Indoor residual spraying (IRS) ndiye njira yayikulu yoyeserera ma vector a visceral leishmaniasis (VL) ku India.Ndizochepa zomwe zimadziwika pakukhudzidwa ndi kuwongolera kwa IRS pamitundu yosiyanasiyana ya mabanja.Apa tikuwunika ngati IRS yogwiritsa ntchito mankhwala ophera tizilombo ili ndi zotsalira zomwezo komanso zolowera m'mabanja amitundu yonse m'mudzi.Tidapanganso mamapu ophatikizika omwe ali pachiwopsezo komanso mitundu yowunikira kachulukidwe ka udzudzu kutengera momwe zinthu ziliri m'nyumba, kukhudzidwa kwa mankhwala ophera tizilombo, komanso mawonekedwe a IRS kuti tiwunikire kugawa kwapang'onopang'ono kwa ma vector pamlingo wa microscale.
Kafukufukuyu adachitika m'midzi iwiri ya Mahnar block m'boma la Vaishali ku Bihar.Kuwongolera kwa VL ma vectors (P. argentipes) ndi IRS pogwiritsa ntchito mankhwala ophera tizilombo awiri [dichlorodiphenyltrichloroethane (DDT 50%) ndi ma pyrethroids opangidwa (SP 5%)] adawunikidwa.Kugwira ntchito kwakanthawi kotsalira kwa mankhwala ophera tizilombo pamitundu yosiyanasiyana yamakhoma kudawunikidwa pogwiritsa ntchito njira ya cone bioassay monga momwe bungwe la World Health Organisation lidalimbikitsira.Kukhudzika kwa nsomba zamtundu wa silverfish ku mankhwala ophera tizilombo kunayesedwa pogwiritsa ntchito in vitro bioassay.Kuchulukana kwa udzudzu kusanachitike komanso pambuyo pa IRS m'malo okhala ndi m'malo osungira nyama kumayang'aniridwa pogwiritsa ntchito misampha yopepuka yomwe idayikidwa ndi Centers for Disease Control kuyambira 6:00 pm mpaka 6:00 am. kusanthula.Tekinoloje yowunikira malo a GIS idagwiritsidwa ntchito popanga mapu a kagawidwe ka mankhwala ophera tizilombo malinga ndi mtundu wapanyumba, ndipo mawonekedwe a IRS apanyumba adagwiritsidwa ntchito pofotokozera kugawa kwapakati kwa shrimp zasiliva.
Udzudzu wa siliva umakhudzidwa kwambiri ndi SP (100%), koma umasonyeza kukana kwambiri kwa DDT, ndi chiwopsezo cha kufa kwa 49.1%.SP-IRS idanenedwa kuti imavomerezedwa bwino ndi anthu kuposa DDT-IRS pakati pamitundu yonse ya mabanja.Kuchita bwino kotsalira kumasiyanasiyana pamakoma osiyanasiyana;palibe mankhwala ophera tizilombo omwe adakumana ndi World Health Organisation's IRS yomwe idalimbikitsa nthawi yoti achitepo kanthu.Nthawi zonse pambuyo pa IRS, kuchepa kwa tizilombo tonunkha chifukwa cha SP-IRS kunali kwakukulu pakati pa magulu am'banja (mwachitsanzo, opopera mankhwala ndi alonda) kuposa DDT-IRS.Mapu ophatikizidwa owopsa akuwonetsa kuti SP-IRS ili ndi mphamvu yowongolera udzudzu kuposa DDT-IRS m'malo onse owopsa amtundu wapakhomo.Multilevel logistic regression analysis idapeza zinthu zisanu zowopsa zomwe zidalumikizidwa kwambiri ndi kachulukidwe ka shrimp.
Zotsatirazi zipereka kumvetsetsa bwino kwa machitidwe a IRS pakuwongolera visceral leishmaniasis ku Bihar, zomwe zingathandize kutsogolera zoyeserera zamtsogolo zowongolera zinthu.
Visceral leishmaniasis (VL), yomwe imadziwikanso kuti kala-azar, ndi matenda omwe amafalitsidwa ndi madera otentha omwe amayamba chifukwa cha tizirombo toyambitsa matenda amtundu wa Leishmania.Kudera la Indian subcontinent (IS), komwe anthu ndi okhawo omwe amasungira madzi, tizilomboti (ie Leishmania donovani) timapatsira anthu kudzera kulumidwa ndi udzudzu wachikazi (Phlebotomus argentipes) [1, 2].Ku India, VL imapezeka makamaka m'maboma anayi apakati ndi kum'mawa: Bihar, Jharkhand, West Bengal ndi Uttar Pradesh.Kuphulika kwina kwanenedwanso ku Madhya Pradesh (Central India), Gujarat (Western India), Tamil Nadu ndi Kerala (South India), komanso kumadera akumwera kwa Himalayan kumpoto kwa India, kuphatikiza Himachal Pradesh ndi Jammu ndi Kashmir.3].Pakati pazigawo zomwe zakhala zikuchitika, Bihar ndiwopezeka kwambiri ndipo zigawo 33 zomwe zakhudzidwa ndi VL zikupitilira 70% ya milandu yonse ku India chaka chilichonse [4].Pafupifupi anthu 99 miliyoni m'derali ali pachiwopsezo, ndipo pafupifupi chaka chilichonse milandu 6,752 (2013-2017).
Ku Bihar ndi madera ena a ku India, zoyesayesa zoyendetsera VL zimadalira njira zitatu zazikuluzikulu: kuzindikira koyambirira, chithandizo chamankhwala, ndi kulamulira kwa vector pogwiritsa ntchito kupopera mankhwala ophera tizilombo m'nyumba (IRS) m'nyumba ndi zinyama [4, 5].Monga zotsatira za kampeni yolimbana ndi malungo, IRS inayendetsa bwino VL m'zaka za m'ma 1960 pogwiritsa ntchito dichlorodiphenyltrichloroethane (DDT 50% WP, 1 g ai/m2), ndi kulamulira kwadongosolo kunayendetsa bwino VL mu 1977 ndi 1992 [5, 6].Komabe, kafukufuku waposachedwapa watsimikizira kuti shrimp ya silverbellied yayamba kukana kwambiri DDT [4,7,8].Mu 2015, National Vector Borne Disease Control Programme (NVBDCP, New Delhi) inasintha IRS kuchoka ku DDT kupita ku synthetic pyrethroids (SP; alpha-cypermethrin 5% WP, 25 mg ai/m2) [7, 9].Bungwe la World Health Organisation (WHO) lakhazikitsa cholinga chochotsa VL pofika chaka cha 2020 (ie <1 mlandu pa anthu 10,000 pachaka pamisewu / block level) [10].Kafukufuku wambiri wasonyeza kuti IRS ndiyothandiza kwambiri kuposa njira zina zowongolera ma vector pochepetsa kuchulukana kwa ntchentche zamchenga [11,12,13].Chitsanzo chaposachedwa chimaloseranso kuti m'mikhalidwe yayikulu ya miliri (mwachitsanzo, kuchuluka kwa mliri wa 5/10,000), IRS yogwira mtima yophimba 80% ya mabanja ikhoza kukwaniritsa zolinga zothetsa chaka chimodzi kapena zitatu m'mbuyomo [14].VL imakhudza anthu osauka kwambiri akumidzi omwe ali m'madera omwe ali ndi kachilomboka ndipo kulamulira kwawo kwa vector kumangodalira IRS, koma zotsatira zotsalira za ndondomekoyi pamitundu yosiyanasiyana ya mabanja sizinaphunzirepo m'munda m'madera okhudzidwa [15, 16].Komanso, pambuyo ntchito kwambiri kulimbana VL, mliri m'midzi ina inatha kwa zaka zingapo ndipo anasanduka otentha mawanga [17].Chifukwa chake, ndikofunikira kuwunika momwe IRS imatsalira pakuwunika kachulukidwe ka udzudzu m'mabanja osiyanasiyana.Kuphatikiza apo, mapu owopsa a geospatial amathandizira kumvetsetsa ndikuwongolera kuchuluka kwa udzudzu ngakhale atachitapo kanthu.Machitidwe a chidziwitso cha Geographic (GIS) ndi kuphatikiza kwa matekinoloje a mapu a digito omwe amathandiza kusungirako, kuphimba, kusintha, kusanthula, kubweza ndi kuwonetsetsa kwamitundu yosiyanasiyana ya chilengedwe ndi chikhalidwe cha anthu pazifukwa zosiyanasiyana [18, 19, 20]..Global Positioning System (GPS) imagwiritsidwa ntchito pofufuza malo omwe zigawo zapadziko lapansi [21, 22].GIS ndi GPS-based spatial modeling zida ndi njira zakhala zikugwiritsidwa ntchito pazochitika zingapo za miliri, monga kuwunika kwa malo ndi kwakanthawi kwa matenda ndi kulosera zam'tsogolo, kukhazikitsa ndi kuwunika njira zowongolera, kuyanjana kwa tizilombo toyambitsa matenda ndi zinthu zachilengedwe, komanso mapu owopsa a malo.[20,23,24,25,26].Zambiri zomwe zasonkhanitsidwa ndikuchokera kumapu owopsa a geospatial zitha kuwongolera njira zowongolera munthawi yake komanso zogwira mtima.
Kafukufukuyu adawunika momwe ntchito yotsalira ya DDT ndi SP-IRS imathandizira panyumba pansi pa National VL Vector Control Programme ku Bihar, India.Zolinga zoonjezera zinali kupanga mapu ophatikizika a malo owopsa ndi njira yowunikira kuchuluka kwa udzudzu kutengera momwe malo amakhala, kutengeka ndi tizilombo toyambitsa matenda, komanso momwe IRS yapakhomo ikuyendera kuti awone momwe udzudzu umakhala wocheperako pang'ono.
Phunziroli linachitikira ku Mahnar chipika cha Vaishali chigawo cha kumpoto kwa Ganga (mkuyu 1).Makhnar ndi malo ovuta kwambiri, omwe ali ndi chiwerengero cha 56.7 cha VL pachaka (170 milandu mu 2012-2014), chiwerengero cha pachaka ndi 2.5-3.7 milandu pa 10,000;Midzi iwiri inasankhidwa: Chakeso monga malo olamulira (Mkuyu 1d1; palibe milandu ya VL m'zaka zisanu zapitazi) ndi Lavapur Mahanar monga malo omwe amapezeka (mkuyu 1d2; kwambiri endemic, ndi 5 kapena zambiri milandu pa 1000 anthu pachaka ).pazaka 5 zapitazi).Midzi idasankhidwa potengera njira zitatu zazikulu: malo ndi kupezeka (mwachitsanzo, yomwe ili pamtsinje wosavuta kulowa chaka chonse), kuchuluka kwa anthu ndi kuchuluka kwa mabanja (mwachitsanzo mabanja 200; Chaqueso ali ndi mabanja 202 ndi 204 okhala ndi kukula kwa mabanja) .4.9 ndi 5.1 anthu) ndi Lavapur Mahanar motero) ndi mtundu wapakhomo (HT) ndi chikhalidwe cha kugawa kwawo (ie kugawira mwachisawawa wosakaniza HT).Midzi yophunzirira yonseyi ili mkati mwa 500 m kuchokera ku tawuni ya Makhnar ndi chipatala chachigawo.Kafukufukuyu adawonetsa kuti anthu okhala m'midzi yophunzirira anali otanganidwa kwambiri ndi kafukufuku.Nyumba zomwe zili m'mudzi wophunzitsira [wokhala ndi zipinda zogona 1-2 zokhala ndi khonde lolumikizidwa, khitchini imodzi, bafa limodzi ndi nkhokwe imodzi (yophatikizidwa kapena yotsekedwa)] imakhala ndi makoma a njerwa / matope ndi pansi, makoma a njerwa okhala ndi pulasitala ya simenti ya laimu.ndi pansi simenti, makoma a njerwa osapusitsidwa ndi osapentidwa, pansi pa dongo ndi denga la udzu.Dera lonse la Vaishali lili ndi nyengo yamvula yamvula (July mpaka August) ndi nyengo youma (November mpaka December).Mvula wapakati pachaka ndi 720.4 mm (kusiyana 736.5-1076.7 mm), chinyezi chachifupi 65 ± 5% (kusiyana 16-79%), pafupifupi kutentha kwa mwezi ndi 17.2-32.4 ° C.May ndi June ndi miyezi yotentha kwambiri (kutentha 39-44 °C), pamene January ndi wozizira kwambiri (7-22 °C).
Mapu a malo ophunzirira akuwonetsa komwe kuli Bihar pamapu aku India (a) komanso komwe kuli chigawo cha Vaishali pamapu a Bihar (b).Makhnar Block (c) Midzi iwiri idasankhidwa kuti ichite kafukufukuyu: Chakeso monga malo owongolera ndi Lavapur Makhnar ngati malo ochitirapo kanthu.
Monga gawo la National Kalaazar Control Programme, Bihar Society Health Board (SHSB) idachita maulendo awiri a pachaka a IRS mchaka cha 2015 ndi 2016 (mzere woyamba, February-March; kuzungulira kwachiwiri, June-July)[4].Kuwonetsetsa kuti ntchito zonse za IRS zikugwira ntchito bwino, ndondomeko yaying'ono yakonzedwa ndi Rajendra Memorial Medical Institute (RMRIMS; Bihar), Patna, wothandizira wa Indian Council of Medical Research (ICMR; New Delhi).nodal Institute.Midzi ya IRS idasankhidwa potengera njira ziwiri zazikuluzikulu: mbiri ya milandu ya VL ndi retrodermal kala-azar (RPKDL) m'mudzimo (mwachitsanzo, midzi yomwe ili ndi mlandu umodzi kapena kuposerapo panthawi iliyonse m'zaka zitatu zapitazi, kuphatikiza chaka chokhazikitsidwa. )., midzi yosagwirizana ndi "malo otentha" (mwachitsanzo, midzi yomwe yakhala ikufotokoza milandu mosalekeza kwa zaka ≥ 2 kapena ≥ 2 milandu pa anthu 1000) ndi midzi yatsopano yomwe yakhala ikufalikira (palibe milandu m'zaka zitatu zapitazi) midzi m'chaka chatha cha Chaka chogwiritsiridwa ntchito chafotokozedwa mu [17].Midzi yoyandikana nayo yomwe imakhazikitsa gawo loyamba lamisonkho yadziko lonse, midzi yatsopano ikuphatikizidwanso mu gawo lachiwiri la ndondomeko ya msonkho wa dziko.Mu 2015, maulendo awiri a IRS pogwiritsa ntchito DDT (DDT 50% WP, 1 g ai/m2) adachitidwa m'midzi yophunzirira.Kuyambira 2016, IRS yakhala ikugwiritsidwa ntchito pogwiritsa ntchito pyrethroids (SP; alpha-cypermethrin 5% VP, 25 mg ai/m2).Kupopera mbewu mankhwalawa kunkachitika pogwiritsa ntchito pampu ya Hudson Xpert (13.4 L) yokhala ndi chotchinga chopondereza, valavu yosinthira (1.5 bar) ndi nozzle ya 8002 yosalala yandege yopangira porous [27].ICMR-RMRIMS, Patna (Bihar) idawunika IRS kunyumba ndi mudzi ndikupereka zidziwitso zoyambira za IRS kwa anthu akumidzi kudzera pa maikolofoni mkati mwa masiku 1-2 oyamba.Gulu lililonse la IRS lili ndi chowunikira (choperekedwa ndi RMRIMS) chowunika momwe gulu la IRS likuyendera.Ombudsmen, pamodzi ndi magulu a IRS, amatumizidwa ku mabanja onse kuti adziwitse ndi kutsimikizira mitu ya mabanja za ubwino wa IRS.M'magawo awiri a kafukufuku wa IRS, kufalikira kwa mabanja m'midzi yophunzirayo kudafikira 80% [4].Mkhalidwe wa kupopera mbewu mankhwalawa (mwachitsanzo, kusapopera mbewu, kupopera pang'ono, kupopera mbewu mankhwalawa kwathunthu; kufotokozedwa mu Fayilo Yowonjezera 1: Gulu S1) adajambulidwa m'mabanja onse a m'mudzimo panthawi yonse ya IRS.
Phunziroli linachitidwa kuyambira June 2015 mpaka July 2016. IRS inagwiritsa ntchito malo a matenda kuti ayambe kuchitapo kanthu (ie, masabata a 2 asanalowepo; kafukufuku woyambira) ndi pambuyo pake (ie, 2, 4, ndi masabata a 12 pambuyo pochitapo kanthu; kafukufuku wotsatira) kuyang'anira, kuwongolera kachulukidwe, ndi kupewa kuuluka kwa mchenga pamzere uliwonse wa IRS.m'nyumba iliyonse Usiku umodzi (ie kuyambira 18:00 mpaka 6:00) msampha wopepuka [28].Misampha yopepuka yaikidwa m’zipinda zogona ndi m’malo osungira ziweto.M'mudzi momwe phunzirolo lidachitikira, mabanja a 48 adayesedwa kuti akachuluke mchenga pamaso pa IRS (mabanja 12 patsiku kwa masiku 4 otsatizana mpaka tsiku lisanafike tsiku la IRS).Nyumba khumi ndi ziwiri (12) zinasankhidwa pagulu lililonse la mabanja anayi (monga pulasitala wadongo (PMP), pulasitala wa simenti ndi nyumba za laimu (CPLC), nyumba za njerwa zosapulasidwa ndi zosapentidwa (BUU) ndi nyumba zofolera ndi udzu (TH).Pambuyo pake, mabanja a 12 okha (mwa mabanja 48 asanayambe IRS) adasankhidwa kuti apitirize kusonkhanitsa deta ya udzudzu pambuyo pa msonkhano wa IRS.Malinga ndi malingaliro a WHO, mabanja a 6 adasankhidwa kuchokera ku gulu lothandizira (mabanja omwe akulandira chithandizo cha IRS) ndi gulu la alonda (mabanja omwe ali m'midzi yoloweramo, eni ake omwe anakana chilolezo cha IRS) [28].Pakati pa gulu lolamulira (mabanja a m'midzi yoyandikana nawo omwe sanakumanepo ndi IRS chifukwa cha kusowa kwa VL), mabanja 6 okha ndi omwe adasankhidwa kuti aziyang'anira kuchuluka kwa udzudzu isanayambe komanso itatha magawo awiri a IRS.Pamagulu onse atatu owunika kachulukidwe ka udzudzu (mwachitsanzo, kulowererapo, kulondera ndi kuwongolera), mabanja adasankhidwa kuchokera m'magulu atatu omwe ali pachiwopsezo (mwachitsanzo, otsika, apakati ndi apamwamba; mabanja awiri kuchokera pamlingo uliwonse wowopsa) ndipo mawonekedwe a chiopsezo cha HT adasankhidwa (magawo ndi magawo ndi zikuwonetsedwa mu Table 1 ndi Table 2, motsatira) [29, 30].Mabanja awiri pamlingo wowopsa adasankhidwa kuti apewe kuyerekeza kuchulukira kwa udzudzu ndi kufananiza pakati pamagulu.Mu gulu lothandizira, kuchulukitsitsa kwa udzudzu wa post-IRS kunkayang'aniridwa m'magulu awiri a mabanja a IRS: kuchiritsidwa kwathunthu (n = 3; 1 banja pa gulu lachiwopsezo) ndi kuthandizidwa pang'ono (n = 3; 1 banja pa mlingo wa gulu loopsya).).gulu langozi).
Udzudzu wonse wogwidwa m'munda wosonkhanitsidwa m'machubu oyesera adasamutsidwa ku labotale, ndipo machubu oyeserawo adaphedwa pogwiritsa ntchito ubweya wa thonje woviikidwa mu chloroform.Ntchentche zasiliva zidagonekedwa ndikusiyanitsidwa ndi tizilombo tina ndi udzudzu kutengera mawonekedwe a morphological pogwiritsa ntchito zizindikiritso zodziwika bwino [31].Nsomba zonse zasiliva zazimuna ndi zazikazi zidayikidwa m'zitini padera mu 80% mowa.Kuchulukana kwa udzudzu pa msampha/usiku kunawerengedwa pogwiritsa ntchito njira iyi: chiwerengero cha udzudzu chomwe chimasonkhanitsidwa/chiwerengero cha misampha yopepuka yoyikidwa usiku uliwonse.Kusintha kwa kuchuluka kwa udzudzu (SFC) chifukwa cha IRS pogwiritsa ntchito DDT ndi SP kunayerekezedwa pogwiritsa ntchito njira iyi [32]:
kumene A ndiye maziko a SFC oyendetsera mabanja, B ndi IRS akutanthauza SFC ya mabanja omenyerapo kanthu, C ndiye njira yoyambira ya SFC yoyang'anira mabanja, ndipo D ndiye SFC wanthawi zonse wa IRS woyang'anira/mabanja alonda.
Zotsatira za kulowererapo, zolembedwa ngati zoyipa komanso zabwino, zikuwonetsa kuchepa ndi kuwonjezeka kwa SFC pambuyo pa IRS, motsatana.Ngati SFC pambuyo pa IRS idakhalabe yofanana ndi SFC yoyambira, zotsatira zake zidawerengedwa ngati ziro.
Malinga ndi bungwe la World Health Organisation Pesticide Evaluation Scheme (WHOPES), kukhudzika kwa shrimp zamtundu wa silverleg ku mankhwala ophera tizilombo a DDT ndi SP adawunikidwa pogwiritsa ntchito njira zoyeserera za in vitro bioassays [33].Nsomba zazikazi zathanzi komanso zosadyetsedwa zasiliva (18-25 SF pagulu) zidawonetsedwa ndi mankhwala ophera tizilombo ku Universiti Sains Malaysia (USM, Malaysia; mothandizidwa ndi World Health Organisation) pogwiritsa ntchito World Health Organisation Pesticide Sensitivity Test Kit [4,9, 33] , 34].Gulu lililonse la ma bioassays ophera tizilombo adayesedwa kasanu ndi katatu (zoyeserera zinayi, iliyonse imathamanga nthawi imodzi ndikuwongolera).Mayeso owongolera adachitidwa pogwiritsa ntchito mapepala omwe adayikidwa kale ndi risella (ya DDT) ndi mafuta a silicone (a SP) operekedwa ndi USM.Pambuyo pa mphindi 60 akuwonekera, udzudzu udayikidwa m'machubu a WHO ndikupatsidwa thonje la thonje lonyowa loviikidwa mu 10% ya shuga.Chiwerengero cha udzudzu chomwe chinaphedwa pambuyo pa ola la 1 ndipo imfa yomaliza pambuyo pa maola 24 inawonedwa.Kukaniza kumafotokozedwa molingana ndi malangizo a World Health Organisation: kufa kwa 98-100% kukuwonetsa kutengeka, 90-98% ikuwonetsa kukana komwe kumafunikira kutsimikiziridwa, ndipo <90% ikuwonetsa kukana [33, 34].Chifukwa imfa mu gulu lolamulira linachokera ku 0 mpaka 5%, palibe kusintha kwa imfa komwe kunachitika.
Mphamvu ya bioefficacy ndi zotsalira za mankhwala ophera tizirombo paziswe zam'munda zomwe zili m'munda zidawunikidwa.M'mabanja atatu (m'nyumba imodzi yokhala ndi pulasitala wadongo kapena PMP, pulasitala ya simenti ndi zokutira laimu kapena CPLC, njerwa zosapula kapena zosapenta kapena BUU) pakatha masabata 2, 4 ndi 12 mutatha kupopera mbewu mankhwalawa.Kuyesa kwachilengedwe kwa WHO kunachitika pama cones okhala ndi misampha yopepuka.kukhazikitsidwa [27, 32].Kutenthetsa m'nyumba sikunaphatikizidwe chifukwa cha makoma osagwirizana.Pakuwunika kulikonse, ma cones 12 adagwiritsidwa ntchito m'nyumba zonse zoyesera (ma cones anayi panyumba, imodzi pamtundu uliwonse wa khoma).Gwirizanitsani ma cones pakhoma lililonse la chipindacho pamtunda wosiyana: wina pamutu (kuyambira 1.7 mpaka 1.8 m), awiri m'chiuno (kuchokera ku 0,9 mpaka 1 m) ndi wina pansi pa bondo (kuchokera ku 0,3 mpaka 0.5 m).Udzudzu waukazi khumi wosadyetsedwa (10 pa chulucho; wotengedwa kuchokera kumalo owongolera pogwiritsa ntchito chopondera) adayikidwa m'chipinda chilichonse chapulasitiki cha WHO (kondomu imodzi pamtundu wa banja) monga zowongolera.Pambuyo pa mphindi 30, chotsani udzudzu mosamala;conical chipinda chogwiritsa ntchito chopumira m'chigono ndikuchisamutsa mu machubu a WHO okhala ndi 10% ya shuga wothira.Kufa komaliza pambuyo pa maola 24 kunalembedwa pa 27 ± 2 ° C ndi 80 ± 10% chinyezi chachibale.Ziwerengero za anthu omwe amafa ndi ziwerengero pakati pa 5% ndi 20% zimasinthidwa pogwiritsa ntchito njira ya Abbott [27] motere:
pomwe P ndiye kufa kosinthidwa, P1 ndiye kuchuluka kwa anthu omwe amafa, ndipo C ndiye chiwongolero chakufa.Mayesero okhala ndi kuwongolera kufa> 20% adatayidwa ndikuyambiranso [27, 33].
Kafukufuku wokwanira wapakhomo adachitika m'mudzi wolowererapo.Malo a GPS a banja lililonse adajambulidwa komanso kapangidwe kake ndi mtundu wake, malo okhala, komanso momwe angathandizire.Pulatifomu ya GIS yapanga malo a digito omwe amaphatikiza magawo amalire pamudzi, chigawo, chigawo ndi maboma.Malo onse apakhomo amalembedwa pogwiritsa ntchito zigawo za GIS zapamidzi, ndipo zambiri zamakhalidwe awo zimalumikizidwa ndikusinthidwa.Pamalo aliwonse apanyumba, chiwopsezo chinayesedwa potengera HT, kutengeka kwa vector, komanso IRS (Table 1) [11, 26, 29, 30].Malo onse apakhomo adasinthidwa kukhala mamapu am'mutu pogwiritsa ntchito zolemetsa zamtunda (IDW; kusamvana kutengera dera lanyumba la 6 m2, mphamvu 2, kuchuluka kwamalo ozungulira = 10, pogwiritsa ntchito ma radius osakira, zosefera zotsika).ndi mapu a cubic convolution) ukadaulo wotanthauzira malo [35].Mitundu iwiri ya mamapu owopsa a malo adapangidwa: mamapu amtundu wa HT-based thematic vector sensitivity ndi IRS status (ISV ndi IRSS) mamapu amutu.Mamapu awiri omwe ali pachiwopsezo adaphatikizidwa pogwiritsa ntchito kusanthula kolemetsa [36].Munthawi imeneyi, zigawo za raster zidasinthidwa kukhala makalasi okonda wamba pazowopsa zosiyanasiyana (mwachitsanzo, apamwamba, apakati, ndi otsika / opanda chiopsezo).Chigawo chilichonse chosinthidwanso chinachulukitsidwa ndi kulemera komwe adapatsidwa kutengera kufunikira kwa magawo omwe amathandizira kuchuluka kwa udzudzu (kutengera kuchuluka kwa midzi yophunzirira, malo oswana udzudzu, komanso kupuma ndi kudyetsa) [26, 29]., 30, 37].Mapu onsewa anali olemera 50:50 chifukwa adathandizira mofanana ndi kuchuluka kwa udzudzu (Fayilo yowonjezera 1: Table S2).Pofotokoza mwachidule mamapu olemedwa kwambiri, mapu omaliza owopsa amapangidwa ndikuwonetsedwa papulatifomu ya GIS.Mapu omaliza omwe ali pachiwopsezo amaperekedwa ndikufotokozedwa motengera Sand Fly Risk Index (SFRI) owerengedwa pogwiritsa ntchito njira iyi:
Mu ndondomekoyi, P ndi chiwerengero cha chiopsezo, L ndiye chiwopsezo chonse cha malo a banja lililonse, ndipo H ndiye chiwopsezo chachikulu cha banja m'dera la kafukufuku.Tinakonzekera ndikuchita zigawo za GIS ndi kusanthula pogwiritsa ntchito ESRI ArcGIS v.9.3 (Redlands, CA, USA) kupanga mapu owopsa.
Tinachita kafukufuku wobwerezabwereza kuti tiwone zotsatira zophatikizana za HT, ISV, ndi IRSS (monga tafotokozera mu Table 1) pa kachulukidwe ka udzudzu m'nyumba (n = 24).Makhalidwe a nyumba ndi zoopsa zomwe zimachokera ku IRS zomwe zinalembedwa mu phunziroli zinatengedwa ngati zosiyana zofotokozera, ndipo kuchuluka kwa udzudzu kunagwiritsidwa ntchito ngati kuyankha kosiyana.Kusanthula kwa Univariate Poisson regression kunachitika pamitundu iliyonse yofotokozera yokhudzana ndi kuchuluka kwa mchenga.Pakuwunika kosasinthika, zosintha zomwe sizinali zofunikira komanso zokhala ndi P mtengo wokulirapo kuposa 15% zidachotsedwa pakuwunika kobwerezabwereza.Kuti tifufuze kuyanjana, mawu okhudzana ndi zosakaniza zonse zomwe zingatheke (zomwe zimapezeka mu kusanthula kosasintha) zinaphatikizidwa panthawi imodzi muzofufuza zambiri zobwerezabwereza, ndipo mawu osafunikira adachotsedwa pachitsanzo mwachitsanzo kuti apange chitsanzo chomaliza.
Kuunikira kwachiwopsezo chapakhomo kunachitika m'njira ziwiri: kuunika kwapakhomo ndi kuwunika kophatikizana kwa malo owopsa pamapu.Kuyerekeza kwachiwopsezo chapakhomo kuyerekezedwa pogwiritsa ntchito kusanthula kwa mgwirizano pakati pa ziwopsezo zapakhomo ndi kachulukidwe ka ntchentche zamchenga (zosonkhanitsidwa kuchokera ku mabanja 6 achitetezo ndi mabanja 6 olowererapo; milungu isanachitike komanso pambuyo pa kukhazikitsa IRS).Madera omwe ali pachiwopsezo amayerekezedwa pogwiritsa ntchito kuchuluka kwa udzudzu womwe umasonkhanitsidwa kuchokera m'mabanja osiyanasiyana ndikuyerekeza pakati pa magulu omwe ali pachiwopsezo (ie madera otsika, apakatikati ndi omwe ali pachiwopsezo chachikulu).Mu kuzungulira kulikonse kwa IRS, mabanja 12 (mabanja 4 pagawo lililonse la magawo atatu owopsa; zosonkhanitsira zausiku zimachitika pakatha milungu 2, 4, ndi 12 pambuyo pa IRS) adasankhidwa mwachisawawa kuti asonkhanitse udzudzu kuti ayese mapu owopsa.Zomwezo zapakhomo (ie HT, VSI, IRSS ndi kachulukidwe ka udzudzu) zinagwiritsidwa ntchito kuyesa njira yomaliza yobwerera.Kusanthula kosavuta kwa mgwirizano kunachitika pakati pa zowonera m'munda ndi kuchuluka kwa udzudzu wapakhomo wonenedweratu.
Ziwerengero zofotokozera monga zapakati, zochepa, zopambana, 95% nthawi zodalirika (CI) ndi maperesenti adawerengedwa kuti afotokoze mwachidule deta ya entomological ndi IRS.Avereji ya nambala/kachulukidwe ndi kufa kwa nsikidzi za siliva (zotsalira zopha tizilombo) pogwiritsa ntchito mayeso a parametric [zitsanzo zophatikizika t-mayeso (za data yomwe nthawi zambiri imagawika)] ndi mayeso osakhala a parametric (saina Wilcoxon) kuti afananize kuchita bwino pakati pa mitundu yapamtunda m'nyumba (ie , BUU vs. CPLC, BUU vs. PMP, ndi CPLC vs. PMP) kuyesa kwa deta yomwe siinagawidwe kawirikawiri).Kusanthula konse kunachitika pogwiritsa ntchito pulogalamu ya SPSS v.20 (SPSS Inc., Chicago, IL, USA).
Kufalikira kwa mabanja m'midzi yolowererapo panthawi ya IRS DDT ndi SP kunawerengedwa.Mabanja okwana 205 adalandira IRS pamzere uliwonse, kuphatikizapo mabanja 179 (87.3%) mu DDT kuzungulira ndi mabanja 194 (94.6%) mu SP kuzungulira VL vekitala.Kuchuluka kwa mabanja omwe amamwa mankhwala ophera tizilombo kunali kwakukulu panthawi ya SP-IRS (86.3%) kuposa nthawi ya DDT-IRS (52.7%).Chiwerengero cha mabanja omwe adatuluka mu IRS pa nthawi ya DDT chinali 26 (12.7%) ndipo chiwerengero cha mabanja omwe adatuluka mu IRS panthawi ya SP chinali 11 (5.4%).Munthawi ya DDT ndi SP, chiwerengero cha mabanja omwe adalandira chithandizo pang'ono chinali 71 (34.6% ya mabanja omwe adalandira chithandizo) ndi mabanja 17 (8.3% ya mabanja omwe adalandira chithandizo), motsatana.
Malinga ndi malangizo a WHO okana mankhwala ophera tizilombo, kuchuluka kwa nsomba za siliva pamalo ochitirapo nkhanza kunali kosavuta ku alpha-cypermethrin (0.05%) monga momwe anthu ambiri amafa panthawi yoyeserera (maola 24) anali 100%.Chiwopsezo chomwe chinawonedwa chinali 85.9% (95% CI: 81.1-90.6%).Kwa DDT, chiwerengero cha kugogoda pa maola a 24 chinali 22.8% (95% CI: 11.5-34.1%), ndipo chiwerengero cha kufa kwa mayeso a pakompyuta chinali 49.1% (95% CI: 41.9-56.3%).Zotsatira zinasonyeza kuti silverfoots zinayamba kukana DDT pamalo ochitirapo kanthu.
Patebulo 3 ikufotokoza mwachidule zotsatira za bioanalysis ya ma cones amitundu yosiyanasiyana ya malo (nthawi yosiyana pambuyo pa IRS) yothandizidwa ndi DDT ndi SP.Deta yathu inasonyeza kuti pambuyo pa maola 24, onse 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 (kwa 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 kwa nthawi ya SP-IRS: masabata a 2 pambuyo pa kupopera kwa mitundu yonse ya khoma (ie 95.6% yonse). ndi masabata a 4 pambuyo pa kupopera mbewu kwa makoma a CPLC okha (ie 82.5) mu gulu la DDT, anthu amafa nthawi zonse amakhala pansi pa 70% pamitundu yonse ya nthawi pambuyo pa IRS bioassay Masabata a kupopera mbewu mankhwalawa anali 25.1% ndi 63.2%, motsatana, mitundu itatu yapamwamba kwambiri yakufa ndi DDT inali 61.1% (kwa masabata a PMP 2 pambuyo pa IRS), 36.9% (kwa CPLC 4 masabata pambuyo pa IRS), ndi 28.9%. kwa CPLC masabata a 4 pambuyo pa IRS) Mitengo yochepa ndi 55% (ya BUU, masabata a 2 pambuyo pa IRS), 32.5% (ya PMP, masabata a 4 pambuyo pa IRS) ndi 20% (ya PMP, masabata a 4 pambuyo pa IRS);US IRS).Kwa SP, chiwerengero cha imfa chapamwamba kwambiri cha mitundu yonse ya padziko lapansi chinali 97.2% (ya CPLC, masabata a 2 pambuyo pa IRS), 82.5% (ya CPLC, masabata 4 pambuyo pa IRS), ndi 67.5% (ya CPLC, masabata 4 pambuyo pa IRS).Masabata 12 pambuyo pa IRS).US IRS).masabata pambuyo pa IRS);mitengo yotsika kwambiri inali 94.4% (ya BUU, masabata a 2 pambuyo pa IRS), 75% (ya PMP, masabata a 4 pambuyo pa IRS), ndi 58.3% (ya PMP, masabata a 12 pambuyo pa IRS).Pa mankhwala onse ophera tizirombo, kufa kwa malo okhala ndi PMP kumasiyana mwachangu pakapita nthawi kusiyana ndi komwe kumapangidwa ndi CPLC- ndi BUU.
Table 4 ikufotokoza mwachidule zotsatira zothandizira (ie, pambuyo pa IRS kusintha kwa udzudzu wochuluka) wa DDT- ndi SP-based IRS rounds (Fayilo yowonjezera 1: Chithunzi S1).Kwa DDT-IRS, kuchepetsedwa kwa kachilomboka kachikumbu pambuyo pa nthawi ya IRS kunali 34.1% (pa masabata awiri), 25.9% (pa masabata anayi), ndi 14.1% (pa masabata 12).Kwa SP-IRS, kuchepetsa kuchepa kunali 90.5% (pa masabata a 2), 66.7% (pa masabata a 4), ndi 55.6% (pa masabata a 12).Kutsika kwakukulu kwa kuchuluka kwa shrimp zasiliva m'mabanja achitetezo munthawi ya malipoti a DDT ndi SP IRS kunali 2.8% (pa milungu iwiri) ndi 49.1% (pa milungu iwiri), motsatana.Pa nthawi ya SP-IRS, kuchepa (kusanachitike ndi pambuyo pake) kwa mphutsi zoyera kunali kofanana m'nyumba zopopera mankhwala (t (2) = - 9.09, P <0.001) ndi mabanja a sentinel (t (2) = - 1.29, P = 0.33 .Zapamwamba poyerekeza ndi DDT-IRS nthawi zonse za 3 pambuyo pa IRS.Pa mankhwala onse ophera tizirombo, kuchulukira kwa tizilombo ta siliva kumawonjezeka m'mabanja a alonda masabata 12 pambuyo pa IRS (ie, 3.6% ndi 9.9% ya SP ndi DDT, motsatana).Pamisonkhano ya SP ndi DDT kutsatira IRS, ma shrimp 112 ndi 161 adasonkhanitsidwa kuchokera kumafamu a sentinel, motsatana.
Palibe kusiyana kwakukulu kwa kachulukidwe ka shrimp ya siliva pakati pamagulu apanyumba (ie spray vs sentinel: t(2)= - 3.47, P = 0.07; spray vs control: t(2) = - 2.03 , P = 0.18; sentinel vs. control : pa masabata a IRS pambuyo pa DDT, t (2) = - 0.59, P = 0.62).Mosiyana ndi izi, kusiyana kwakukulu kwa kachulukidwe ka shrimp ya siliva kunawonedwa pakati pa gulu lopopera ndi gulu lowongolera (t (2) = - 11.28, P = 0.01) komanso pakati pa gulu lopopera ndi gulu lowongolera (t (2) = - 4, 42, P = 0.05).IRS masabata angapo pambuyo pa SP.Kwa SP-IRS, palibe kusiyana kwakukulu komwe kunawonedwa pakati pa odikirira ndi mabanja olamulira (t (2) = -0.48, P = 0.68).Chithunzi 2 chikuwonetsa kuchuluka kwa kachulukidwe ka pheasant komwe kumawonedwa pamafamu mokwanira komanso pang'ono ndi mawilo a IRS.Panalibe kusiyana kwakukulu pakati pa kachulukidwe ka pheasants omwe amayendetsedwa mokwanira pakati pa mabanja omwe amayendetsedwa mokwanira komanso pang'ono (kutanthauza 7.3 ndi 2.7 pa msampha / usiku).DDT-IRS ndi SP-IRS, motero), ndipo mabanja ena anapopera mankhwala onse ophera tizilombo (kutanthauza 7.5 ndi 4.4 pa usiku kwa DDT-IRS ndi SP-IRS, motero) (t(2) ≤ 1.0, P> 0.2).Komabe, kachulukidwe ka shrimp m'mafamu opopera pang'ono komanso pang'ono amasiyana kwambiri pakati pa kuzungulira kwa SP ndi DDT IRS (t(2) ≥ 4.54, P ≤ 0.05).
Kuyerekeza kuchulukirachulukira kwa nsikidzi zonunkha zokhala ndi mapiko a siliva m'mabanja osamalidwa mokwanira komanso pang'ono m'mudzi wa Mahanar, Lavapur, mkati mwa milungu iwiri IRS isanachitike komanso masabata 2, 4 ndi 12 pambuyo pa kuzungulira kwa IRS, DDT ndi SP.
Mapu okhudzana ndi chiopsezo cha malo (mudzi wa Lavapur Mahanar; malo onse: 26,723 km2) adapangidwa kuti azindikire malo omwe ali ndi chiopsezo chochepa, chapakati komanso chachikulu kuti ayang'anire kutuluka ndi kuyambiranso kwa shrimp yasiliva isanayambe komanso masabata angapo pambuyo pa kukhazikitsidwa kwa IRS (Mkuyu 3). , 4)...Chiwopsezo chachikulu m'mabanja pakupanga mapu owopsa adavotera "12" (ie, "8" pamapu owopsa a HT ndi "4" a VSI- ndi mamapu owopsa a IRSS).Chiwerengero chochepa chowerengera chiopsezo ndi "zero" kapena "palibe chiopsezo" kupatulapo mapu a DDT-VSI ndi IRSS omwe ali ndi chiwerengero chochepa cha 1. Mapu a chiopsezo chochokera ku HT amasonyeza kuti dera lalikulu (ie 19,994.3 km2; 74.8%) ya Lavapur Mudzi wa Mahanar ndi malo omwe amakhala pachiwopsezo chachikulu pomwe anthu amatha kukumana ndi udzudzu.Kufalikira kwa dera kumasiyanasiyana pakati pa apamwamba (DDT 20.2%; SP 4.9%), apakati (DDT 22.3%; SP 4.6%) ndi otsika/opanda chiopsezo (DDT 57.5%; SP 90.5) madera %) (t (2) = 12.7, P <0.05) pakati pa ma graph owopsa a DDT ndi SP-IS ndi IRSS (Mkuyu 3, 4).Mapu omaliza owopsa omwe adapangidwa adawonetsa kuti SP-IRS inali ndi mphamvu zoteteza bwino kuposa DDT-IRS m'malo onse owopsa a HT.Malo omwe ali pachiopsezo chachikulu cha HT adachepetsedwa kukhala osachepera 7% (1837.3 km2) pambuyo pa SP-IRS ndipo malo ambiri (ie 53.6%) anakhala malo owopsa kwambiri.Panthawi ya DDT-IRS, chiwerengero cha madera omwe ali ndi chiopsezo chachikulu komanso chochepa choyesedwa ndi mapu ophatikizika owopsa anali 35.5% (9498.1 km2) ndi 16.2% (4342.4 km2), motsatira.Mchenga kachulukidwe ntchentche kuyeza m'mabanja mankhwala ndi sentinel pamaso ndi milungu ingapo pambuyo kukhazikitsa IRS anakonza ndi visualized pa ophatikizana chiopsezo mapu kwa aliyense kuzungulira IRS (ie, DDT ndi SP) (Fig. 3, 4).Panali mgwirizano wabwino pakati pa ziwopsezo zapakhomo ndi kuchuluka kwa kachulukidwe ka shrimp kambirimbiri kolembedwa IRS isanachitike komanso itatha (mkuyu 5).Miyezo ya R2 (P <0.05) ya kusanthula kosasinthika yowerengedwa kuchokera kumagulu awiri a IRS inali: 0.78 2 milungu isanafike DDT, 0.81 2 masabata pambuyo pa DDT, 0.78 4 masabata pambuyo pa DDT, 0,83 pambuyo pa DDT- DDT masabata 12, DDT Total pambuyo SP anali 0,85, 0,82 2 masabata pamaso SP, 0,38 2 masabata pambuyo SP, 0,56 4 masabata pambuyo SP, 0,81 12 masabata pambuyo SP ndi 0,79 2 masabata pambuyo SP wonse (Fayilo yowonjezera 1: Table S3).Zotsatira zawonetsa kuti zotsatira za kulowererapo kwa SP-IRS pa ma HT onse zidakwezedwa pamasabata a 4 kutsatira IRS.DDT-IRS idakhalabe yosagwira ntchito kwa ma HT onse nthawi zonse pambuyo pokhazikitsa IRS.Zotsatira za kuwunika kwa gawo la mapu ophatikizika owopsa zikufotokozedwa mwachidule mu Table 5. Pamaulendo a IRS, zikutanthauza kuchuluka kwa shrimp za silverbellied ndi kuchuluka kwa kuchuluka kwambiri m'malo omwe ali pachiwopsezo chachikulu (ie,> 55%) anali apamwamba kuposa otsika komanso otsika. madera omwe ali pachiwopsezo chapakatikati nthawi zonse za post-IRS.Malo a mabanja a entomological (ie omwe asankhidwa kuti asonkhanitse udzudzu) amajambulidwa ndikuwonetsedwa mu Fayilo yowonjezera 1: Chithunzi S2.
Mitundu itatu ya mamapu owopsa a GIS otengera malo (ie HT, IS ndi IRSS komanso kuphatikiza kwa HT, IS ndi IRSS) kuti azindikire madera omwe ali pachiwopsezo cha DDT-IRS isanachitike komanso itatha m'mudzi wa Mahnar, Lavapur, chigawo cha Vaishali (Bihar)
Mitundu itatu ya mamapu owopsa a GIS otengera malo (ie HT, IS ndi IRSS komanso kuphatikiza kwa HT, IS ndi IRSS) kuti azindikire madera omwe ali pachiwopsezo cha shrimp (poyerekeza ndi Kharbang)
Mphamvu za DDT-(a, c, e, g, i) ndi SP-IRS (b, d, f, h, j) pamagulu osiyanasiyana a magulu omwe ali pachiwopsezo cha mabanja adawerengeredwa poyerekezera ndi "R2" pakati pa zoopsa zapakhomo. .Kuyerekeza kwa zizindikiro zapakhomo ndi kachulukidwe wapakati wa P. argentipes masabata a 2 IRS isanakhazikitsidwe ndi masabata 2, 4 ndi 12 pambuyo pa kukhazikitsidwa kwa IRS m'mudzi wa Lavapur Mahnar, m'chigawo cha Vaishali, Bihar.
Table 6 ikufotokoza mwachidule zotsatira za kusanthula kosasintha kwa zinthu zonse zoopsa zomwe zimakhudza kuchuluka kwa flake.Zowopsa zonse (n = 6) zidapezeka kuti zimagwirizana kwambiri ndi kuchuluka kwa udzudzu wapakhomo.Zinawonedwa kuti mulingo wofunikira wamitundu yonse yoyenera umatulutsa ma P ochepera 0.15.Chifukwa chake, zosintha zonse zofotokozera zidasungidwa kuti ziwunikidwe kambiri.Kuphatikizika koyenera kwambiri kwa mtundu womaliza kudapangidwa kutengera zinthu zisanu zowopsa: TF, TW, DS, ISV, ndi IRSS.Table 7 imatchula tsatanetsatane wa magawo omwe asankhidwa mu chitsanzo chomaliza, komanso kusintha kosintha, 95% nthawi zodalirika (CIs), ndi P values.Mtundu womaliza ndi wofunika kwambiri, wokhala ndi mtengo wa R2 wa 0.89 (F(5)=27 .9, P<0.001).
TR idachotsedwa pamtundu womaliza chifukwa inali yochepa kwambiri (P = 0.46) ndi zosintha zina zofotokozera.Njira yopangidwa idagwiritsidwa ntchito kulosera za kuchulukana kwa ntchentche zamchenga potengera zomwe zidachokera m'mabanja 12 osiyanasiyana.Zotsatira zovomerezeka zidawonetsa kulumikizana kwakukulu pakati pa kuchuluka kwa udzudzu komwe kumawonedwa m'munda ndi kuchuluka kwa udzudzu komwe kunanenedweratu ndi chitsanzo (r = 0.91, P <0.001).
Cholinga chake ndikuchotsa VL kumayiko omwe apezeka ku India pofika 2020 [10].Kuyambira 2012, India yapita patsogolo kwambiri pakuchepetsa kuchulukana ndi kufa kwa VL [10].Kusintha kuchokera ku DDT kupita ku SP mu 2015 kunali kusintha kwakukulu m'mbiri ya IRS ku Bihar, India [38].Kuti mumvetsetse kuopsa kwa VL ndi kuchuluka kwa ma vectors ake, maphunziro angapo a macro-level achitika.Komabe, ngakhale kugawa kwapang'onopang'ono kwa kufalikira kwa VL kwalandira chidwi chowonjezereka m'dziko lonselo, kafukufuku wochepa wachitika pamlingo wang'ono.Kuphatikiza apo, pamlingo wang'ono, zambiri sizigwirizana komanso zovuta kuzisanthula ndikumvetsetsa.Monga momwe tikudziwira, kafukufukuyu ndi lipoti loyamba loyesa mphamvu zotsalira ndi zotsatira za IRS pogwiritsa ntchito mankhwala ophera tizilombo DDT ndi SP pakati pa HTs pansi pa National VL Vector Control Programme ku Bihar (India).Uku ndikuyesanso koyamba kupanga mapu owopsa a malo ndi njira yowunikira kachulukidwe ka udzudzu kuti awulule kufalikira kwa udzudzu pamlingo wocheperako pansi pazikhalidwe za IRS.
Zotsatira zathu zidawonetsa kuti kutengera kwa SP-IRS kunali kwakukulu m'mabanja onse komanso kuti mabanja ambiri adakonzedwa mokwanira.Zotsatira za bioassay zidawonetsa kuti ntchentche zamchenga zasiliva m'mudzi wophunzirira zinali zovuta kwambiri ku beta-cypermethrin koma zotsika ku DDT.Avereji yakufa kwa shrimp ya siliva kuchokera ku DDT ndi yosakwana 50%, kusonyeza kukana kwakukulu kwa DDT.Izi zikugwirizana ndi zotsatira za maphunziro am'mbuyomu omwe adachitika nthawi zosiyanasiyana m'midzi yosiyanasiyana ya VL-endemic states of India, kuphatikizapo Bihar [8,9,39,40].Kuphatikiza pa kukhudzidwa kwa mankhwala ophera tizilombo, mphamvu yotsalira ya mankhwala ophera tizilombo komanso zotsatira za kuchitapo kanthu ndizofunikanso.Kutalika kwa zotsatira zotsalira ndizofunika pa ndondomeko ya mapulogalamu.Imatsimikizira nthawi pakati pa kuzungulira kwa IRS kuti anthu azikhala otetezedwa mpaka kutsitsi kotsatira.Zotsatira za Cone bioassay zidawonetsa kusiyana kwakukulu kwaimfa pakati pa mitundu yapakhoma pamagawo osiyanasiyana pambuyo pa IRS.Kufa pazifukwa za DDT nthawi zonse kunali pansi pa mlingo wokhutiritsa wa WHO (ie, ≥80%), pamene pa makoma a SP, imfa inakhalabe yokhutiritsa mpaka sabata lachinayi pambuyo pa IRS;Kuchokera pazotsatirazi, zikuwonekeratu kuti ngakhale shrimp ya silverleg yomwe imapezeka m'malo ophunzirira imakhala yovuta kwambiri ku SP, mphamvu yotsalira ya SP imasiyana malinga ndi HT.Monga DDT, SP imakumananso ndi nthawi yogwira ntchito yomwe yafotokozedwa mu malangizo a WHO [41, 42].Kusagwira ntchito bwino kumeneku kungakhale chifukwa cha kusagwira bwino ntchito kwa IRS (mwachitsanzo, kusuntha mpope pa liwiro loyenera, mtunda kuchokera pakhoma, kuchuluka kwa madzi otuluka ndi kukula kwa madontho amadzi ndi kuyika kwawo pakhoma), komanso kugwiritsa ntchito mopanda nzeru mankhwala ophera tizilombo (ie. kukonzekera yankho) [11,28,43].Komabe, popeza kuti kafukufukuyu adachitidwa mosamalitsa ndikuyang'aniridwa, chifukwa china cholephera kukumana ndi World Health Organisation yomwe idalimbikitsa tsiku lotha ntchito ingakhale mtundu wa SP (ie, kuchuluka kwa zomwe zimagwira ntchito kapena "AI") zomwe zimapanga QC.
Mwa mitundu itatu yapamtunda yomwe imagwiritsidwa ntchito poyesa kulimbikira kwa mankhwala ophera tizilombo, kusiyana kwakukulu kwaimfa kudawonedwa pakati pa BUU ndi CPLC pamankhwala awiri ophera tizilombo.Kupeza kwina kwatsopano ndikuti CPLC idawonetsa ntchito yabwino yotsalira pafupifupi nthawi zonse mutatha kupopera mbewu mankhwalawa ndikutsatiridwa ndi malo a BUU ndi PMP.Komabe, milungu iwiri pambuyo pa IRS, PMP idalemba ziwopsezo zapamwamba kwambiri komanso zachiwiri zakufa kuchokera ku DDT ndi SP, motsatana.Zotsatirazi zikuwonetsa kuti mankhwala ophera tizilombo omwe aikidwa pamwamba pa PMP sapitilira nthawi yayitali.Kusiyana kumeneku pakugwira bwino ntchito kwa zotsalira za mankhwala ophera tizilombo pakati pa mitundu ya khoma kungakhale chifukwa cha zifukwa zosiyanasiyana, monga kapangidwe ka mankhwala apakhoma (kuchuluka kwa pH kumapangitsa kuti mankhwala ena ophera tizirombo aphwanyike mwachangu), kuchuluka kwa mayamwidwe (kwambiri pamakoma a dothi), kupezeka. za kuwonongeka kwa mabakiteriya ndi kuchuluka kwa kuwonongeka kwa zipangizo zapakhoma, komanso kutentha ndi chinyezi [44, 45, 46, 47, 48, 49].Zotsatira zathu zimathandizira maphunziro ena angapo okhudzana ndi kutsalira kwa malo okhala ndi mankhwala ophera tizilombo motsutsana ndi ma vectors osiyanasiyana a matenda [45, 46, 50, 51].
Ziwerengero za kuchepetsa udzudzu m'mabanja othandizidwa zinasonyeza kuti SP-IRS inali yothandiza kwambiri kuposa DDT-IRS poletsa udzudzu nthawi zonse za post-IRS (P <0.001).Pazozungulira za SP-IRS ndi DDT-IRS, mitengo yotsika kwa mabanja omwe adalandira chithandizo kuyambira masabata awiri mpaka 12 anali 55.6-90.5% ndi 14.1-34.1% motsatana.Zotsatirazi zinawonetsanso kuti zotsatira zazikulu pa kuchuluka kwa P. argentipes m'mabanja a sentinel adawonedwa mkati mwa masabata a 4 a IRS kukhazikitsa;argentipes adawonjezeka m'magawo onse a IRS masabata 12 pambuyo pa IRS;Komabe, panalibe kusiyana kwakukulu kwa chiwerengero cha udzudzu m'mabanja a sentinel pakati pa maulendo awiri a IRS (P = 0.33).Zotsatira za kachulukidwe ka shrimp pakati pa magulu am'banja pagulu lililonse sizinawonetsenso kusiyana kwakukulu mu DDT m'magulu onse anayi (ie, sprayed vs. sentinel; sprayed vs. control; sentinel vs. control; full vs. partial).).Magulu awiri apabanja IRS ndi SP-IRS (ie, sentinel vs. control ndi full vs. partial).Komabe, kusiyana kwakukulu mu kachulukidwe ka shrimp pakati pa DDT ndi SP-IRS kuzungulira kumawonedwa m'mafamu opopera pang'ono komanso opopera.Kuwona uku, kuphatikizidwa ndi mfundo yakuti zotsatirapo zinawerengedwa kangapo pambuyo pa IRS, zikusonyeza kuti SP ndi yothandiza poletsa udzudzu m'nyumba zomwe zimathandizidwa pang'ono kapena mokwanira, koma osathandizidwa.Komabe, ngakhale kuti panalibe kusiyana kwakukulu kwa chiwerengero cha udzudzu m'nyumba za alonda pakati pa maulendo a DDT-IRS ndi SP IRS, chiwerengero cha udzudzu chomwe chinasonkhanitsidwa panthawi ya DDT-IRS chinali chochepa poyerekeza ndi kuzungulira kwa SP-IRS..Kuchuluka kumaposa kuchuluka.Chotsatirachi chikusonyeza kuti mankhwala ophera tizilombo omwe ali ndi IRS kwambiri pakati pa anthu apakhomo akhoza kukhala ndi zotsatira zowononga udzudzu m'mabanja omwe sanapoperapo mankhwala.Malinga ndi zotsatira zake, SP inali ndi njira yabwino yodzitetezera ku kulumidwa ndi udzudzu kuposa DDT m'masiku oyamba pambuyo pa IRS.Kuphatikiza apo, alpha-cypermethrin ndi ya gulu la SP, imakhala ndi mkwiyo wokhudzana ndi udzudzu ndipo ndiyoyenera IRS [51, 52].Izi zitha kukhala chimodzi mwazifukwa zazikulu zomwe alpha-cypermethrin imakhala ndi zotsatira zochepa m'malo otuluka.Kafukufuku wina [52] adapeza kuti ngakhale alpha-cypermethrin adawonetsa mayankho omwe adalipo komanso ziwopsezo zazikulu zoyeserera m'ma labotale komanso m'nyumba, chigawocho sichinapangitse kuyankha kwaudzudzu pansi pamikhalidwe yoyendetsedwa ndi labotale.kanyumba.webusayiti.
Mu phunziro ili, mitundu itatu ya mapu owopsa a malo adapangidwa;Kuyerekeza kwapakhomo ndi dera lachiwopsezo cha malo adawunikidwa powona kuchuluka kwa shrimp za silverleg.Kuwunika kwa madera omwe ali pachiwopsezo kutengera HT kunawonetsa kuti madera ambiri akumidzi (> 78%) a Lavapur-Mahanara ali pachiwopsezo chachikulu cha kufalikira kwa mchenga ndikuyambiranso.Ichi mwina ndiye chifukwa chachikulu chomwe Rawalpur Mahanar VL ndiyotchuka kwambiri.ISV ndi IRSS yonse, komanso mapu omaliza ophatikizika owopsa, adapezeka kuti akupanga magawo ochepa a madera omwe ali pachiwopsezo chachikulu panthawi ya SP-IRS kuzungulira (koma osati kuzungulira kwa DDT-IRS).Pambuyo pa SP-IRS, madera akuluakulu omwe ali ndi chiopsezo chachikulu komanso chochepa chotengera GT adasinthidwa kukhala madera omwe ali ndi chiopsezo chochepa (ie 60.5%; kuyerekezera kwa mapu owopsa), omwe ndi otsika pafupifupi kanayi (16.2%) kuposa DDT.- Zomwe zili pa tchati chowopsa cha IRS pamwambapa.Chotsatirachi chimasonyeza kuti IRS ndi chisankho choyenera choletsa udzudzu, koma mlingo wa chitetezo umadalira mtundu wa mankhwala ophera tizilombo, tcheru (kwa vector chandamale), kuvomereza (panthawi ya IRS) ndi ntchito yake;
Zotsatira zakuwunika kwa chiwopsezo chapakhomo zidawonetsa kuvomerezana kwabwino (P <0.05) pakati pa kuyerekeza kwachiwopsezo ndi kachulukidwe kansomba za silverleg zomwe zasonkhanitsidwa kuchokera m'mabanja osiyanasiyana.Izi zikuwonetsa kuti magawo omwe azindikirika pachiwopsezo chapakhomo ndi kuchuluka kwawo komwe angawopsezedwe ndizoyenera kuyerekeza kuchuluka kwa shrimp zam'deralo.Mtengo wa R2 wa kusanthula kwa mgwirizano wa pambuyo pa IRS DDT unali ≥ 0.78, womwe unali wofanana kapena wokulirapo kuposa mtengo wa pre-IRS (ie, 0.78).Zotsatira zake zidawonetsa kuti DDT-IRS inali yothandiza m'malo onse owopsa a HT (ie, apamwamba, apakati, ndi otsika).Pakuzungulira kwa SP-IRS, tidapeza kuti mtengo wa R2 udasinthasintha m'masabata achiwiri ndi achinayi pambuyo pa kukhazikitsidwa kwa IRS, zikhalidwe zomwe IRS isanakhazikitsidwe milungu iwiri isanachitike komanso milungu 12 pambuyo pa kukhazikitsidwa kwa IRS zinali zofanana;Chotsatirachi chikuwonetsa zotsatira zazikulu za kuwonekera kwa SP-IRS pa udzudzu, zomwe zikuwonetsa kutsika kwanthawi yayitali pambuyo pa IRS.Zotsatira za SP-IRS zawonetsedwa ndikukambidwa m'mitu yapitayi.
Zotsatira za kafukufuku wa madera omwe ali pachiwopsezo cha mapu ophatikizidwa zidawonetsa kuti panthawi ya IRS, shrimp yayikulu kwambiri idasonkhanitsidwa m'malo omwe ali pachiwopsezo chachikulu (ie,> 55%), kutsatiridwa ndi madera omwe ali pachiwopsezo chapakati ndi chochepa.Mwachidule, kuunika kwachiwopsezo cha malo a GIS kwatsimikizira kukhala chida chothandiza chopangira zisankho zophatikizira magawo osiyanasiyana a data yapayekha kapena kuphatikiza kuti azindikire madera omwe ali pachiwopsezo cha ntchentche zamchenga.Mapu owopsa omwe apangidwa amapereka chidziwitso chokwanira cha momwe zinthu zisanachitike komanso pambuyo pake (mwachitsanzo, mtundu wapakhomo, mawonekedwe a IRS, ndi zotsatirapo) m'dera lophunzirira lomwe limafunikira kuchitapo kanthu mwachangu kapena kuwongolera, makamaka pamlingo wocheperako.Mkhalidwe wotchuka kwambiri.Ndipotu, kafukufuku wambiri wagwiritsira ntchito zida za GIS kuti adziwe zoopsa za malo obereketsa ma vector ndi kugawa kwa malo a matenda pamlingo waukulu [24, 26, 37].
Makhalidwe a nyumba ndi zowopsa za njira zotengera IRS zidawunikidwa kuti zigwiritsidwe ntchito pakuwunika kachulukidwe ka shrimp.Ngakhale zinthu zisanu ndi chimodzi (ie, TF, TW, TR, DS, ISV, ndi IRSS) zinali zogwirizana kwambiri ndi kuchuluka kwa nsomba za silverleg m'mawunivesite osiyanasiyana, ndi chimodzi chokha chomwe chinasankhidwa mu chitsanzo chomaliza cha maulendo angapo mwa asanu.Zotsatira zikuwonetsa kuti machitidwe otsogolera ogwidwa ndi zochitika zothandizira za IRS TF, TW, DS, ISV, IRSS, ndi zina zotero m'dera lophunzirira ndizoyenera kuyang'anira kutuluka, kubwezeretsa ndi kubereka kwa shrimp zasiliva.Pakuwunika kobwerezabwereza kambiri, TR sinapezeke kuti ndi yofunika ndipo chifukwa chake sinasankhidwe munjira yomaliza.Mtundu womaliza unali wofunikira kwambiri, ndi magawo osankhidwa akufotokozera 89% ya kachulukidwe ka shrimp za silverleg.Zotsatira zolondola zachitsanzo zidawonetsa kulumikizana kwamphamvu pakati pa zomwe zidanenedweratu ndi kuwonedwa kwa shrimp zasiliva.Zotsatira zathu zimathandiziranso maphunziro am'mbuyomu omwe amakambitsirana zachiwopsezo cha chikhalidwe cha anthu komanso nyumba zomwe zimakhudzidwa ndi kuchuluka kwa VL komanso kugawa kwa malo a vector kumidzi ya Bihar [15, 29].
M'kafukufukuyu, sitinawunikenso momwe mankhwala ophera tizilombo adayikidwa pamakoma opopera komanso mtundu (ie) wa mankhwala omwe amagwiritsidwa ntchito ku IRS.Kusiyanasiyana kwa mtundu ndi kuchuluka kwa mankhwala ophera tizilombo kumatha kukhudza kufa kwa udzudzu komanso kuchitapo kanthu kwa IRS.Chifukwa chake, kuyerekeza kufa pakati pa mitundu yapamtunda ndi zotsatirapo zomwe zingachitike m'magulu am'banja zitha kusiyana ndi zotsatira zenizeni.Poganizira mfundo zimenezi, phunziro latsopano lingakonzedwe.Kuwunika kwa madera omwe ali pachiwopsezo (pogwiritsa ntchito mapu a GIS) a midzi yophunzirira kumaphatikizapo madera otseguka pakati pa midzi, zomwe zimakhudza kagawidwe ka madera omwe ali pachiwopsezo (ie kuzindikiritsa madera) ndikufikira kumadera osiyanasiyana owopsa;Komabe, kafukufukuyu adachitidwa pamlingo wocheperako, kotero kuti malo opanda munthu ali ndi zotsatira zochepa pakugawika kwa madera omwe ali pachiwopsezo;Kuphatikiza apo, kuzindikira ndikuwunika madera osiyanasiyana omwe ali pachiwopsezo m'dera lonse lamudzi kungapereke mwayi wosankha madera omanga nyumba zatsopano zamtsogolo (makamaka kusankha madera omwe ali pachiwopsezo chochepa).Ponseponse, zotsatira za kafukufukuyu zimapereka chidziwitso chosiyanasiyana chomwe sichinaphunzirepo pamlingo wa microscopic kale.Chofunika kwambiri, kuyimira malo a mapu owopsa a m'midzi kumathandiza kuzindikira ndi kusonkhanitsa mabanja omwe ali m'madera omwe ali ndi chiopsezo chosiyana, poyerekeza ndi kafukufuku wanthawi zonse, njira iyi ndi yosavuta, yosavuta, yotsika mtengo komanso yosagwira ntchito, yopereka chidziwitso kwa ochita zisankho.
Zotsatira zathu zikuwonetsa kuti nsomba zamtundu wa silverfish m'mudzi wophunzirira zayamba kukana (ie, zimagonjetsedwa kwambiri) ndi DDT, ndipo kutuluka kwa udzudzu kunachitika mwamsanga pambuyo pa IRS;Alpha-cypermethrin ikuwoneka ngati chisankho choyenera kwa IRS kulamulira ma vector a VL chifukwa cha kufa kwake kwa 100% komanso kuchitapo kanthu bwino polimbana ndi silverflies, komanso kuvomereza kwake kwabwinoko kumudzi poyerekeza ndi DDT-IRS.Komabe, tidapeza kuti kufa kwa udzudzu pamakoma otetezedwa ndi SP kumasiyanasiyana malinga ndi mtundu wapamtunda;Kusakwanira kotsalira kotsalira kunawonedwa ndipo WHO idalimbikitsa nthawi IRS isanapezeke.Phunziroli limapereka poyambira bwino poyambira zokambirana, ndipo zotsatira zake zimafunikira kuphunzira mopitilira kuti tipeze zomwe zimayambitsa zenizeni.Zolosera zolosera za kachulukidwe kachulukidwe ka mchenga wamchenga zidawonetsa kuti kuphatikiza kwa mawonekedwe a nyumba, kukhudzidwa kwa tizilombo ndi ma IRS angagwiritsidwe ntchito kuyerekeza kuchuluka kwa ntchentche zamchenga m'midzi yomwe ili ku VL ku Bihar.Kafukufuku wathu akuwonetsanso kuti kuphatikiza kwa GIS-based spatial risk map (macro level) kungakhale chida chothandiza pozindikira madera omwe ali pachiwopsezo kuti ayang'anire kuwonekera ndi kuyambiranso kwa mchenga usanayambike komanso pambuyo pa misonkhano ya IRS.Kuonjezera apo, mapu owopsa a malo amapereka chidziwitso chokwanira cha kukula ndi chikhalidwe cha madera omwe ali pachiopsezo pamagulu osiyanasiyana, omwe sangathe kuphunziridwa kudzera mu kafukufuku wachikhalidwe komanso njira zosonkhanitsira deta.Zambiri zangozi ya Microspatial zomwe zasonkhanitsidwa kudzera mu mamapu a GIS zingathandize asayansi ndi ofufuza zaumoyo wa anthu kupanga ndi kukhazikitsa njira zatsopano zowongolera (mwachitsanzo, kulowererapo kamodzi kapena kuwongolera ma vector ophatikizika) kuti afikire magulu osiyanasiyana a mabanja malinga ndi momwe amavutikira.Kuphatikiza apo, mapu owopsa amathandizira kukhathamiritsa kugawa ndi kugwiritsa ntchito zowongolera panthawi yoyenera komanso malo oyenera kuti pulogalamuyo ikhale yogwira mtima.
Bungwe Loyanganira Thanzi Padziko Lonse la Pansi.Matenda osasamala, kupambana kobisika, mwayi watsopano.2009. http://apps.who.int/iris/bitstream/10665/69367/1/WHO_CDS_NTD_2006.2_eng.pdf.Tsiku lofikira: Marichi 15, 2014
Bungwe Loyanganira Thanzi Padziko Lonse la Pansi.Kuwongolera kwa Leishmaniasis: lipoti la msonkhano wa World Health Organisation Expert Committee on Leishmaniasis Control.2010. http://apps.who.int/iris/bitstream/10665/44412/1/WHO_TRS_949_eng.pdf.Tsiku lofikira: Marichi 19, 2014
Singh S. Kusintha kwa zochitika mu miliri, kuwonetseratu zachipatala ndi matenda a leishmania ndi HIV coinfection ku India.Int J Inf Dis.2014; 29:103-12.
National Vector Borne Disease Control Programme (NVBDCP).Limbikitsani pulogalamu yachiwonongeko ya Kala Azar.2017. https://www.who.int/leishmaniasis/resources/Accelerated-Plan-Kala-azar1-Feb2017_light.pdf.Tsiku lofikira: Epulo 17, 2018
Muniaraj M. Pokhala ndi chiyembekezo chochepa chothetsa kala-azar (visceral leishmaniasis) pofika chaka cha 2010, miliri yomwe imachitika nthawi ndi nthawi ku India, kodi njira zowongolera ma vector kapena kuphatikizika kwa kachilombo koyambitsa matenda a chitetezo chamthupi kapena chithandizo kuyenera kuyimbidwa mlandu?Topparasitol.2014; 4:10-9.
Thakur KP Njira yatsopano yochotsera Kala azar kumidzi ya Bihar.Indian Journal of Medical Research.2007; 126:447-51.
Nthawi yotumiza: May-20-2024