluka kwa udzudzu kunagwiritsidwa ntchito ngati zosintha zoyankhira. Kusanthula kobwerezabwereza kwa Poisson kwa Univariate kunachitidwa pa kusintha kulikonse kofotokozera komwe kumakhudzana ndi kuchuluka kwa ntchentche zam'madzi. Pa kusanthula kobwerezabwereza, zosintha zomwe sizinali zofunika komanso zomwe zinali ndi P yoposa 15% zinachotsedwa pa kusanthula kobwerezabwereza kambirimbiri. Kuti tiwunikire kuyanjana, mawu olumikizirana a kuphatikiza konse komwe kungatheke kwa zosintha zofunika (zomwe zimapezeka mu kusanthula kobwerezabwereza) adaphatikizidwa nthawi imodzi mu kusanthula kobwerezabwereza kambirimbiri, ndipo mawu osafunikira adachotsedwa mu chitsanzocho pang'onopang'ono kuti apange chitsanzo chomaliza.
Kuwunika zoopsa za pabanja kunachitika m'njira ziwiri: kuwunika zoopsa za pabanja komanso kuwunika malo owopsa pamapu. Kuwunika zoopsa za pabanja kunayesedwa pogwiritsa ntchito kusanthula kwa ubale pakati pa kuyerekezera zoopsa za pabanja ndi kuchuluka kwa ntchentche zamchenga (zosonkhanitsidwa kuchokera ku mabanja 6 oteteza ndi mabanja 6 olowererapo; milungu isanafike komanso itatha IRS). Madera owopsa a malo anayesedwa pogwiritsa ntchito chiwerengero chapakati cha udzudzu wosonkhanitsidwa kuchokera ku mabanja osiyanasiyana ndikuyerekeza pakati pa magulu owopsa (monga madera otsika, apakati ndi oopsa kwambiri). Mu gawo lililonse la IRS, mabanja 12 (mabanja anayi m'magawo atatu aliwonse a madera owopsa; kusonkhanitsa usiku kumachitika milungu iwiri iliyonse, inayi, ndi 12 pambuyo pa IRS) adasankhidwa mwachisawawa kuti asonkhanitse udzudzu kuti ayesere mapu owopsa. Deta yomweyi ya pabanja (monga HT, VSI, IRSS ndi kuchuluka kwa udzudzu) idagwiritsidwa ntchito kuyesa chitsanzo chomaliza cha regression. Kusanthula kosavuta kwa ubale kunachitika pakati pa kuyang'ana m'munda ndi kuchuluka kwa udzudzu wa pabanja komwe kunanenedweratu ndi chitsanzo.
Ziwerengero zofotokozera monga pakati, zochepa, zazikulu, 95% zodalirika (CI) ndi maperesenti zinawerengedwa kuti zifotokoze mwachidule deta yokhudzana ndi tizilombo toyambitsa matenda ndi IRS. Chiwerengero chapakati/kuchulukana ndi kufa kwa tizilombo ta siliva (zotsalira za tizilombo toyambitsa matenda) pogwiritsa ntchito mayeso a parametric [zitsanzo zophatikizidwa t-test (ya deta yogawidwa mwachizolowezi)] ndi mayeso osagwiritsidwa ntchito pa parametric (Wilcoxon signed rank) kuti tiyerekezere kugwira ntchito pakati pa mitundu ya pamwamba m'nyumba (ie, BUU vs. CPLC, BUU vs. PMP, ndi CPLC vs. PMP) ya deta yosagawidwa mwachizolowezi). Kusanthula konse kunachitika pogwiritsa ntchito pulogalamu ya SPSS v.20 (SPSS Inc., Chicago, IL, USA).
Kuchuluka kwa mabanja m'midzi yolowererapo panthawi ya IRS DDT ndi SP kunawerengedwa. Mabanja 205 onse adalandira IRS munthawi iliyonse, kuphatikiza mabanja 179 (87.3%) munthawi ya DDT ndi mabanja 194 (94.6%) munthawi ya SP yowongolera ma ventricle a VL. Chiŵerengero cha mabanja omwe adachiritsidwa ndi mankhwala ophera tizilombo chinali chachikulu panthawi ya SP-IRS (86.3%) kuposa nthawi ya DDT-IRS (52.7%). Chiwerengero cha mabanja omwe adasankha kuchoka ku IRS panthawi ya DDT chinali 26 (12.7%) ndipo chiwerengero cha mabanja omwe adasankha kuchoka ku IRS panthawi ya SP chinali 11 (5.4%). Pa nthawi ya DDT ndi SP, chiwerengero cha mabanja omwe adachiritsidwa pang'ono omwe adalembetsa chinali 71 (34.6% ya mabanja onse omwe adachiritsidwa) ndi mabanja 17 (8.3% ya mabanja onse omwe adachiritsidwa), motsatana.
Malinga ndi malangizo a WHO okhudza kukana mankhwala ophera tizilombo, kuchuluka kwa nkhanu zasiliva pamalo ochitira opaleshoni kunali kotetezeka kwambiri ku alpha-cypermethrin (0.05%) chifukwa chiwerengero cha imfa chomwe chinanenedwa panthawi ya mayeso (maola 24) chinali 100%. Chiwerengero cha imfa chomwe chinawonedwa chinali 85.9% (95% CI: 81.1–90.6%). Pa DDT, chiwerengero cha imfa chomwe chinapezeka pa maola 24 chinali 22.8% (95% CI: 11.5–34.1%), ndipo chiwerengero cha imfa chomwe chinapezeka pa mayeso amagetsi chinali 49.1% (95% CI: 41.9–56.3%). Zotsatira zake zinasonyeza kuti nkhanu zasiliva zinayamba kukana kwathunthu ku DDT pamalo ochitira opaleshoni.
Mu tebulo Gome 3 likufotokoza mwachidule zotsatira za bioanalysis ya ma cones a mitundu yosiyanasiyana ya malo (nthawi zosiyana pambuyo pa IRS) zomwe zathandizidwa ndi DDT ndi SP. Deta yathu inasonyeza kuti patatha maola 24, mankhwala ophera tizilombo (BUU vs. CPLC: t(2)= – 6.42, P = 0.02; BUU vs. PMP: t(2) = 0.25, P = 0.83; CPLC vs. PMP: t(2)= 1.03, P = 0.41 (ya DDT-IRS ndi BUU) CPLC: t(2)= − 5.86, P = 0.03 ndi PMP: t(2) = 1.42, P = 0.29; IRS, CPLC ndi PMP: t(2) = 3.01, P = 0.10 ndi SP: t(2) = 9.70, P = 0.01; chiwerengero cha imfa chinachepa pang'onopang'ono pakapita nthawi. Kwa SP-IRS: milungu iwiri pambuyo popopera mitundu yonse ya makoma (monga 95.6% yonse) ndi milungu 4 Kuthira makoma a CPLC kokha (monga 82.5). Mu gulu la DDT, imfa zinali pansi pa 70% pa mitundu yonse ya makoma nthawi zonse pambuyo pa kuyesedwa kwa IRS. Chiwerengero cha imfa zoyesera za DDT ndi SP pambuyo pa milungu 12 yothira chinali 25.1% ndi 63.2%, motsatana. Mitundu itatu ya pamwamba, chiwerengero chachikulu cha imfa ndi DDT chinali 61.1% (kwa PMP milungu iwiri pambuyo pa IRS), 36.9% (kwa CPLC milungu 4 pambuyo pa IRS), ndi 28.9% (kwa CPLC milungu 4 pambuyo pa IRS). Mitengo yocheperako ndi 55% (kwa BUU, milungu 2 pambuyo pa IRS), 32.5% (kwa PMP, milungu 4 pambuyo pa IRS) ndi 20% (kwa PMP, milungu 4 pambuyo pa IRS); US IRS). Kwa SP, chiwerengero chachikulu cha imfa pa mitundu yonse ya pamwamba chinali 97.2% (kwa CPLC, milungu iwiri pambuyo pa IRS), 82.5% (kwa CPLC, milungu inayi pambuyo pa IRS), ndi 67.5% (kwa CPLC, milungu inayi pambuyo pa IRS). milungu 12 pambuyo pa IRS). US IRS). milungu ina pambuyo pa IRS); chiwerengero chotsika kwambiri chinali 94.4% (kwa BUU, milungu iwiri pambuyo pa IRS), 75% (kwa PMP, milungu inayi pambuyo pa IRS), ndi 58.3% (kwa PMP, milungu 12 pambuyo pa IRS). Pa mankhwala onse awiri ophera tizilombo, imfa pa malo ochiritsidwa ndi PMP zimasiyana mofulumira pakapita nthawi kuposa pamalo ochiritsidwa ndi CPLC ndi BUU.
Gome 4 likufotokoza mwachidule zotsatira za kulowererapo (monga kusintha kwa IRS mu kuchuluka kwa udzudzu) za maulendo a IRS ozikidwa pa DDT ndi SP (Fayilo yowonjezera 1: Chithunzi S1). Pa DDT-IRS, kuchepa kwa chiwerengero cha tizilombo ta siliva titadutsa nthawi ya IRS kunali 34.1% (pa milungu iwiri), 25.9% (pa milungu inayi), ndi 14.1% (pa milungu 12). Pa SP-IRS, kuchuluka kwa kuchepa kunali 90.5% (pa milungu iwiri), 66.7% (pa milungu inayi), ndi 55.6% (pa milungu 12). Kuchepa kwakukulu kwa kuchuluka kwa siliva shrimp m'mabanja a sentinel panthawi ya malipoti a DDT ndi SP IRS kunali 2.8% (pa milungu iwiri) ndi 49.1% (pa milungu iwiri), motsatana. Mu nthawi ya SP-IRS, kuchepa (asanayambe komanso atamaliza) kwa ma pheasants oyera kunali kofanana m'mabanja opopera (t(2)= – 9.09, P < 0.001) ndi mabanja a sentinel (t(2) = – 1.29, P = 0.33). Kwambiri poyerekeza ndi DDT-IRS nthawi zonse zitatu pambuyo pa IRS. Pa mankhwala onse awiri ophera tizilombo, kuchuluka kwa tizilombo ta siliva kunawonjezeka m'mabanja a sentinel milungu 12 pambuyo pa IRS (monga, 3.6% ndi 9.9% ya SP ndi DDT, motsatana). Pa nthawi ya SP ndi DDT pambuyo pa misonkhano ya IRS, nkhono 112 ndi 161 zasiliva zinasonkhanitsidwa kuchokera ku minda ya sentinel, motsatana.
Palibe kusiyana kwakukulu pakati pa kuchuluka kwa shrimp zasiliva komwe kunawonedwa pakati pa magulu a mabanja (monga kupopera motsutsana ndi sentinel: t(2)= – 3.47, P = 0.07; kupopera motsutsana ndi kulamulira: t(2) = – 2.03, P = 0.18; sentinel motsutsana ndi kulamulira: mkati mwa milungu ya IRS pambuyo pa DDT, t(2) = - 0.59, P = 0.62). Mosiyana ndi zimenezi, kusiyana kwakukulu pakati pa kuchuluka kwa shrimp zasiliva kunawonedwa pakati pa gulu lopopera ndi gulu lolamulira (t(2) = – 11.28, P = 0.01) ndi pakati pa gulu lopopera ndi gulu lolamulira (t(2) = – 4, 42, P = 0.05). IRS milungu ingapo pambuyo pa SP. Kwa SP-IRS, palibe kusiyana kwakukulu komwe kunawonedwa pakati pa mabanja a sentinel ndi olamulira (t(2)= -0.48, P = 0.68). Chithunzi 2 chikuwonetsa kuchuluka kwa mbalame za silver-belly pheasant zomwe zimawonedwa m'mafamu omwe amachiritsidwa mokwanira komanso pang'ono ndi mawilo a IRS. Panalibe kusiyana kwakukulu pakuchuluka kwa mbalame za silver-belly zomwe zimasamalidwa bwino pakati pa mabanja omwe amasamalidwa mokwanira komanso pang'ono (avereji 7.3 ndi 2.7 pa msampha/usiku). DDT-IRS ndi SP-IRS, motsatana), ndipo mabanja ena adapopera mankhwala onse awiri (avereji 7.5 ndi 4.4 pausiku pa DDT-IRS ndi SP-IRS, motsatana) (t(2) ≤ 1.0, P > 0.2). Komabe, kuchuluka kwa mbalame za silver shrimp m'mafamu omwe amapopera mokwanira komanso pang'ono kunasiyana kwambiri pakati pa mitundu ya SP ndi DDT IRS (t(2) ≥ 4.54, P ≤ 0.05).
Kuchuluka kwa tizilombo toyambitsa matenda tokhala ndi mapiko asiliva m'mabanja omwe amachiritsidwa mokwanira komanso pang'ono m'mudzi wa Mahanar, Lavapur, mkati mwa masabata awiri IRS isanayambe komanso masabata awiri, anayi ndi khumi ndi awiri pambuyo pa IRS, DDT ndi SP.
Mapu okwana a chiopsezo cha malo (mudzi wa Lavapur Mahanar; malo onse: 26,723 km2) adapangidwa kuti adziwe madera omwe ali pachiwopsezo chochepa, chapakati komanso chapamwamba kuti ayang'anire kubuka ndi kubwereranso kwa nkhono zasiliva zisanachitike komanso milungu ingapo pambuyo pokhazikitsa IRS (Zithunzi 3, 4). . . Chiwerengero chachikulu cha chiopsezo cha mabanja panthawi yopanga mapu owopsa a malo chidawerengedwa kuti ndi "12" (mwachitsanzo, "8" ya mamapu owopsa a HT ndi "4" ya mamapu owopsa a VSI ndi IRSS). Chiwerengero chochepa cha chiopsezo chowerengedwa ndi "zero" kapena "palibe chiopsezo" kupatula mamapu a DDT-VSI ndi IRSS omwe ali ndi chiwerengero chocheperako cha 1. Mamapu owopsa a HT adawonetsa kuti dera lalikulu (monga 19,994.3 km2; 74.8%) a mudzi wa Lavapur Mahanar ndi dera lomwe lili pachiwopsezo chachikulu komwe anthu okhalamo amatha kukumana ndi udzudzu ndikubwereranso. Kufalikira kwa malo kumasiyana pakati pa madera okwera (DDT 20.2%; SP 4.9%), apakatikati (DDT 22.3%; SP 4.6%) ndi madera otsika/opanda chiopsezo (DDT 57.5%; SP 90.5) %) (t (2) = 12.7, P < 0.05) pakati pa ma graph a zoopsa za DDT ndi SP-IS ndi IRSS (Chithunzi 3, 4). Mapu omaliza a zoopsa omwe adapangidwa adawonetsa kuti SP-IRS inali ndi mphamvu zodzitetezera bwino kuposa DDT-IRS m'magawo onse a madera oopsa a HT. Malo oopsa kwambiri a HT adachepetsedwa kufika pa ochepera 7% (1837.3 km2) SP-IRS itatha ndipo madera ambiri (monga 53.6%) adakhala malo otsika oopsa. Mu nthawi ya DDT-IRS, kuchuluka kwa madera omwe ali pachiwopsezo chachikulu komanso chochepa komwe kunayesedwa ndi mapu ophatikizana a chiopsezo chinali 35.5% (9498.1 km2) ndi 16.2% (4342.4 km2), motsatana. Kuchulukana kwa ntchentche zamchenga komwe kunayesedwa m'mabanja omwe amathandizidwa ndi omwe ali m'malo osungiramo ziweto asanafike komanso milungu ingapo IRS itakhazikitsidwa kunajambulidwa ndikujambulidwa pa mapu ophatikizana a chiopsezo cha kuzungulira kulikonse kwa IRS (monga, DDT ndi SP) (Zithunzi 3, 4). Panali mgwirizano wabwino pakati pa zigoli za pachiwopsezo cha mabanja ndi kuchulukana kwapakati kwa nkhono zasiliva zomwe zinalembedwa IRS isanayambe komanso itatha (Chithunzi 5). Ma mtengo a R2 (P < 0.05) a kusanthula kogwirizana komwe kunawerengedwa kuchokera ku magawo awiri a IRS anali: 0.78 masabata awiri DDT isanafike, 0.81 masabata awiri pambuyo pa DDT, 0.78 masabata anayi pambuyo pa DDT, 0.83 pambuyo pa DDT-DDT masabata 12, DDT Total pambuyo pa SP inali 0.85, 0.82 masabata awiri SP isanafike, 0.38 masabata awiri pambuyo pa SP, 0.56 masabata anayi pambuyo pa SP, 0.81 masabata 12 pambuyo pa SP ndi 0.79 masabata awiri pambuyo pa SP yonse (Fayilo yowonjezera 1: Table S3). Zotsatira zinawonetsa kuti zotsatira za kulowererapo kwa SP-IRS pa ma HT onse zidawonjezeka m'masabata anayi pambuyo pa IRS. DDT-IRS sinagwire ntchito pa ma HT onse nthawi zonse pambuyo pa IRS. Zotsatira za kuwunika kwa malo ozungulira mapu ophatikizika a chiopsezo zafotokozedwa mwachidule mu Gome 5. Pa ziwerengero za IRS, kuchuluka kwa nsomba za silverbelly ndi kuchuluka kwa kuchuluka konse m'malo omwe ali pachiwopsezo chachikulu (monga, >55%) kunali kwakukulu kuposa m'malo omwe ali pachiwopsezo chochepa komanso chapakati pa nthawi zonse za IRS. Malo omwe mabanja a tizilombo toyambitsa matenda (monga omwe asankhidwa kuti asonkhanitsidwe ndi udzudzu) akuwonetsedwa ndikuwonetsedwa mu Fayilo Yowonjezera 1: Chithunzi S2.
Mitundu itatu ya mamapu a chiopsezo cha malo pogwiritsa ntchito GIS (monga HT, IS ndi IRSS ndi kuphatikiza HT, IS ndi IRSS) kuti mudziwe madera omwe ali pachiwopsezo cha tizilombo toyambitsa matenda asanayambe komanso atatha DDT-IRS kumudzi wa Mahnar, Lavapur, chigawo cha Vaishali (Bihar)
Mitundu itatu ya mamapu owopsa a malo ozikidwa pa GIS (monga HT, IS ndi IRSS ndi kuphatikiza kwa HT, IS ndi IRSS) kuti azindikire madera oopsa a shrimp yasiliva (poyerekeza ndi Kharbang)
Zotsatira za DDT-(a, c, e, g, i) ndi SP-IRS (b, d, f, h, j) pa magulu osiyanasiyana a anthu omwe ali pachiwopsezo cha mabanja zinawerengedwa poyesa "R2" pakati pa zoopsa za mabanja. Kuyerekeza kwa zizindikiro za mabanja ndi kuchuluka kwa P. argentipes masabata awiri IRS isanayambe kugwiritsidwa ntchito komanso masabata awiri, anayi ndi khumi ndi awiri IRS itatha kugwiritsidwa ntchito m'mudzi wa Lavapur Mahnar, chigawo cha Vaishali, Bihar.
Gome 6 likufotokoza mwachidule zotsatira za kusanthula kwa univariate kwa zinthu zonse zoopsa zomwe zimakhudza kuchulukana kwa flake. Zinthu zonse zoopsa (n = 6) zinapezeka kuti zikugwirizana kwambiri ndi kuchulukana kwa udzudzu m'nyumba. Zinaonedwa kuti kuchuluka kwa zinthu zonse zofunikira kunapanga P values yosakwana 0.15. Chifukwa chake, zinthu zonse zofotokozera zinasungidwa kuti ziwunikenso zambiri. Kuphatikiza koyenera kwambiri kwa chitsanzo chomaliza kunapangidwa kutengera zinthu zisanu zoopsa: TF, TW, DS, ISV, ndi IRSS. Gome 7 limalemba tsatanetsatane wa magawo omwe asankhidwa mu chitsanzo chomaliza, komanso ma adjusted odds ratios, 95% confidence intervals (CIs), ndi P values. Chitsanzo chomaliza ndi chofunikira kwambiri, ndi R2 value ya 0.89 (F(5)=27 .9, P<0.001).
TR sanaphatikizidwe mu chitsanzo chomaliza chifukwa chinali chosafunikira kwenikweni (P = 0.46) ndi ma variable ena ofotokozera. Chitsanzo chopangidwacho chinagwiritsidwa ntchito kulosera kuchuluka kwa ntchentche zam'mphepete mwa nyanja kutengera deta yochokera m'mabanja 12 osiyanasiyana. Zotsatira za kutsimikizira zinawonetsa mgwirizano wamphamvu pakati pa kuchuluka kwa udzudzu komwe kunawonedwa m'munda ndi kuchuluka kwa udzudzu komwe kunanenedweratu ndi chitsanzocho (r = 0.91, P < 0.001).
Cholinga chake ndi kuchotsa VL m'maiko omwe ali ku India pofika chaka cha 2020 [10]. Kuyambira mu 2012, India yapita patsogolo kwambiri pochepetsa kuchuluka kwa VL ndi imfa [10]. Kusintha kuchoka ku DDT kupita ku SP mu 2015 kunali kusintha kwakukulu m'mbiri ya IRS ku Bihar, India [38]. Kuti timvetse chiopsezo cha VL pamalo ndi kuchuluka kwa ma vectors ake, maphunziro angapo a macro-level achitika. Komabe, ngakhale kufalikira kwa VL pamalo kwalandiridwa chidwi kwambiri mdziko lonselo, kafukufuku wochepa wachitika pamlingo wa micro. Kuphatikiza apo, pamlingo wa micro, deta siili yofanana ndipo ndi yovuta kusanthula ndikumvetsetsa. Monga momwe tikudziwira, kafukufukuyu ndiye lipoti loyamba kuwunika momwe IRS imagwirira ntchito komanso momwe imakhudzira tizilombo toyambitsa matenda DDT ndi SP pakati pa ma HT pansi pa National VL Vector Control Program ku Bihar (India). Uku ndi kuyesa koyamba kupanga mapu a chiopsezo cha malo ndi chitsanzo chowunikira kuchuluka kwa udzudzu kuti awulule kufalikira kwa udzudzu pamalo pa microscale pansi pa mikhalidwe ya IRS.
Zotsatira zathu zasonyeza kuti kugwiritsa ntchito SP-IRS m'mabanja kunali kwakukulu m'mabanja onse ndipo mabanja ambiri adakonzedwa mokwanira. Zotsatira za kafukufuku wa bioassay zasonyeza kuti ntchentche za mchenga wasiliva m'mudzi wofufuzayo zinali zovuta kwambiri ku beta-cypermethrin koma zochepa ku DDT. Chiwerengero cha imfa cha silver shrimp kuchokera ku DDT ndi chochepera 50%, zomwe zikusonyeza kuti DDT imakana kwambiri ku DDT. Izi zikugwirizana ndi zotsatira za kafukufuku wakale womwe unachitika nthawi zosiyanasiyana m'midzi yosiyanasiyana ya mayiko omwe ali ndi VL ku India, kuphatikizapo Bihar [8,9,39,40]. Kuwonjezera pa kukhudzidwa ndi mankhwala ophera tizilombo, mphamvu yotsala ya mankhwala ophera tizilombo komanso zotsatira za kulowererapo ndizofunikiranso. Kutalika kwa zotsatira zotsalira ndikofunikira pa nthawi yokonzekera mapulogalamu. Zimatsimikiza nthawi pakati pa kuzungulira kwa IRS kuti anthu azikhala otetezeka mpaka kupopera kwina. Zotsatira za kafukufuku wa bioassay wa cone zawonetsa kusiyana kwakukulu kwa imfa pakati pa mitundu ya pamwamba pa khoma nthawi zosiyanasiyana pambuyo pa IRS. Imfa pamalo omwe adachiritsidwa ndi DDT nthawi zonse inali pansi pa mulingo wokwanira wa WHO (mwachitsanzo, ≥80%), pomwe pamakoma omwe adachiritsidwa ndi SP, imfa idapitilira mpaka sabata yachinayi pambuyo pa IRS; Kuchokera ku zotsatirazi, n'zoonekeratu kuti ngakhale kuti nkhanu zasiliva zomwe zimapezeka m'dera lophunzirira zimakhala zovuta kwambiri ku SP, mphamvu yotsala ya SP imasiyana malinga ndi HT. Monga DDT, SP simakwaniritsa nthawi yogwira ntchito yomwe yafotokozedwa mu malangizo a WHO [41, 42]. Kusagwira ntchito bwino kumeneku kungakhale chifukwa cha kusagwiritsa ntchito bwino kwa IRS (monga kusuntha pampu pa liwiro loyenera, mtunda kuchokera pakhoma, kuchuluka kwa madzi otuluka ndi kukula kwa madontho amadzi ndi malo awo pakhoma), komanso kugwiritsa ntchito mankhwala ophera tizilombo mopanda nzeru (monga kukonzekera yankho) [11,28,43]. Komabe, popeza kafukufukuyu adachitika motsogozedwa ndi kuyang'aniridwa mosamala, chifukwa china chosakwaniritsa tsiku lotha ntchito lomwe bungwe la World Health Organization limalimbikitsa chingakhale mtundu wa SP (monga, kuchuluka kwa chogwiritsira ntchito kapena "AI") chomwe chimapanga QC.
Mwa mitundu itatu ya pamwamba yomwe imagwiritsidwa ntchito poyesa kupirira kwa mankhwala ophera tizilombo, kusiyana kwakukulu kwa imfa kunawonedwa pakati pa BUU ndi CPLC pa mankhwala awiri ophera tizilombo. Chinanso chatsopano chomwe chapezeka ndichakuti CPLC inawonetsa magwiridwe antchito abwino kwambiri pafupifupi nthawi zonse pambuyo popopera kutsatiridwa ndi malo a BUU ndi PMP. Komabe, milungu iwiri pambuyo pa IRS, PMP inalemba kuchuluka kwa imfa zapamwamba kwambiri komanso zachiwiri kuchokera ku DDT ndi SP, motsatana. Zotsatirazi zikusonyeza kuti mankhwala ophera tizilombo omwe adayikidwa pamwamba pa PMP sapitilira kwa nthawi yayitali. Kusiyana kumeneku pakugwira ntchito bwino kwa zotsalira za mankhwala ophera tizilombo pakati pa mitundu ya makoma kungakhale chifukwa cha zifukwa zosiyanasiyana, monga kapangidwe ka mankhwala a pakhoma (kuwonjezeka kwa pH komwe kumayambitsa kuti mankhwala ena ophera tizilombo asweke mwachangu), kuchuluka kwa kuyamwa (kokwera pamakoma a nthaka), kupezeka kwa kuwonongeka kwa mabakiteriya ndi kuchuluka kwa kuwonongeka kwa zinthu za pakhoma, komanso kutentha ndi chinyezi [44, 45, 46, 47, 48, 49]. Zotsatira zathu zikuthandizira maphunziro ena angapo okhudza kugwira ntchito bwino kwa malo ophera tizilombo motsutsana ndi matenda osiyanasiyana [45, 46, 50, 51].
Ziwerengero za kuchepa kwa udzudzu m'mabanja omwe alandira chithandizo zinasonyeza kuti SP-IRS inali yothandiza kwambiri kuposa DDT-IRS poletsa udzudzu nthawi zonse pambuyo pa IRS (P < 0.001). Pa maulendo a SP-IRS ndi DDT-IRS, kuchuluka kwa kuchepa kwa mabanja omwe alandira chithandizo kuyambira masabata awiri mpaka khumi ndi awiri kunali 55.6-90.5% ndi 14.1-34.1%, motsatana. Zotsatirazi zinasonyezanso kuti zotsatira zazikulu pa kuchuluka kwa P. argentipes m'mabanja omwe alandira chithandizo zinawonedwa mkati mwa masabata anayi kuchokera pamene IRS inakhazikitsa; argentipes anawonjezeka m'magawo onse awiri a IRS masabata 12 pambuyo pa IRS; Komabe, panalibe kusiyana kwakukulu pa chiwerengero cha udzudzu m'mabanja omwe alandira chithandizo pakati pa maulendo awiri a IRS (P = 0.33). Zotsatira kuchokera ku kusanthula kwa ziwerengero za kuchuluka kwa siliva shrimp pakati pa magulu a m'mabanja omwe alandira chithandizo zinasonyezanso kusiyana kwakukulu kwa DDT m'magulu onse anayi a m'mabanja (monga, wopopera ndi woponya; wopopera ndi wowongolera; woponya ndi wowongolera; woponya ndi wowongolera; womaliza ndi wowongolera pang'ono). Magulu awiri a mabanja a IRS ndi SP-IRS (monga, sentinel motsutsana ndi kulamulira ndi zonse poyerekeza ndi pang'ono). Komabe, kusiyana kwakukulu kwa kuchuluka kwa shrimp yasiliva pakati pa kuzungulira kwa DDT ndi SP-IRS kunawonedwa m'mafamu omwe anathiridwa mankhwala pang'ono komanso mokwanira. Izi, pamodzi ndi mfundo yakuti zotsatira za kulowererapo zinawerengedwa kangapo pambuyo pa IRS, zikusonyeza kuti SP ndi yothandiza poletsa udzudzu m'nyumba zomwe zimachiritsidwa pang'ono kapena mokwanira, koma osachiritsidwa. Komabe, ngakhale kuti panalibe kusiyana kwakukulu pa ziwerengero pa chiwerengero cha udzudzu m'nyumba zomwe zimathiridwa mankhwala pang'ono kapena mokwanira, koma osachiritsidwa. Komabe, ngakhale kuti panalibe kusiyana kwakukulu pa chiwerengero cha udzudzu m'nyumba zomwe zimathiridwa mankhwala pang'ono kapena mokwanira pakati pa kuzungulira kwa DDT-IRS ndi SP IRS, chiwerengero cha udzudzu chomwe chinasonkhanitsidwa panthawi ya kuzungulira kwa DDT-IRS chinali chotsika poyerekeza ndi kuzungulira kwa SP-IRS. .Kuchuluka kumaposa kuchuluka. Zotsatirazi zikusonyeza kuti mankhwala ophera tizilombo omwe amakhudzidwa ndi ma virus omwe ali ndi IRS yayikulu kwambiri pakati pa anthu okhala m'nyumba akhoza kukhala ndi zotsatirapo zabwino pakuwongolera udzudzu m'nyumba zomwe sizinathiridwe mankhwala. Malinga ndi zotsatira zake, SP inali ndi mphamvu yabwino yopewera kulumidwa ndi udzudzu kuposa DDT m'masiku oyamba pambuyo pa IRS. Kuphatikiza apo, alpha-cypermethrin ndi ya gulu la SP, imakhala ndi kuyabwa kwa contact komanso poizoni mwachindunji kwa udzudzu ndipo ndi yoyenera IRS [51, 52]. Ichi chikhoza kukhala chimodzi mwa zifukwa zazikulu zomwe alpha-cypermethrin ilibe mphamvu zambiri m'malo otulukira. Kafukufuku wina [52] adapeza kuti ngakhale alpha-cypermethrin idawonetsa mayankho omwe alipo komanso kuchuluka kwa kugwetsa mu mayeso a labotale ndi m'nyumba zogona, mankhwalawo sanapange yankho lotha kuthamangitsa udzudzu pansi pa mikhalidwe yolamulidwa ya labotale.
Mu kafukufukuyu, mitundu itatu ya mamapu a zoopsa za malo idapangidwa; Kuyerekeza kwa chiopsezo cha malo m'nyumba ndi m'dera kunayesedwa kudzera mukuwona kuchuluka kwa nkhanu za silverleg. Kusanthula kwa madera oopsa kutengera HT kunawonetsa kuti madera ambiri a m'midzi (>78%) a Lavapur-Mahanara ali pachiwopsezo chachikulu cha kupezeka kwa ntchentche zamchenga ndi kubwereranso. Ichi mwina ndi chifukwa chachikulu chomwe Rawalpur Mahanar VL ili yotchuka kwambiri. ISV ndi IRSS yonse, komanso mapu omaliza a zoopsa, adapezeka kuti akupanga kuchuluka kochepa kwa madera omwe ali pachiwopsezo chachikulu panthawi ya SP-IRS (koma osati DDT-IRS round). Pambuyo pa SP-IRS, madera akuluakulu a chiopsezo chachikulu komanso chapakati kutengera GT adasinthidwa kukhala madera otsika a chiopsezo (monga 60.5%; kuyerekezera kwa mapu oopsa), komwe kuli kotsika pafupifupi kanayi kuposa DDT. - Mkhalidwewu uli pa tchati cha chiopsezo cha IRS pamwambapa. Zotsatirazi zikusonyeza kuti IRS ndiyo njira yoyenera yopewera udzudzu, koma kuchuluka kwa chitetezo kumadalira mtundu wa mankhwala ophera tizilombo, kukhudzidwa (kwa vekitala), kuvomerezeka (panthawi ya IRS) ndi momwe amagwiritsidwira ntchito;
Zotsatira za kuwunika zoopsa za m'banja zinasonyeza mgwirizano wabwino (P < 0.05) pakati pa kuyerekezera zoopsa ndi kuchuluka kwa nkhanu zasiliva zomwe zasonkhanitsidwa kuchokera m'mabanja osiyanasiyana. Izi zikusonyeza kuti magawo omwe adadziwika a chiopsezo cha m'banja ndi zigoli zawo za chiopsezo ndizofunikira kwambiri poyesa kuchuluka kwa nkhanu zasiliva m'deralo. Mtengo wa R2 wa kusanthula kwa mgwirizano wa IRS DDT pambuyo pa IRS unali ≥ 0.78, womwe unali wofanana kapena wokulirapo kuposa mtengo wa IRS usanachitike (mwachitsanzo, 0.78). Zotsatirazo zinasonyeza kuti DDT-IRS inali yogwira ntchito m'malo onse oopsa a HT (mwachitsanzo, okwera, apakati, ndi otsika). Pa gawo la SP-IRS, tinapeza kuti mtengo wa R2 unasinthasintha m'masabata achiwiri ndi achinayi pambuyo pa kukhazikitsa kwa IRS, mitengo ya milungu iwiri IRS isanayambe ndi milungu 12 pambuyo pa kukhazikitsa kwa IRS inali yofanana; Zotsatirazi zikuwonetsa zotsatira zazikulu za SP-IRS pa udzudzu, zomwe zinawonetsa kuchepa kwa nthawi pambuyo pa IRS. Zotsatira za SP-IRS zafotokozedwa ndikukambidwa m'mitu yapitayi.
Zotsatira kuchokera ku kafukufuku wa malo omwe ali pachiwopsezo cha mapu ophatikizidwa zinawonetsa kuti panthawi ya IRS, chiwerengero chachikulu cha nkhono zasiliva chinasonkhanitsidwa m'malo omwe ali pachiwopsezo chachikulu (monga, >55%), kutsatiridwa ndi madera omwe ali pachiwopsezo chapakati ndi chochepa. Mwachidule, kuwunika kwa chiopsezo cha malo pogwiritsa ntchito GIS kwakhala chida chothandiza popanga zisankho zosonkhanitsira zigawo zosiyanasiyana za deta ya malo payekhapayekha kapena kuphatikiza kuti mudziwe madera omwe ali pachiwopsezo cha ntchentche zamchenga. Mapu opangidwa omwe ali pachiwopsezo amapereka kumvetsetsa kwathunthu kwa momwe zinthu zingakhalire zisanachitike komanso zitachitika (monga, mtundu wa banja, momwe IRS ilili, ndi zotsatira zake) m'dera lophunzirira lomwe limafuna kuchitapo kanthu mwachangu kapena kusintha, makamaka pamlingo waung'ono. Mkhalidwe wotchuka kwambiri. Ndipotu, maphunziro angapo agwiritsa ntchito zida za GIS pojambula chiopsezo cha malo oberekera nyama ndi kufalikira kwa matenda m'malo osiyanasiyana pamlingo waukulu [24, 26, 37].
Makhalidwe a nyumba ndi zinthu zoopsa zomwe zingachitike chifukwa cha njira zopezera chithandizo zochokera ku IRS zidawunikidwa kuti zigwiritsidwe ntchito pofufuza kuchuluka kwa nsomba za silver shrimp. Ngakhale zinthu zonse zisanu ndi chimodzi (monga TF, TW, TR, DS, ISV, ndi IRSS) zidagwirizana kwambiri ndi kuchuluka kwa nsomba za silverleg shrimp m'malo osiyanasiyana, chimodzi chokha ndi chomwe chidasankhidwa mu chitsanzo chomaliza cha multiple regression model mwa zisanu. Zotsatira zake zikuwonetsa kuti makhalidwe a kasamalidwe ka anthu ogwidwa ndi zinthu zina zolowerera za IRS TF, TW, DS, ISV, IRSS, ndi zina zotero m'dera lophunzirira ndizoyenera kuyang'anira kumera, kuchira ndi kubereka kwa nsomba za silver shrimp. Mu kusanthula kwa multiple regression, TR sinapezeke kuti ndi yofunika kwambiri ndipo chifukwa chake sinasankhidwe mu chitsanzo chomaliza. Chitsanzo chomaliza chinali chofunikira kwambiri, ndipo magawo osankhidwa akufotokoza 89% ya kuchuluka kwa nsomba za silverleg shrimp. Zotsatira za kulondola kwa chitsanzocho zidawonetsa mgwirizano wamphamvu pakati pa kuchuluka kwa nsomba za silver shrimp zomwe zidanenedweratu komanso zomwe zidawonedwa. Zotsatira zathu zimathandiziranso maphunziro akale omwe adakambirana za zinthu zoopsa za anthu komanso nyumba zomwe zimagwirizanitsidwa ndi kufalikira kwa VL komanso kufalikira kwa vector m'madera akumidzi ku Bihar [15, 29].
Mu kafukufukuyu, sitinayang'ane momwe mankhwala ophera tizilombo amakhalira pamakoma opopera ndi mtundu (monga) wa mankhwala ophera tizilombo omwe amagwiritsidwa ntchito ku IRS. Kusiyana kwa ubwino ndi kuchuluka kwa mankhwala ophera tizilombo kungakhudze imfa ya udzudzu komanso momwe njira za IRS zimagwirira ntchito. Chifukwa chake, kuyerekezera kwa imfa pakati pa mitundu ya pamwamba ndi zotsatira za kulowererapo pakati pa magulu a mabanja kungasiyane ndi zotsatira zenizeni. Poganizira mfundo izi, kafukufuku watsopano akhoza kukonzedwa. Kuwunika kwa dera lonse lomwe lili pachiwopsezo (pogwiritsa ntchito mapu a zoopsa za GIS) m'midzi yophunzirira kumaphatikizapo malo otseguka pakati pa midzi, zomwe zimakhudza kugawa madera oopsa (monga kuzindikira madera) ndikufikira madera osiyanasiyana oopsa; Komabe, kafukufukuyu adachitika pamlingo wochepa, kotero malo opanda kanthu ali ndi zotsatira zochepa pa kugawa madera oopsa; Kuphatikiza apo, kuzindikira ndikuwunika madera osiyanasiyana oopsa mkati mwa dera lonse la mudzi kungapereke mwayi wosankha madera omangira nyumba zatsopano mtsogolo (makamaka kusankha madera omwe ali pachiwopsezo chochepa). Ponseponse, zotsatira za kafukufukuyu zimapereka chidziwitso chosiyanasiyana chomwe sichinaphunzirepo pamlingo wa microscopic kale. Chofunika kwambiri, kufotokozera malo a mapu a zoopsa za mudzi kumathandiza kuzindikira ndi kugawa mabanja m'magulu osiyanasiyana a zoopsa, poyerekeza ndi kafukufuku wachikhalidwe, njira iyi ndi yosavuta, yosavuta, yotsika mtengo komanso yosafuna ntchito zambiri, yopereka chidziwitso kwa opanga zisankho.
Zotsatira zathu zikusonyeza kuti nsomba za m'nyanja za siliva zomwe zili m'mudzi wofufuza zayamba kukana (monga, sizimalimbana kwambiri ndi DDT), ndipo kutuluka kwa udzudzu kunawonedwa nthawi yomweyo IRS itachitika; Alpha-cypermethrin ikuwoneka kuti ndiyo njira yoyenera yowongolera ma vector a VL ku IRS chifukwa cha kufa kwake 100% komanso kuchitapo kanthu bwino polimbana ndi ntchentche zasiliva, komanso kulandiridwa bwino ndi anthu ammudzi poyerekeza ndi DDT-IRS. Komabe, tapeza kuti kufa kwa udzudzu pamakoma ochiritsidwa ndi SP kumasiyana malinga ndi mtundu wa pamwamba; mphamvu yotsala yofooka idawonedwa ndipo nthawi yomwe WHO idalimbikitsa IRS sinakwaniritsidwe. Kafukufukuyu akupereka poyambira pabwino pokambirana, ndipo zotsatira zake zimafuna kafukufuku wowonjezereka kuti adziwe zomwe zimayambitsa. Kulondola kolosera kwa chitsanzo chowunikira kuchuluka kwa ntchentche zam'nyanja kunawonetsa kuti kuphatikiza kwa makhalidwe a nyumba, kukhudzidwa kwa tizilombo toyambitsa matenda ndi momwe IRS ilili kungagwiritsidwe ntchito kuyerekeza kuchuluka kwa ntchentche zam'nyanja m'midzi ya VL ku Bihar. Kafukufuku wathu akuwonetsanso kuti mapu ophatikizana a chiopsezo cha malo okhala ndi GIS (mlingo waukulu) akhoza kukhala chida chothandiza pozindikira madera oopsa kuti ayang'anire kutuluka ndi kubwereranso kwa mchenga misonkhano isanayambe komanso itatha ya IRS. Kuphatikiza apo, mamapu oika chiopsezo cha malo amapereka chidziwitso chokwanira cha kukula ndi mtundu wa madera oika chiopsezo pamlingo wosiyanasiyana, zomwe sizingaphunziridwe kudzera mu kafukufuku wachikhalidwe komanso njira zosonkhanitsira deta. Chidziwitso cha zoopsa za microspatial chomwe chasonkhanitsidwa kudzera mu mamapu a GIS chingathandize asayansi ndi ofufuza zaumoyo wa anthu kupanga ndikukhazikitsa njira zatsopano zowongolera (monga kulowererapo kamodzi kapena kulamulira kwa vector yolumikizidwa) kuti ifike m'magulu osiyanasiyana a mabanja kutengera mtundu wa milingo ya zoopsa. Kuphatikiza apo, mamapu oika chiopsezo amathandiza kukonza kugawa ndi kugwiritsa ntchito zinthu zowongolera panthawi yoyenera komanso pamalo oyenera kuti pulogalamuyo igwire bwino ntchito.
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Nthawi yotumizira: Meyi-20-2024