Kutsika kwaposachedwa kwa vuto la malungo ku Côte d'Ivoire makamaka kwabwera chifukwa chogwiritsa ntchito maukonde ophera tizirombo okhalitsa (LIN).Komabe, kupita patsogolo kumeneku kukusokonekera chifukwa cha kukana mankhwala ophera tizilombo, kusintha kwa makhalidwe kwa anthu a Anopheles gambiae, komanso kufalitsa malungo otsalira, zomwe zikuchititsa kuti pakufunika zipangizo zina.Choncho, cholinga cha phunziroli chinali kuyesa mphamvu yogwiritsira ntchito LLIN ndi Bacillus thuringiensis (Bti) ndikuyerekeza ndi LLIN.
Kafukufukuyu adachitika kuyambira Marichi 2019 mpaka February 2020 kudutsa mikono iwiri yophunzirira (LLIN + Bti mkono ndi LLIN mkono wokha) mdera laumoyo la Korhogo kumpoto kwa Côte d'Ivoire.Mu gulu la LLIN + Bti, malo a mphutsi a Anopheles amathandizidwa ndi Bti milungu iwiri iliyonse kuwonjezera pa LLIN.Udzudzu wa Larval ndi wamkulu adasonkhanitsidwa ndikuzindikiridwa mwachilengedwe kumitundu ndi mitundu pogwiritsa ntchito njira zokhazikika.Amembala Ann.Zovuta za Gambia zidatsimikiziridwa pogwiritsa ntchito ukadaulo wa polymerase chain reaction.Matenda a Plasmodium An.Kupezeka kwa malungo ku Gambia komanso anthu akumaloko adawunikidwanso.
Zonsezi, Anopheles spp.Kuchuluka kwa mphutsi kunali kochepa mu gulu la LLIN + Bti poyerekeza ndi gulu la LLIN lokha 0.61 [95% CI 0.41-0.81] mphutsi / dive (l/dive) 3.97 [95% CI 3.56-4 .38] l/dive (RR = 6.50; 95% CI 5.81-7.29 P <0.001).Kuthamanga kwathunthu kwa An.Zochitika za kuluma kwa S. gambiae zinali 0.59 [95% CI 0.43-0.75] pa munthu / usiku mu gulu la LLIN + Bti lokha, poyerekeza ndi 2.97 [95% CI 2.02-3.93] kuluma pa munthu / usiku mu gulu la LLIN-okha (P <0.001).Anopheles gambiae sl amadziwika kuti Anopheles mosquito.Anopheles gambiae (ss) (95.1%; n = 293), akutsatiridwa ndi Anopheles gambiae (4.9%; n = 15).Mlozera wamagazi amunthu m'malo ophunzirira anali 80.5% (n = 389).EIR ya gulu la LLIN + Bti inali kulumidwa ndi 1.36 pa munthu pa chaka (ib/p/y), pamene EIR ya gulu lokha la LLIN inali 47.71 ib/p/y.Chiwopsezo cha malungo chinachepa kwambiri kuchokera ku 291.8 ‰ (n = 765) mpaka 111.4 ‰ (n = 292) mu gulu la LLIN + Bti (P <0.001).
Kuphatikiza kwa LLIN ndi Bti kunachepetsa kwambiri matenda a malungo.Kuphatikiza kwa LLIN ndi Bti kungakhale njira yodalirika yolumikizirana yowongolera bwino An.Dziko la Gambia lilibe malungo.
Ngakhale kupita patsogolo pakuwongolera malungo m'zaka makumi angapo zapitazi, vuto la malungo lidakali vuto lalikulu ku sub-Saharan Africa [1].Bungwe la World Health Organization (WHO) posachedwapa linanena kuti panali matenda a malungo 249 miliyoni ndipo pafupifupi 608,000 amafa chifukwa cha malungo padziko lonse mu 2023 [2].Chigawo cha Africa cha WHO chimapanga 95% ya matenda a malungo padziko lapansi ndi 96% ya imfa za malungo, ndi amayi apakati ndi ana osakwana zaka 5 omwe amakhudzidwa kwambiri [2, 3].
Maukonde ophera tizirombo okhalitsa (LLIN) ndi kupopera mbewu m'nyumba zotsalira (IRS) zathandiza kwambiri kuchepetsa vuto la malungo ku Africa [4].Kukula kwa zida zowongolera ma vectors a malungo kudapangitsa kuchepa kwa 37% kwa matenda a malungo komanso kuchepa kwa kufa ndi 60% pakati pa 2000 ndi 2015 [5].Komabe, zomwe zawonedwa kuyambira chaka cha 2015 zayimilira mochititsa mantha kapena kuchulukirachulukira, pomwe kufa kwa malungo kumakhalabe kokwera kwambiri, makamaka ku sub-Saharan Africa [3].Kafukufuku angapo apeza kufalikira ndi kufalikira kwa kukana pakati pa chotengera chachikulu cha malungo Anopheles ku mankhwala ophera tizilombo omwe amagwiritsidwa ntchito paumoyo wa anthu monga cholepheretsa mtsogolo kuchita bwino kwa LLIN ndi IRS [6,7,8].Kuonjezera apo, kusintha kwa khalidwe loluma vekitala panja komanso usiku umakhala ndi udindo wotsalira kufalitsa malungo ndipo ndizovuta kwambiri [9, 10].Zochepa za LLIN ndi IRS pakuwongolera ma vector omwe amafalitsa zotsalira ndikuchepetsa kwakukulu pakuyesa kuthetsa malungo [11].Kuphatikiza apo, kulimbikira kwa malungo kumafotokozedwa ndi nyengo ndi zochitika za anthu, zomwe zimapangitsa kuti pakhale malo okhala mphutsi [12].
Kasamalidwe ka Larval source Management (LSM) ndi njira yopangira ma vector omwe cholinga chake ndi kuchepetsa kuchuluka kwa malo oswana komanso kuchuluka kwa mphutsi ndi udzudzu zomwe zili mkati mwake [13].LSM yalimbikitsidwa ndi maphunziro angapo ngati njira yowonjezera yophatikizira yowongolera ma vector a malungo [14, 15].M'malo mwake, kuchita bwino kwa LSM kumapereka phindu lawiri motsutsana ndi kulumidwa kwa mitundu ya malungo m'nyumba ndi kunja [4].Kuphatikiza apo, kuwongolera ma vector okhala ndi ma LSM opangidwa ndi larvicide monga Bacillus thuringiensis israelensis (Bti) kumatha kukulitsa njira zowongolera malungo.Zakale, LSM yakhala ndi gawo lalikulu pakuwongolera bwino kwa malungo ku United States, Brazil, Egypt, Algeria, Libya, Morocco, Tunisia ndi Zambia [16,17,18].Ngakhale kuti LSM yakhala ndi gawo lofunika kwambiri pakugwirizanitsa tizilombo toyambitsa matenda m'mayiko ena omwe athetseratu malungo, LSM sinaphatikizidwe kwambiri mu ndondomeko ndi machitidwe oletsa tizilombo toyambitsa malungo ku Africa ndipo amagwiritsidwa ntchito pokhapokha poyang'anira ma vector m'mayiko ena akumwera kwa Sahara.mayiko [14,15,16,17,18,19].Chifukwa chimodzi cha izi ndi chikhulupiliro chofala chakuti malo obereketsa ndi ochuluka kwambiri komanso ovuta kuwapeza, zomwe zimapangitsa LSM kukhala yodula kwambiri kukhazikitsa [4, 5, 6, 7, 8, 9, 10, 11, 13, 14].Choncho, bungwe la World Health Organization lalimbikitsa kwa zaka zambiri kuti zothandizira zomwe zimayendetsedwa kuti zithetse malungo ziyenera kuganizira za LLIN ndi IRS [20, 21].Sizinafike mpaka 2012 pomwe World Health Organisation idalimbikitsa kuphatikiza kwa LSM, makamaka njira za Bti, monga chothandizira LLIN ndi IRS m'malo ena kum'mwera kwa Sahara ku Africa [20].Popeza WHO analimbikitsa izi, kafukufuku woyendetsa angapo achitika pa kuthekera, mphamvu ndi mtengo wa biolarvicides ku sub-Saharan Africa, kusonyeza mphamvu ya LSM kuchepetsa kachulukidwe udzudzu Anopheles ndi malungo kufala kwachangu mwa mawu [22, 23].., 24].
Côte d'Ivoire ili m'gulu la mayiko 15 omwe ali ndi vuto la malungo kwambiri padziko lonse lapansi [25].Kuchuluka kwa malungo ku Côte d'Ivoire kumayimira 3.0% ya zovuta za malungo padziko lonse lapansi, zomwe zikuyerekezedwa ndi kuchuluka kwa milandu kuyambira 300 mpaka 500 pa anthu 1000 [25].Ngakhale nyengo yamvula yayitali kuyambira Novembala mpaka Meyi, malungo amafalikira chaka chonse kumpoto kwa savanna m'dzikolo [26].Kufala kwa malungo m'derali kumayenderana ndi kukhalapo kwa anthu ambiri opanda zizindikiro za Plasmodium falciparum [27].M’derali, chotengera malungo chofala kwambiri ndi Anopheles gambiae (SL).Chitetezo cha m'deralo.Udzudzu wa Anopheles gambiae umapangidwa ndi Anopheles gambiae (SS), womwe umalimbana kwambiri ndi mankhwala ophera tizirombo ndipo motero umakhala pachiwopsezo chotenga malungo otsalira [26].Kugwiritsa ntchito LLIN kungakhale ndi zotsatira zochepa pakuchepetsa kufala kwa malungo chifukwa cha kukana kwa tizilombo toyambitsa matenda am'deralo ndipo chifukwa chake ndi gawo lodetsa nkhawa kwambiri.Maphunziro oyendetsa ndege pogwiritsa ntchito Bti kapena LLIN awonetsa kuchita bwino pochepetsa kuchuluka kwa ma vector a udzudzu kumpoto kwa Côte d'Ivoire.Komabe, palibe maphunziro apitalo omwe adawonetsa zotsatira za ntchito zobwerezabwereza za Bti pamodzi ndi LLIN pa kufalitsa malungo ndi matenda a malungo m'dera lino.Choncho, phunziroli likufuna kuyesa zotsatira za kugwiritsidwa ntchito pamodzi kwa LLIN ndi Bti pakufalitsa malungo poyerekezera gulu la LLIN + Bti ndi gulu la LLIN lokha m'midzi inayi kumpoto kwa Côte d'Ivoire.Ankaganiziridwa kuti kugwiritsa ntchito LSM yochokera ku Bti pamwamba pa LLIN kungawonjezeke phindu pochepetsanso kuchuluka kwa udzudzu wa malungo poyerekeza ndi LLIN yokha.Njira yophatikizikayi, yoyang'ana udzudzu wa Anopheles womwe umanyamula Bti ndi udzudzu wamkulu wa Anopheles wonyamula LLIN, ungakhale wofunikira kwambiri pakuchepetsa kufala kwa malungo m'madera omwe ali ndi malungo ambiri, monga midzi ya kumpoto kwa Côte d'Ivoire.Choncho, zotsatira za kafukufukuyu zingathandize kusankha ngati angaphatikizepo LSM m’mapulogalamu olimbana ndi matenda a malungo (NMCPs) m’maiko omwe afala a kum’mwera kwa chipululu cha Sahara.
Kafukufukuyu adachitika m'midzi inayi ya dipatimenti ya Napieldougou (yomwe imadziwikanso kuti Napier) ku Korhogo sanitary zone kumpoto kwa Côte d'Ivoire (Mkuyu 1).Midzi yomwe ikuphunziridwa: Kakologo (9° 14′ 2″ N, 5° 35′ 22″ E), Kolekakha (9° 17′ 24″ N, 5° 31′ 00″ E .), Lofinekaha (9° 17′ 31 ″).) 5° 36′ 24″ N) ndi Nambatiurkaha (9° 18′ 36″ N, 5° 31′ 22″ E).Chiwerengero cha anthu aku Napierledougou mu 2021 akuti anali anthu 31,000, ndipo chigawochi chili ndi midzi 53 yokhala ndi zipatala ziwiri [28].M'chigawo cha Napyledougou, kumene malungo ndi omwe amachititsa kuti anthu azipita kuchipatala, kugonekedwa m'chipatala komanso kupha anthu, LLIN yokha imagwiritsidwa ntchito poyang'anira ma vectors a Anopheles [29].Midzi yonse inayi m'magulu onse ophunzirira amathandizidwa ndi zipatala zomwezo, zomwe zolemba zawo zakuchipatala za malungo zidawunikidwanso mu kafukufukuyu.
Mapu a ku Côte d'Ivoire akusonyeza malo ophunzirira.(Mapu source ndi mapulogalamu: data ya GADM ndi ArcMap 10.6.1. LLIN net yophera tizilombo kwanthawi yayitali, Bti Bacillus thuringiensis israelensis
Kuchuluka kwa malungo pakati pa anthu omwe akuyembekezeredwa ku Napier Health Center kudafika 82.0% (milandu ya 2038) (data ya pre-Bti).M'midzi yonse inayi, mabanja amagwiritsa ntchito PermaNet® 2.0 LLIN yokha, yomwe inafalitsidwa ndi NMCP ya ku Ivory Coast mchaka cha 2017, ndi> 80% [25, 26, 27, 28, 30].Midziyi ndi ya m'chigawo cha Korhogo, chomwe chimayang'anira gulu lankhondo la Ivory Coast National Military Council ndipo limapezeka chaka chonse.Uliwonse mwa midzi inayi uli ndi mabanja osachepera 100 komanso pafupifupi anthu ofanana, ndipo malinga ndi kaundula wa zaumoyo (chikalata chogwira ntchito cha Unduna wa Zaumoyo ku Ivory Coast), matenda angapo a malungo amanenedwa chaka chilichonse.Malungo amayamba ndi Plasmodium falciparum (P. falciparum) ndipo amapatsira anthu ndi Plasmodium.Gambiae imafalitsidwanso ndi udzudzu wa Anopheles ndi Anopheles nili m'chigawochi [28].Local complex An.Gambiae imakhala ndi udzudzu wa Anopheles.gambiae ss ili ndi ma frequency apamwamba a kusintha kwa kdr (ma frequency osiyanasiyana: 90.70-100%) komanso pafupipafupi ace-1 alleles (ma frequency osiyanasiyana: 55.56-95%) [29].
Avereji yamvula ya pachaka ndi kutentha kumayambira 1200 mpaka 1400 mm ndi 21 mpaka 35 °C motsatira, ndi chinyezi (RH) chikuyembekezeka 58%.Dera lophunzirirali lili ndi nyengo yamtundu wa Sudan yokhala ndi nyengo yowuma ya miyezi 6 (November mpaka Epulo) komanso nyengo yamvula ya miyezi 6 (May mpaka Okutobala).Derali likukumana ndi zovuta zina za kusintha kwa nyengo, monga kutha kwa zomera ndi nyengo yotentha yotalikirapo, yomwe imadziwika ndi kuwuma kwa mathithi amadzi (malo otsetsereka, minda ya mpunga, maiwe, mathithi) omwe amatha kukhala malo okhalamo mphutsi za udzudzu wa Anopheles. .Udzudzu[26].
Phunziroli linachitidwa mu gulu la LLIN + Bti, loyimiridwa ndi midzi ya Kakologo ndi Nambatiurkaha, ndipo m'gulu la LLIN lokha, loimiridwa ndi midzi ya Kolekaha ndi Lofinekaha.Panthawi ya kafukufukuyu, anthu m'midzi yonseyi ankangogwiritsa ntchito PermaNet® 2.0 LLIN.
Kuchita bwino kwa LLIN (PermaNet 2.0) kuphatikiza ndi Bti motsutsana ndi udzudzu wa Anopheles komanso kufalitsa malungo kudawunikidwa pamayesero olamulidwa mwachisawawa (RCT) ndi manja awiri ophunzirira: gulu la LLIN + Bti (gulu lamankhwala) ndi gulu la LLIN lokha (gulu lolamulira. ).Manja a LLIN + Bti amaimiridwa ndi Kakologo ndi Nambatiourkaha, pomwe Kolekaha ndi Lofinékaha adapangidwa ngati mapewa a LLIN okha.M'midzi yonse inayi, anthu akumaloko akugwiritsa ntchito LLIN PermaNet® 2.0 yomwe idalandiridwa kuchokera ku Ivory Coast NMCP mchaka cha 2017. Zikuganiziridwa kuti zikhalidwe zogwiritsira ntchito PermaNet® 2.0 ndi zofanana m'midzi yosiyana chifukwa adalandira netiweki chimodzimodzi..Mu gulu la LLIN + Bti, malo a mphutsi a Anopheles amathandizidwa ndi Bti milungu iwiri iliyonse kuwonjezera pa LLIN yomwe imagwiritsidwa ntchito kale ndi anthu.Malo okhala mphutsi mkati mwa midzi komanso pamtunda wa makilomita awiri kuchokera pakati pa mudzi uliwonse adathandizidwa motsatira malingaliro a World Health Organization ndi NMCP ya Côte d'Ivoire [31].Mosiyana ndi zimenezi, gulu lokha la LLIN silinalandire chithandizo cha larvicidal Bti panthawi yophunzira.
Bti wosabalalika m'madzi (Vectobac WG, 37.4% wt; lot number 88-916-PG; 3000 International Toxicity Units IU/mg; Valent BioScience Corp, USA) idagwiritsidwa ntchito pa mlingo wa 0.5 mg/L..Gwiritsani ntchito chopopera chikwama cha 16L ndi mfuti yopopera ya fiberglass yokhala ndi chogwirira ndi nozzle yosinthika yokhala ndi kuthamanga kwa 52 ml pa sekondi imodzi (3.1 L/mphindi).Kukonzekera nebulizer yomwe ili ndi madzi 10 L, kuchuluka kwa Bti kuchepetsedwa mu kuyimitsidwa ndi 0.5 mg / L × 10 L = 5 mg.Mwachitsanzo, kudera lomwe lili ndi mapangidwe amadzi a 10 L, pogwiritsa ntchito 10 L sprayer kuti athetse madzi ambiri, kuchuluka kwa Bti komwe kumafunika kuchepetsedwa ndi 0.5 mg / L × 20 L = 10 mg.10 mg Bti idayesedwa m'munda pogwiritsa ntchito sikelo yamagetsi.Pogwiritsa ntchito spatula, konzani slurry mwa kusakaniza kuchuluka kwa Bti mu chidebe chomaliza cha 10 L.Izi mlingo anasankhidwa pambuyo mayesero kumunda mphamvu ya Bti motsutsana instars zosiyanasiyana Anopheles spp.ndi Culex spp.m'malo achilengedwe m'malo osiyanasiyana, koma ofanana ndi malo a kafukufuku wamakono [32].Mlingo wakugwiritsa ntchito kuyimitsidwa kwa larvicide ndi nthawi yogwiritsira ntchito malo aliwonse oswana adawerengedwa potengera kuchuluka kwa madzi komwe amaswana [33].Ikani Bti pogwiritsa ntchito makina opopera pamanja.Nebulizers amayesedwa ndikuyesedwa panthawi yochita masewera olimbitsa thupi komanso m'malo osiyanasiyana kuti atsimikizire kuti Bti yolondola imaperekedwa.
Kuti tipeze nthawi yabwino yochizira mphutsi zoswana, gululo lidazindikira kupopera mbewu pawindo.Zenera la kupopera mbewu mankhwalawa ndi nthawi yomwe mankhwala amagwiritsidwa ntchito kuti agwire bwino ntchito: mu phunziroli, zenera la kupopera limachokera ku maola 12 mpaka masabata awiri, kutengera kulimbikira kwa Bti.Mwachiwonekere, kutengeka kwa Bti ndi mphutsi pamalo oswana kumafuna nthawi kuchokera ku 7:00 mpaka 18:00.Mwanjira imeneyi, nthawi ya mvula yamphamvu imatha kupewedwa ngati mvula isiya kupopera mbewu mankhwalawa ndikuyambiranso tsiku lotsatira ngati nyengo ikugwirizana.Madeti opopera mbewu ndi masiku enieni ndi nthawi zimatengera nyengo yomwe yawonedwa.Kuti awonetsere zopopera zachikwama pamlingo womwe mukufuna kugwiritsa ntchito Bti, katswiri aliyense amaphunzitsidwa kuyang'ana ndi kuyika mphuno yopopera ndikusunga kupanikizika.Kuyesa kumatsirizidwa potsimikizira kuti mlingo woyenera wa mankhwala a Bti umagwiritsidwa ntchito mofanana pa gawo lililonse.Chitani malo okhala mphutsi milungu iwiri iliyonse.Ntchito za Larvicidal zimachitika mothandizidwa ndi akatswiri anayi odziwa bwino ntchito komanso ophunzitsidwa bwino.Zochita za Larvicidal ndi otenga nawo mbali amayang'aniridwa ndi oyang'anira odziwa zambiri.Chithandizo cha larvicidal chidayamba mu Marichi 2019 nthawi yachilimwe.M'malo mwake, kafukufuku wam'mbuyomu adawonetsa kuti nyengo yowuma ndiyo nthawi yoyenera kwambiri pakulowererapo kwa larvicidal chifukwa cha kukhazikika kwa malo oswana komanso kuchepa kwa kuchuluka kwawo [27].Kuteteza mphutsi m’nyengo ya chilimwe kukuyembekezeka kuletsa kukopa kwa udzudzu m’nyengo yamvula.Ma kilogalamu awiri (02) a Bti amtengo wa US$99.29 amalola gulu lophunzira lomwe likulandira chithandizo kumadera onse.Mu gulu la LLIN + Bti, kulowererapo kwa larvicidal kunatha chaka chonse, kuyambira March 2019 mpaka February 2020. Chiwerengero cha 22 cha mankhwala a larvicidal chinachitika mu gulu la LLIN + Bti.
Zotsatira zomwe zingatheke (monga kuyabwa, chizungulire kapena mphuno yothamanga) zinkayang'aniridwa kupyolera mu kafukufuku waumwini wa Bti biolarvicide nebulizers ndi okhala m'nyumba omwe akugwira nawo ntchito mu gulu la LIN + Bti.
Kafukufuku wapakhomo adachitika pakati pa mabanja 400 (mabanja 200 pa gulu lophunzira) kuti athe kuyerekeza kuchuluka kwa LLIN omwe amagwiritsidwa ntchito pakati pa anthu.Pofufuza za m'mabanja, njira yofunsa mafunso imagwiritsidwa ntchito.Kukula kwa kugwiritsa ntchito LLIN kudagawidwa m'magulu atatu azaka: zaka 15.Mafunsowo anamalizidwa ndi kufotokozedwa m’chinenero cha Senoufo kwa mkulu wa banjalo kapena munthu wina wamkulu wazaka 18.
Kukula kochepa kwa banja lomwe adafunsidwa kudawerengedwa pogwiritsa ntchito njira yomwe Vaughan ndi Morrow adafotokoza [34].
n ndiye saizi yachitsanzo, e ndi malire a cholakwika, t ndiye chitetezo chochokera kumlingo wodalirika, ndipo p ndi gawo la makolo a anthu omwe ali ndi chikhumbo choperekedwa.Chigawo chilichonse cha gawoli chimakhala ndi mtengo wokhazikika, kotero (t) = 1.96;Pakafukufukuyu panali mabanja 384 ochepa okha.
Asanayambe kuyesa kwamakono, mitundu yosiyanasiyana ya malo a mphutsi za Anopheles m'magulu a LLIN+Bti ndi LLIN adadziwika, kuyesedwa, kufotokozedwa, kulembedwa ndi kulembedwa.Gwiritsani ntchito tepi kuyeza kukula kwa zisa.Kuchulukana kwa mphutsi za udzudzu kunayesedwa mwezi ndi mwezi kwa miyezi 12 pa malo 30 osankhidwa mwachisawawa pamudzi uliwonse, pa malo okwana 60 oswana pa gulu lophunzira.Panali zitsanzo za mphutsi 12 pa malo ophunzirira, ofanana ndi 22 Bti mankhwala.Cholinga chosankha malo 30 oswanawa m'mudzi uliwonse chinali kutenga malo okwanira osonkhanitsira mphutsi m'midzi yonse ndi magawo ophunzirira kuti achepetse kukondera.Mphutsi zinasonkhanitsidwa poviika ndi supuni 60 ml [35].Chifukwa chakuti ma nazale ena ndi ang'onoang'ono komanso osaya, ndikofunikira kugwiritsa ntchito ndowa yaying'ono kupatula ndowa ya WHO (350 ml).Madive 5, 10 kapena 20 okwana 5, 10 kapena 20 adapangidwa kuchokera kumalo osungira zisa okhala ndi 10 m motsatana.Morphological chizindikiritso cha anasonkhanitsa mphutsi (mwachitsanzo Anopheles, Culex ndi Aedes) inachitika mwachindunji m'munda [36].Mphutsi zosonkhanitsidwazo zidagawidwa m'magulu awiri kutengera kukula kwake: mphutsi zoyamba (magawo 1 ndi 2) ndi mphutsi zochedwa (magawo 3 ndi 4) [37].Mphutsi zinkawerengedwa motsatira mibadwo komanso pa siteji iliyonse ya chitukuko.Pambuyo powerenga, mphutsi za udzudzu zimabweretsedwanso kumalo omwe amaswana ndi kuwonjezeredwa ku voliyumu yake yoyamba ndi madzi oyambira ndi madzi amvula.
Malo oswana anali kuonedwa kuti ndi abwino ngati pali mphutsi imodzi kapena chiphuphu chamtundu uliwonse wa udzudzu.Kuchuluka kwa larval kunatsimikiziridwa mwa kugawa chiwerengero cha mphutsi zamtundu womwewo ndi chiwerengero cha madzi.
Kafukufuku aliyense ankatenga masiku aŵiri otsatizana, ndipo miyezi iwiri iliyonse, udzudzu wachikulire unkasonkhanitsidwa m’mabanja 10 osankhidwa mwachisawawa m’mudzi uliwonse.Mu kafukufukuyu, gulu lirilonse la kafukufuku lidachita kafukufuku wa mabanja 20 pamasiku atatu otsatizana.Udzudzu unkagwidwa pogwiritsa ntchito misampha yazenera (WT) ndi misampha ya pyrethrum spray (PSC) [38, 39].Poyamba, nyumba zonse za m’mudzi uliwonse zinawerengedwa manambala.Nyumba zinayi m’mudzi uliwonse zinasankhidwa mwachisawawa kukhala malo osonkhanitsira udzudzu wachikulire.M’nyumba iliyonse yosankhidwa mwachisawawa, udzudzu unkatengedwa kuchokera m’chipinda chachikulu chogona.Zipinda zogona zomwe zasankhidwa zili ndi zitseko ndi mawindo ndipo zidakhalamo usiku watha.Zipinda zogona zimakhala zotsekedwa ntchito isanayambe komanso panthawi yotolera udzudzu kuti udzudzu usawuluke m'chipindamo.WT idayikidwa pazenera lililonse lachipinda chilichonse ngati potengerapo udzudzu.Tsiku lotsatira, udzudzu umene umalowa kuntchito kuchokera kuzipinda zogona anatoledwa pakati pa 06:00 ndi 08:00 am.Sonkhanitsani udzudzu kuchokera kumalo anu ogwirira ntchito pogwiritsa ntchito cholembera pakamwa ndikusunga mu kapu ya pepala yotayidwa yophimbidwa ndi chidutswa chaiwisi.Ukonde wa udzudzu.Udzudzu womwe ukupumula m'chipinda chimodzi udagwidwa atangotoleredwa ndi WT pogwiritsa ntchito pyrethroid-based PSC.Mukayala mapepala oyera pachipinda chogona, tsekani zitseko ndi mazenera ndikupopera mankhwala ophera tizilombo (zosakaniza zogwira ntchito: 0,25% transfluthrin + 0,20% permetrin).Pafupifupi mphindi 10 mpaka 15 mutatha kupopera mbewu mankhwalawa, chotsani choyala m'chipinda chogona, gwiritsani ntchito ma tweezers kuti mutenge udzudzu uliwonse womwe wagwera pamapepala oyera, ndikusunga mu mbale ya Petri yodzaza ndi madzi a thonje.Chiwerengero cha anthu omwe adagona usiku wonse m'zipinda zosankhidwa chinalembedwanso.Udzudzu wosonkhanitsidwa umasamutsidwa mwachangu ku labotale yomwe ili pamalopo kuti ikakonzedwenso.
Mu labotale, udzudzu wosonkhanitsidwa umadziwika kuti ndi mtundu ndi mitundu [36].Ovary a Anna.gambiae SL pogwiritsa ntchito maikulosikopu ophatikizira abinocular ndi dontho lamadzi osungunuka loyikidwa pagalasi [35].Mkhalidwe waparity udawunikidwa kuti ulekanitse amayi ochuluka kuchokera kwa amayi osabereka kutengera mawonekedwe a ovarian ndi tracheal morphology, komanso kudziwa kuchuluka kwa kubereka komanso zaka zakuthupi [35].
Mlozera wachibale umatsimikiziridwa poyesa gwero la ufa wamagazi wotengedwa kumene.gambiae ndi enzyme-linked immunosorbent assay (ELISA) pogwiritsa ntchito magazi a anthu, ziweto (ng'ombe, nkhosa, mbuzi) ndi nkhuku [40].Entomological infestation (EIR) idawerengedwa pogwiritsa ntchito An.Kuyerekeza kwa akazi a SL ku Gambia [41] Kuphatikiza apo, An.Kutengeka ndi Plasmodium gambiae kunatsimikiziridwa posanthula mutu ndi chifuwa cha akazi ambiri pogwiritsa ntchito njira ya circumsporozoite antigen ELISA (CSP ELISA) [40].Pomaliza, pali mamembala a Ann.gambiae adadziwika posanthula miyendo, mapiko ndi pamimba pogwiritsa ntchito njira za polymerase chain reaction (PCR) [34].
Zambiri zachipatala za malungo zidapezedwa kuchokera ku kaundula wachipatala wa Napyyedugou Health Centre, womwe umakhudza midzi yonse inayi yophatikizidwa mu kafukufukuyu (ie Kakologo, Kolekaha, Lofinekaha ndi Nambatiurkaha).Kuwunika kwa registry kunayang'ana zolemba kuyambira Marichi 2018 mpaka February 2019 komanso kuyambira Marichi 2019 mpaka February 2020. Zambiri zachipatala kuyambira Marichi 2018 mpaka February 2019 zimayimira zoyambira kapena zisanachitike Bti, pomwe zachipatala kuyambira Marichi 2019 mpaka February 2020 zimayimira Bti isanachitike. deta yolowera.Deta pambuyo pa kulowererapo kwa Bti.Zambiri zachipatala, zaka ndi mudzi wa wodwala aliyense m'magulu ophunzirira a LLIN + Bti ndi LLIN adasonkhanitsidwa mu kaundula wa zaumoyo.Kwa wodwala aliyense, chidziwitso monga mudzi, zaka, matenda, ndi matenda adalembedwa.M'zochitika zomwe zawunikiridwa mu kafukufukuyu, malungo adatsimikiziridwa ndi kuyesa kofulumira (RDT) ndi / kapena microscopy ya malungo pambuyo pa chithandizo cha artemisinin-based combination therapy (ACT) ndi wothandizira zaumoyo.Matenda a malungo adagawidwa m'magulu atatu azaka (ie zaka 15).Chiwopsezo cha malungo pachaka pa anthu 1000 chikuyembekezeka kugawa kuchuluka kwa malungo pa anthu 1000 mwa anthu a m'mudzimo.
Deta yomwe yasonkhanitsidwa mu phunziroli idalowetsedwa kawiri mu nkhokwe ya Microsoft Excel ndiyeno idalowetsedwa mu pulogalamu yotseguka R [42] mtundu 3.6.3 kuti mufufuze mawerengero.Phukusi la ggplot2 limagwiritsidwa ntchito kujambula ziwembu.Zitsanzo za mizera yokhazikika pogwiritsa ntchito Poisson regression zidagwiritsidwa ntchito kuyerekeza kuchuluka kwa mphutsi komanso kuchuluka kwa udzudzu pamunthu pausiku pakati pamagulu ophunzirira.Relevance chiŵerengero (RR) miyeso ntchito kuyerekeza zikutanthauza kachulukidwe larval ndi kuluma mitengo ya Culex ndi Anopheles udzudzu.Gambia SL idayikidwa pakati pa magulu awiri ophunzirira pogwiritsa ntchito gulu la LLIN + Bti ngati maziko.Kukula kwake kunawonetsedwa ngati kusamvana ndi 95% nthawi zodalirika (95% CI).Chiŵerengero (RR) cha mayeso a Poisson chinagwiritsidwa ntchito kuyerekezera kuchuluka ndi kuchuluka kwa malungo asanayambe komanso atatha kulowererapo kwa Bti mu gulu lirilonse lophunzira.Mulingo wofunikira womwe unagwiritsidwa ntchito unali 5%.
Ndondomeko ya kafukufukuyu idavomerezedwa ndi National Research Ethics Committee ya Unduna wa Zaumoyo ndi Zaumoyo Zapagulu ku Côte d'Ivoire (N/Ref: 001//MSHP/CNESVS-kp), komanso chigawo cha zaumoyo ndi oyang'anira. ku Korhogo.Asanatolere mphutsi za udzudzu ndi akuluakulu, chilolezo chodziwitsidwa chosaina chinapezedwa kuchokera kwa omwe adachita nawo kafukufuku wapanyumba, eni ake, ndi/kapena okhalamo.Zambiri zabanja ndi zachipatala sizodziwika komanso zachinsinsi ndipo zimapezeka kwa ofufuza osankhidwa okha.
Malo okwana 1198 omanga zisa anachezeredwa.Pa malo a chisa awa omwe anafunsidwa m'dera lophunzirira, 52.5% (n = 629) anali a gulu la LLIN + Bti ndi 47.5% (n = 569) ku gulu lokha la LLIN (RR = 1.10 [95% CI 0.98-1.24) ], P = 0.088).Nthawi zambiri, malo okhala mphutsi am'deralo adagawidwa m'mitundu 12, yomwe gawo lalikulu kwambiri la malo okhala mphutsi anali minda ya mpunga (24.5%, n = 294), kutsatiridwa ndi ngalande zamkuntho (21.0%, n = 252) ndi mbiya (8.3).%. Zolemba za ziboda (4.8%, n = 58), madambo (4.0%, n = 48), mitsuko (5.2%, n = 62), maiwe (1.9%, n = 23) ndi zitsime (0.9%, n = 11) .).
Pazonse, mphutsi za udzudzu za 47,274 zinasonkhanitsidwa kuchokera kumalo ophunzirira, ndi gawo la 14.4% (n = 6,796) mu gulu la LLIN + Bti poyerekeza ndi 85.6% (n = 40,478) mu gulu la LLIN lokha ( (RR = 5.96) [95% CI 5.80-6.11], P ≤ 0.001).Mphutsi zimenezi zimakhala ndi mitundu itatu ya udzudzu, ndipo mitundu yambiri ya udzudzu ndi Anopheles.(48.7%, n = 23,041), yotsatiridwa ndi Culex spp.(35.0%, n = 16,562) ndi Aedes spp.(4.9%, n = 2340).Aphungu anali 11.3% ya ntchentche zosakhwima (n = 5344).
Kuchulukana kwapakati pa Anopheles spp.mphutsi.Mu phunziro ili, chiwerengero cha mphutsi pa scoop chinali 0.61 [95% CI 0.41-0.81] L / dip mu gulu la LLIN + Bti ndi 3.97 [95% CI 3.56-4.38] L / dive mu gulu LLIN kokha (posankha).Fayilo 1: Chithunzi S1).Kuchulukana kwapakati kwa Anopheles spp.Gulu lokha la LLIN linali la 6.5 nthawi zambiri kuposa gulu la LLIN + Bti (HR = 6.49; 95% CI 5.80-7.27; P <0.001).No Anopheles udzudzu anali wapezeka pa mankhwala.Mphutsi zinasonkhanitsidwa mu gulu la LLIN + Bti kuyambira mu Januwale, lolingana ndi chithandizo cha makumi awiri cha Bti.Mu gulu la LLIN + Bti, panali kuchepa kwakukulu koyambirira komanso mochedwa kachulukidwe ka mphutsi.
Asanayambe chithandizo cha Bti (March), kuchuluka kwa udzudzu woyambirira wa Anopheles kunali 1.28 [95% CI 0.22-2.35] L / kudumphira mu gulu la LLIN + Bti ndi 1.37 [95% CI 0.36-2.36] l/dive mu gulu la LLIN + Bti.l/dip./kuvinitsa mkono wa LLIN wokha (mkuyu 2A).Pambuyo ntchito Bti mankhwala, ndi kachulukidwe oyambirira Anopheles udzudzu mu LLIN + Bti gulu zambiri pang`onopang`ono utachepa kuchokera 0,90 [95% CI 0.19-1.61] kuti 0,10 [95% CI - 0.03-0.18] l/kuviika.Kachulukidwe ka mphutsi koyambirira kwa Anopheles adakhalabe otsika mu gulu la LLIN + Bti.Mu gulu la LLIN-okha, kusinthasintha kwa kuchuluka kwa Anopheles spp.Mphutsi zoyamba za instar zinkaonedwa ndi kachulukidwe kakang'ono kuyambira 0.23 [95% CI 0.07-0.54] L/dive mpaka 2.37 [95% CI 1.77-2.98] L/dive.Cacikulu, akutanthauza kachulukidwe oyambirira Anopheles mphutsi mu LLIN-okha gulu anali powerengera apamwamba pa 1.90 [95% CI 1.70-2.10] L/madzimadzi, pamene kutanthawuza osalimba oyambirira Anopheles mphutsi mu gulu LLIN anali 0,38 [95% CI 0,28] -0.47]) l/dip.+ Bti gulu (RR = 5.04; 95% CI 4.36-5.85; P <0.001).
Kusintha kwa kachulukidwe kakang'ono ka mphutsi za Anopheles.Ma neti a udzudzu oyambilira (A) komanso mochedwa instar (B) m’gulu lophunzira kuyambira pa Marichi 2019 mpaka February 2020 m’chigawo cha Napier, kumpoto kwa Côte d’Ivoire.LLIN: ukonde wophera tizilombo kwanthawi yayitali Bti: Bacillus thuringiensis, Israel TRT: chithandizo;
Kuchulukana kwapakati kwa Anopheles spp.mphutsi.zaka mochedwa mu gulu la LLIN + Bti.Kuchuluka kwa Bti kusanachitike kunali 2.98 [95% CI 0.26-5.60] L / dip, pamene kuchuluka kwa gulu la LLIN-lokha kunali 1.46 [95% CI 0.26-2.65] l / tsiku Pambuyo pa ntchito ya Bti, kuchuluka kwa mochedwa- instar Anopheles mphutsi mu LLIN + Bti gulu utachepa kuchokera 0.22 [95% CI 0.04-0.40] kuti 0.03 [95% CI 0.00-0.06] L/kuviika (mkuyu. 2B).Mu LLIN-okha gulu, kachulukidwe a mochedwa Anopheles mphutsi chinawonjezeka kuchokera 0,35 [95% CI - 0.15-0.76] kuti 2.77 [95% CI 1.13-4.40] l/madzimadzi ndi zosiyanasiyana mu kachulukidwe mphutsi malinga ndi deti chitsanzo.The kachulukidwe kachulukidwe mochedwa-instar Anopheles mphutsi mu LLIN-okha gulu anali 2.07 [95% CI 1.84-2.29] L/dive, kasanu ndi kamodzi kuposa 0.23 [95% CI 0.11-0.[Chithunzi patsamba 36] l/kumizidwa mu LLIN.+ Bti gulu (RR = 8.80; 95% CI 7.40-10.57; P <0.001).
Kuchulukana kwapakati kwa Culex spp.Makhalidwe anali 0.33 [95% CI 0.21-0.45] L/dip mu LLIN + Bti gulu ndi 2.67 [95% CI 2.23-3.10] L/dip mu LLIN gulu lokha (fayilo yowonjezera 2: Chithunzi S2).Kuchulukana kwapakati kwa Culex spp.Gulu lokha la LLIN linali lalikulu kwambiri kuposa gulu la LLIN + Bti (HR = 8.00; 95% CI 6.90-9.34; P <0.001).
Kuchulukana kwapakati pamtundu wa Culex Culex spp.Asanayambe chithandizo, Bti l / dip anali 1.26 [95% CI 0.10-2.42] l / dip mu gulu la LLIN + Bti ndi 1.28 [95% CI 0.37-2.36] mu gulu lokha LLIN (Mkuyu 3A).Pambuyo pogwiritsira ntchito chithandizo cha Bti, kachulukidwe ka mphutsi za Culex oyambirira anatsika kuchokera ku 0.07 [95% CI - 0.001-0.] mpaka 0.25 [95% CI 0.006-0.51] L / dip.Palibe mphutsi za Culex zomwe zinasonkhanitsidwa kuchokera kumalo okhala mphutsi omwe amathandizidwa ndi Bti kuyambira mu December.Kuchulukana kwa mphutsi zoyamba za Culex kunachepetsedwa kukhala 0.21 [95% CI 0.14-0.28] L / kuviika mu gulu la LLIN + Bti, koma anali apamwamba mu gulu la LLIN lokha pa 1.30 [95% CI 1.10- 1.50] l / kumiza.kugwa/d.Kuchuluka kwa mphutsi zoyambirira za Culex mu gulu la LLIN lokha linali la 6 nthawi zambiri kuposa gulu la LLIN + Bti (RR = 6.17; 95% CI 5.11-7.52; P <0.001).
Kusintha kwa kachulukidwe wapakati wa Culex spp.mphutsi.Mayesero a ubwana (A) ndi moyo waubwana (B) mu gulu lophunzira kuyambira March 2019 mpaka February 2020 m'chigawo cha Napier, kumpoto kwa Côte d'Ivoire.Ukonde wophera tizilombo kwanthawi yayitali LLIN, Bti Bacillus thuringiensis Israel, chithandizo cha Trt
Asanayambe chithandizo cha Bti, kuchuluka kwa mphutsi za Culex mochedwa mu gulu la LLIN + Bti ndi gulu la LLIN linali 0.97 [95% CI 0.09-1.85] ndi 1.60 [95% CI - 0.16-3.37] l / kumizidwa moyenerera (Mkuyu. 3b))Kutanthauza kuchuluka kwa mitundu yochedwa Culex pambuyo poyambitsa chithandizo cha Bti.Kuchulukana kwa gulu la LLIN + Bti kunachepa pang'onopang'ono ndipo kunali kochepa kusiyana ndi gulu la LLIN lokha, lomwe linakhalabe lalitali kwambiri.Kuchulukana kwapakati kwa instar Culex mphutsi zakumapeto zinali 0.12 [95% CI 0.07-0.15] L / dive mu gulu la LLIN + Bti ndi 1.36 [95% CI 1.11-1.61] L/kudumphira mu gulu LLIN yokha.Kuchulukana kwapakati kwa mphutsi za Culex mochedwa kunali kwakukulu kwambiri mu gulu la LLIN-okha kusiyana ndi gulu la LLIN + Bti (RR = 11.19; 95% CI 8.83-14.43; P <0.001).
Asanayambe chithandizo cha Bti, chiwerengero cha pupae pa ladybug chinali 0.59 [95% CI 0.24-0.94] mu gulu la LLIN + Bti ndi 0.38 [95% CI 0.13-0.63] mu LLIN yokha (mkuyu 4).Kuchulukana kwa pupal kunali 0.10 [95% CI 0.06-0.14] mu gulu la LLIN + Bti ndi 0.84 [95% CI 0.75-0.92] mu gulu la LLIN lokha.Chithandizo cha Bti chinachepetsa kwambiri kuchuluka kwa pupal mu gulu la LLIN + Bti poyerekeza ndi gulu la LLIN lokha (OR = 8.30; 95% CI 6.37-11.02; P <0.001).Mu gulu la LLIN + Bti, palibe pupae zomwe zinasonkhanitsidwa pambuyo pa November.
Kusintha pakati pa kachulukidwe ka pupae.Kafukufukuyu adachitika kuyambira Marichi 2019 mpaka February 2020 mdera la Napier kumpoto kwa Côte d'Ivoire.Ukonde wophera tizilombo kwanthawi yayitali LLIN, Bti Bacillus thuringiensis Israel, chithandizo cha Trt
Chiwerengero cha udzudzu wamkulu wa 3456 adasonkhanitsidwa kuchokera kumalo ophunzirira.Udzudzu uli m'gulu la 17 mitundu ya 5 genera (Anopheles, Culex, Aedes, Eretmapodites) (Table 1).M'matenda a malungo An.gambiae sl inali mitundu yochuluka kwambiri yokhala ndi gawo la 74.9% (n = 2587), kutsatiridwa ndi An.gambia sl.funestus (2.5%, n = 86) ndi An null (0.7%, n = 24).Chuma cha Anna.gambiae sl mu gulu la LLIN + Bti (10.9%, n = 375) anali otsika kuposa gulu la LLIN lokha (64%, n = 2212).Palibe mtendere.nli anthu adagawidwa ndi LLIN okha.Komabe, An.gambiae and An.funestus analipo mu gulu la LLIN + Bti komanso gulu la LLIN lokha.
M'maphunziro oyambira Bti asanagwiritse ntchito pamalo obereketsa (miyezi ya 3), chiwerengero chonse cha udzudzu wausiku pa munthu aliyense (b / p / n) mu gulu la LLIN + Bti chinali 0.83 [95% CI 0.50-1.17] , pamene mu gulu la LLIN + Bti linali 0.72 mu gulu la LLIN lokha [95% CI 0.41-1.02] (Mkuyu 5).Mu gulu la LLIN + Bti, kuwonongeka kwa udzudzu wa Culex kunachepa ndipo kunakhalabe kochepa ngakhale kuti chiwerengero cha 1.95 [95% CI 1.35-2.54] bpp mu September pambuyo pa 12th Bti ntchito.Komabe, mu gulu la LLIN-okha, kuchuluka kwa udzudzu kukulumwa pang'onopang'ono kunakula pang'onopang'ono mu September pa 11.33 [95% CI 7.15-15.50] bp / n.Chiwerengero chonse cha kulumidwa ndi udzudzu chinali chochepa kwambiri mu gulu la LLIN + Bti poyerekeza ndi gulu la LLIN lokha pa nthawi iliyonse pa phunziro (HR = 3.66; 95% CI 3.01-4.49; P <0.001).
Kuluma kwa nyama za udzudzu m'dera lophunzirira la Napier kumpoto kwa Côte d'Ivoire kuyambira Marichi 2019 mpaka February 2020 LLIN ukonde wophera tizilombo, Bti Bacillus thuringiensis Israel, chithandizo cha Trt, kuluma b/p/usiku/munthu/ usiku
Anopheles gambiae ndi amene amafalitsa malungo kwambiri m'dera la kafukufuku.Kuthamanga kwa An.Pachiyambi, akazi a ku Gambia anali ndi b / p / n za 0.64 [95% CI 0.27-1.00] mu gulu la LLIN + Bti ndi 0.74 [95% CI 0.30-1.17] mu gulu lokha LLIN (Mkuyu 6) .Panthawi ya Bti, ntchito yopweteka kwambiri inawonedwa mu September, yofanana ndi njira ya khumi ndi iwiri ya chithandizo cha Bti, ndi chiwerengero cha 1.46 [95% CI 0.87-2.05] b / p / n mu gulu la LLIN + Bti ndi a nsonga ya 9 .65 [95% CI 0.87-2.05] w/n 5.23-14.07] LLIN gulu lokha.Kuthamanga kwathunthu kwa An.Chiwerengero cha matenda ku Gambia chinali chochepa kwambiri mu gulu la LLIN + Bti (0.59 [95% CI 0.43-0.75] b / p / n) kusiyana ndi gulu la LLIN lokha (2.97 [95% CI 2, 02-3.93] b /p/ayi).(RR = 3.66; 95% CI 3.01-4.49; P <0.001).
Liwiro loluma la Anna.gambiae sl, gawo lofufuza m'chigawo cha Napier, kumpoto kwa Cote d'Ivoire, kuyambira Marichi 2019 mpaka February 2020 LLIN ukonde wothira tizirombo, Bti Bacillus thuringiensis Israel, Trt chithandizo, kuluma b/p/usiku/ munthu/usiku
Chiwerengero chonse cha 646 amps.Dziko la Gambia lathyoledwa.Ponseponse, kuchuluka kwachitetezo chapafupi.Chiwerengero cha anthu ku Gambia chinali > 70% panthawi yonse yophunzira, kupatulapo July, pamene gulu la LLIN lokha linagwiritsidwa ntchito (Fayilo yowonjezera 3: Chithunzi S3).Komabe, kuchuluka kwa chonde m'malo ophunzirira kunali 74.5% (n = 481).Mu gulu la LLIN + Bti, chiwerengerocho chinakhalabe pamtunda wapamwamba, pamwamba pa 80%, kupatulapo September, pamene chiwerengero chinagwera ku 77,5%.Komabe, kusiyanasiyana kwa kuchuluka kwa kubereka kunawonedwa m'gulu la LLIN-okha, ndipo otsika kwambiri akuti chiwopsezo cha chonde chinali 64.5%.
Kuchokera ku 389 Ann.Kafukufuku wokhudza magawo a magazi ochokera ku Gambia adapeza kuti 80.5% (n = 313) ndi anthu, 6.2% (n = 24) ya akazi amadya magazi osakanikirana (anthu ndi apakhomo) ndipo 5.1% (n = 20) adadya magazi. .Zakudya zochokera ku ziweto (ng'ombe, nkhosa ndi mbuzi) ndi 8.2% (n = 32) za zitsanzo zomwe zidafufuzidwa zinali zopanda chakudya chamagazi.Mu gulu la LLIN + Bti, chiwerengero cha amayi omwe amalandira magazi a anthu chinali 25.7% (n = 100) poyerekeza ndi 54.8% (n = 213) mu gulu la LLIN lokha (Fayilo yowonjezera 5: Table S5).
Chiwerengero chonse cha 308 amps.P. gambiae anayesedwa kuti azindikire mamembala a mitundu yovuta komanso matenda a P. falciparum (Fayilo yowonjezera 4: Table S4).Mitundu iwiri "yogwirizana" imapezeka m'malo ophunzirira, omwe ndi An.gambiae ss (95.1%, n = 293) ndi An.coluzzii (4.9%, n = 15).Anopheles gambiae ss anali otsika kwambiri mu gulu la LLIN + Bti kuposa gulu la LLIN lokha (66.2%, n = 204) (RR = 2.29 [95% CI 1.78-2.97], P <0.001) .Chiwerengero chofanana cha udzudzu wa Anopheles chinapezeka mu gulu la LLIN + Bti (3.6%, n = 11) ndi gulu la LLIN lokha (1.3%, n = 4) (RR = 2.75 [95% CI 0.81-11 .84], P = .118).Kukula kwa matenda a Plasmodium falciparum pakati pa An.SL ku Gambia inali 11.4% (n = 35).Matenda a Plasmodium falciparum.Chiwopsezo cha matenda ku Gambia chinali chochepa kwambiri mu gulu la LLIN + Bti (2.9%, n = 9) kuposa gulu la LLIN lokha (8.4%, n = 26) (RR = 2.89 [95% CI 1. 31-7.01) ], P = 0.006).).Poyerekeza ndi udzudzu wa Anopheles, udzudzu wa Anopheles gambiae unali ndi gawo lalikulu kwambiri la matenda a Plasmodium pa 94.3% (n=32).coluzzii yekha 5.7% (n = 5) (RR = 6.4 [95% CI 2.47-21.04], P <0.001).
Anthu 2,435 ochokera m'mabanja 400 adafunsidwa.Kuchulukana kwapakati ndi anthu 6.1 panyumba iliyonse.Chiwerengero cha umwini wa LLIN pakati pa mabanja chinali 85% (n = 340), poyerekeza ndi 15% (n = 60) kwa mabanja opanda LLIN (RR = 5.67 [95% CI 4.29-7.59], P <0.001) (Fayilo yowonjezera 5 : Gulu S5)..Kugwiritsa ntchito kwa LLIN kunali 40.7% (n = 990) mu gulu la LLIN + Bti poyerekeza ndi 36.2% (n = 882) mu gulu la LLIN lokha (RR = 1.12 [95% CI 1.02-1.23], P = 0.013).Avereji yogwiritsa ntchito maukonde onse pamalo ophunzirira anali 38.4% (n = 1842).Kuchuluka kwa ana osakwana zaka zisanu omwe amagwiritsa ntchito intaneti kunali kofanana m'magulu onse ophunzirira, kugwiritsa ntchito ukonde wa 41.2% (n = 195) mu gulu la LLIN + Bti ndi 43.2% (n = 186) pagulu lokha LLIN.(HR = 1.05 [95% CI 0.85-1.29], P = 0.682).Pakati pa ana a zaka zapakati pa 5 mpaka zaka 15, panalibe kusiyana pakati pa 36.3% (n = 250) mu gulu la LLIN + Bti ndi 36.9% (n = 250) mu gulu la LLIN lokha (RR = 1. 02 [ 95% CI 1.02-1.23], P = 0.894).Komabe, omwe ali ndi zaka zoposa 15 amagwiritsa ntchito maukonde 42.7% (n = 554) kawirikawiri mu gulu la LLIN + Bti kuposa 33.4% (n = 439) mu gulu la LLIN lokha (RR = 1.26 [95% CI 1.11-1.43) ], P <0.001).
Milandu yonse yokwana 2,484 inalembedwa ku Napier Health Center pakati pa Marichi 2018 ndi February 2020. Kuchuluka kwa malungo achipatala mwa anthu onse kunali 82.0% ya matenda onse a matenda (n = 2038).Chiwopsezo cha matenda a malungo pachaka m'derali chinali 479.8 ‰ ndi 297.5 ‰ asanayambe komanso atatha chithandizo cha Bti (Table 2).
Nthawi yotumiza: Jul-01-2024