M'nyumba mankhwala ophera tizilombokupopera mbewu mankhwalawa (IRS) ndi njira yofunika kwambiri yochepetsera kufala kwa Trypanosoma cruzi ndi vector, komwe kumayambitsa matenda a Chagas ku South America.Komabe, kupambana kwa IRS m'chigawo cha Grand Chaco, chomwe chili ku Bolivia, Argentina ndi Paraguay, sikungafanane ndi mayiko ena aku Southern Cone.
Kafukufukuyu adawunika machitidwe a IRS komanso kuwongolera kwabwino kwa mankhwala ophera tizilombo ku Chaco, Bolivia.
The yogwira pophikaalpha-cypermetrin(ai) inajambulidwa pa pepala losefera loyikidwa pakhoma la sprayer ndikuyezedwa mu tanki yopopera yokonzekera pogwiritsa ntchito Insecticide Quantitative Kit (IQK™) yovomerezeka panjira za kuchuluka kwa HPLC.Deta idawunikidwa pogwiritsa ntchito njira yolakwika yabinomial mix-effects regression model kuti muwone mgwirizano pakati pa mankhwala ophera tizilombo omwe amagwiritsidwa ntchito pa pepala losefera ndi kutalika kwa khoma lopopera, kuphimba kutsitsi (malo opoperapo / nthawi yothirira [m2/mphindi]), ndikuwona / kuyembekezera kutsitsi.chiŵerengero cha mtengo.Kusiyana pakati pa kutsata kwa opereka chithandizo chaumoyo ndi eni nyumba kutsata zofunikira zapakhomo za IRS zomwe zasowa zidawunikidwanso.Mlingo wokhazikika wa alpha-cypermethrin mutatha kusakaniza mu akasinja opopera okonzeka adawerengedwa mu labotale.
Kusiyanasiyana kwakukulu kunkawoneka m'magulu a alpha-cypermethrin AI, ndi 10.4% (50/480) yokha ya zosefera ndi 8.8% (5/57) ya nyumba zomwe zimakwaniritsa cholinga cha 50 mg ± 20% AI/m2.Kuchulukira komwe kwasonyezedwa sikudalira kuchuluka komwe kumapezeka muzitsulo zopopera.Pambuyo kusakaniza alpha-cypermethrin ai mu okonzeka padziko njira ya thanki kutsitsi mwamsanga anakhazikika, zomwe zinachititsa kuti liniya imfa ya alpha-cypermethrin ai pa mphindi ndi imfa ya 49% pambuyo mphindi 15.Ndi 7.5% yokha (6/80) ya nyumba zomwe zidathandizidwa pamlingo wopopera wa WHO wa 19 m2/min (±10%), pomwe 77.5% (62/80) ya nyumba zidathandizidwa pamlingo wochepera kuposa momwe amayembekezeredwa.Kuchuluka kwa zinthu zomwe zimaperekedwa kunyumbako sikunali kogwirizana kwambiri ndi kufalikira kwa utsi.Kutsata kwapakhomo sikunakhudze kwambiri kufalikira kwa utsi kapena kuchuluka kwa cypermethrin komwe kumaperekedwa kunyumba.
Kuperekera kwa IRS kocheperako kungakhale chifukwa cha mawonekedwe a mankhwala ophera tizilombo komanso kufunikira kowunikiranso njira zoperekera mankhwala ophera tizilombo, kuphatikiza kuphunzitsa magulu a IRS ndi maphunziro apagulu kuti alimbikitse kutsatira.IQK™ ndi chida chofunikira kwambiri chomwe chimathandiza kuti IRS ikhale yabwino komanso imathandizira kuphunzitsa othandizira azaumoyo komanso kupanga zisankho kwa oyang'anira mu Chagas vector control.
Chagas matenda amayamba chifukwa cha tizilombo toyambitsa matenda Trypanosoma cruzi (kinetoplastid: Trypanosomatidae), yomwe imayambitsa matenda osiyanasiyana mwa anthu ndi nyama zina.Mwa anthu, pachimake symptomatic matenda kumachitika masabata kuti miyezi kutenga matenda ndipo yodziwika ndi malungo, malaise, ndi hepatosplenomegaly.Pafupifupi 20-30% ya matenda amapita ku mawonekedwe osatha, nthawi zambiri cardiomyopathy, yomwe imadziwika ndi zofooka za conduction system, arrhythmias ya mtima, kusokonezeka kwa ventricular kumanzere, ndipo pamapeto pake kulephera kwa mtima komanso, kawirikawiri, matenda a m'mimba.Izi zitha kukhalapo kwa zaka zambiri ndipo zimakhala zovuta kuchiza [1].Palibe katemera.
Kulemera kwapadziko lonse kwa matenda a Chagas mu 2017 kunayesedwa kuti ndi anthu 6.2 miliyoni, zomwe zinachititsa kuti anthu 7900 afe ndi zaka 232,000 za moyo wolemala (DALYs) kwa mibadwo yonse [2,3,4].Triatominus cruzi imafalikira ku Central ndi South America, komanso kumadera akum'mwera kwa North America, ndi Triatominus cruzi (Hemiptera: Reduviidae), kuwerengera 30,000 (77%) ya chiwerengero cha milandu yatsopano ku Latin America mu 2010 [5].Njira zina zopatsirana matenda m’madera omwe si ofala monga ku Ulaya ndi ku United States ndi monga kupatsirana mwachibadwa ndi kuthiridwa magazi omwe ali ndi kachilomboka.Mwachitsanzo, ku Spain, pali pafupifupi 67,500 milandu ya matenda pakati pa anthu osamukira ku Latin America [6], zomwe zimapangitsa kuti pakhale ndalama zapachaka za US $ 9.3 miliyoni [7].Pakati pa 2004 ndi 2007, 3.4% ya amayi omwe ali ndi pakati aku Latin America omwe adasamukira ku chipatala cha Barcelona anali ndi vuto la Trypanosoma cruzi [8].Chifukwa chake, kuyesetsa kuthana ndi kufalikira kwa ma vector m'maiko omwe ali ndi kachilomboka ndikofunikira kwambiri kuti muchepetse kuchuluka kwa matenda m'maiko opanda ma vector a triatomine [9].Njira zowongolera zamakono zimaphatikizapo kupopera mbewu mankhwalawa m'nyumba (IRS) kuti achepetse kuchuluka kwa ma vector m'nyumba ndi kuzungulira nyumba, kuyezetsa kwa amayi kuti azindikire ndi kuthetsa kufala kwa obadwa nawo, kuyesa magazi ndi mabanki oika ziwalo, ndi mapulogalamu a maphunziro [5,10,11,12].
Ku Southern Cone ku South America, vector yayikulu ndi kachilombo ka triatomine.Mtundu uwu ndi wovuta kwambiri komanso wosasamala ndipo umaswana kwambiri m'nyumba ndi m'makola.M'nyumba zosamangidwa bwino, ming'alu ya makoma ndi denga imakhala ndi nsikidzi za triatomine, ndipo kufalikira m'mabanja kumakhala koopsa kwambiri [13, 14].Bungwe la Southern Cone Initiative (INCOSUR) limalimbikitsa zoyesayesa zapadziko lonse lapansi zothana ndi matenda apakhomo ku Tri.Gwiritsani ntchito IRS kuti muzindikire mabakiteriya oyambitsa matenda ndi othandizira ena omwe ali patsamba [15, 16].Izi zidapangitsa kuti chiwerengero cha matenda a Chagas chichepe kwambiri komanso kutsimikiziridwa ndi World Health Organisation kuti kufalikira kwa ma vectors kunathetsedwa m'maiko ena (Uruguay, Chile, madera a Argentina ndi Brazil) [10, 15].
Ngakhale kuti INCOSUR yachita bwino, vekitala ya Trypanosoma cruzi ipitilirabe m'chigawo cha Gran Chaco ku USA, malo okhala m'nkhalango zouma zomwe zimadutsa ma kilomita 1.3 miliyoni kudutsa malire a Bolivia, Argentina ndi Paraguay [10].Anthu okhala m'derali ndi m'gulu la anthu osowa kwambiri ndipo akukhala muumphawi wadzaoneni ndipo alibe mwayi wopeza chithandizo chamankhwala [17].Chiwopsezo cha matenda a T. cruzi ndi kufalitsa ma vector m'maderawa ndi amodzi mwapamwamba kwambiri padziko lonse lapansi [5,18,19,20] ndi 26-72% ya nyumba zomwe zili ndi trypanosomatids.infestans [13, 21] ndi 40-56% Tri.Tizilombo toyambitsa matenda timayambitsa Trypanosoma cruzi [22, 23].Ambiri (> 93%) a matenda a Chagas omwe amafalitsidwa ndi tizilombo ku Southern Cone amapezeka ku Bolivia [5].
IRS pakadali pano ndiyo njira yokhayo yovomerezeka yochepetsera triacine mwa anthu.infestans ndi njira yotsimikizirika kale yochepetsera zolemetsa za matenda angapo oyambitsidwa ndi ma vectors [24, 25].Gawo la nyumba m'mudzi wa Tri.infestans (infection index) ndi chizindikiro chofunikira chomwe akuluakulu azaumoyo amagwiritsa ntchito popanga zisankho za kutumizidwa kwa IRS ndipo, chofunikira kwambiri, kulungamitsa chithandizo cha ana omwe ali ndi kachilombo kosatha popanda chiopsezo choyambukiridwanso [16,26,27,28,29].Kuchita bwino kwa IRS ndi kulimbikira kwa kufalikira kwa ma vector m'dera la Chaco kumakhudzidwa ndi zinthu zingapo: kutsika kwabwino kwa zomangamanga [19, 21], kukhazikitsidwa kwa IRS kocheperako komanso njira zowunikira anthu [30], kusatsimikizika kwa anthu pazofunikira za IRS 31], zochita zazifupi zotsalira za mankhwala ophera tizilombo [32, 33] ndi Tri.infestans achepetsa kukana komanso / kapena kukhudzidwa ndi mankhwala ophera tizilombo [22, 34].
Mankhwala ophera tizilombo a Synthetic pyrethroid amagwiritsidwa ntchito kwambiri mu IRS chifukwa amapha anthu omwe ali ndi kachilombo ka triatomine.Pamalo otsika, mankhwala ophera tizilombo a pyrethroid akhala akugwiritsidwanso ntchito ngati zokwiyitsa kutulutsa ma vectors m'ming'alu ya khoma kuti aziyang'anira [35].Kafukufuku wokhudza kayendetsedwe kabwino ka machitidwe a IRS ndi ochepa, koma kwinakwake kwasonyezedwa kuti pali kusiyana kwakukulu pamagulu a mankhwala ophera tizilombo (AIs) omwe amaperekedwa m'nyumba, ndipo milingo nthawi zambiri imagwera pansi pa zomwe zikugwiritsidwa ntchito [33,36], 37, 38].Chifukwa chimodzi chakusowa kwa kafukufuku wowongolera bwino ndikuti high-performance liquid chromatography (HPLC), mulingo wagolide woyezera kuchuluka kwa zinthu zomwe zimagwira ntchito mu mankhwala ophera tizilombo, ndizovuta mwaukadaulo, zodula, ndipo nthawi zambiri sizoyenera kufalikira kwa anthu.Kupita patsogolo kwaposachedwa pakuyesa kwa labotale tsopano kumapereka njira zina komanso zotsika mtengo zowunikira njira zoperekera mankhwala ophera tizilombo ndi machitidwe a IRS [39, 40].
Kafukufukuyu adapangidwa kuti ayeze kusintha kwa kuchuluka kwa mankhwala ophera tizilombo panthawi yamakampeni anthawi zonse a IRS omwe akulunjika ku Tri.Phytophthora infestans of mbatata m'chigawo cha Chaco, Bolivia.Kuphatikizika kwa mankhwala ophera tizilombo kumayesedwa m'mipangidwe yokonzedwa m'matangi opopera komanso muzosefera zamapepala zomwe zimasonkhanitsidwa m'zipinda zopopera.Zinthu zomwe zingakhudze kuperekedwa kwa mankhwala ophera tizilombo m'nyumba zinawunikidwanso.Kuti izi zitheke, tidagwiritsa ntchito kuyezetsa kwa colorimetric kuti tidziwe kuchuluka kwa ma pyrethroids mu zitsanzo izi.
Kafukufukuyu adachitika ku Itanambicua, m'tauni ya Camili, dipatimenti ya Santa Cruz, Bolivia (20°1′5.94″ S; 63°30′41″ W) (Mkuyu 1).Derali ndi gawo la dera la Gran Chaco ku USA ndipo limadziwika ndi nkhalango zouma zomwe zimatentha 0-49 °C ndi mvula ya 500-1000 mm/chaka [41].Itanambicua ndi amodzi mwa midzi 19 ya ku Guaraní mumzindawu, momwe anthu pafupifupi 1,200 amakhala m'nyumba 220 zomangidwa makamaka ndi njerwa zoyendera dzuwa (adobe), mipanda yachikhalidwe ndi ma tabiques (otchedwa tabique), matabwa, kapena zosakaniza za zinthuzi.Nyumba zina zomwe zili pafupi ndi nyumbayi ndi monga zipinda za ziweto, zipinda zosungiramo zinthu, khitchini ndi zimbudzi, zomangidwa kuchokera ku zipangizo zofanana.Chuma cha m’deralo chimachokera pa ulimi wodzidalira, makamaka chimanga ndi mtedza, komanso nkhuku, nkhumba, mbuzi, abakha ndi nsomba, ndi zotsalira zapakhomo zomwe zimagulitsidwa m’tawuni yamsika ya Kamili (pafupifupi makilomita 12).Tawuni ya Kamili imaperekanso mwayi wochuluka wa ntchito kwa anthu, makamaka m'magawo a zomangamanga ndi ntchito zapakhomo.
Mu kafukufuku wamakono, chiwerengero cha matenda a T. cruzi pakati pa ana a Itanambiqua (zaka 2-15) chinali 20% [20].Izi zikufanana ndi kuchuluka kwa matenda pakati pa ana omwe adanenedwa m'dera loyandikana nalo la Guarani, lomwe lidawonanso kuchuluka kwa anthu chifukwa cha ukalamba, pomwe anthu ambiri opitilira zaka 30 akudwala [19].Kupatsirana kwa ma Vector kumawonedwa ngati njira yayikulu yopatsira matenda m'maderawa, Tri ndiye gwero lalikulu.Infestans amasokoneza nyumba ndi nyumba zakunja [21, 22].
Akuluakulu a zaumoyo omwe angosankhidwa kumene sanathe kupereka malipoti okhudza zochitika za IRS ku Itanambicua kafukufukuyu asanachitike, komabe malipoti ochokera kumadera oyandikana nawo akuwonetsa momveka bwino kuti ntchito za IRS m'tauniyi zakhala zikuyenda mwapang'onopang'ono kuyambira 2000 komanso kupopera mbewu mankhwalawa kwa 20% beta cypermethrin;kunachitika mu 2003, kutsatiridwa ndi kupopera mbewu mankhwalawa m'nyumba zokhala ndi anthu ambiri kuyambira 2005 mpaka 2009 [22] ndi kupopera mbewu mankhwalawa mwadongosolo kuyambira 2009 mpaka 2011 [19].
Mderali, IRS idachitidwa ndi akatswiri atatu azaumoyo ophunzitsidwa bwino ndi anthu pogwiritsa ntchito 20% yopanga alpha-cypermethrin suspension concentrate [SC] (Alphamost®, Hockley International Ltd., Manchester, UK).Tizilombo toyambitsa matenda tinapangidwa ndi chiwerengero cha 50 mg ai/m2 malinga ndi zofunikira za Chagas Disease Control Programme ya Santa Cruz Administrative Department (Servicio Departamental de Salud-SEDES).Mankhwala ophera tizirombo adayikidwa pogwiritsa ntchito chopopera zikwama za Guarany® (Guarany Indústria e Comércio Ltda, Itu, São Paulo, Brazil) cha mphamvu ya malita 8.5 (tanki code: 0441.20), chokhala ndi nozzle yopopera komanso kutulutsa kwake mwadzina. 757 ml / min, kutulutsa mtsinje wa ngodya ya 80 ° pa mphamvu ya silinda ya 280 kPa.Ogwira ntchito zaukhondo ankasakanizanso zitini za aerosol ndi nyumba zopoperapo mankhwala.Ogwira ntchitowa anali ataphunzitsidwa kale ndi dipatimenti ya zaumoyo ya mumzindawo kukonzekera ndi kutumiza mankhwala ophera tizilombo, komanso kupopera mankhwala mkati ndi kunja kwa nyumba.Amalangizidwanso kuti anthu okhalamo achotse zinthu zonse m'nyumba, kuphatikiza mipando (kupatula mafelemu a bedi), osachepera maola 24 IRS isanayambe kuchitapo kanthu kuti athe kulowa mkati mwa nyumbayo popopera mankhwala.Kutsatira lamuloli kumayesedwa monga momwe tafotokozera m'munsimu.Anthu okhalamo amalangizidwanso kudikirira mpaka makoma opakidwa owuma asanalowenso mnyumbamo, monga momwe adalimbikitsira [42].
Kuti athe kuwerengera kuchuluka kwa lambda-cypermethrin AI yoperekedwa m'nyumba, ochita kafukufukuwo adayika mapepala a fyuluta (Whatman No. 1; 55 mm m'mimba mwake) pamakoma a nyumba za 57 kutsogolo kwa IRS.Nyumba zonse zolandira IRS panthawiyo zinkakhudzidwa (nyumba 25/25 mu November 2016 ndi nyumba 32/32 mu January-February 2017).Izi zikuphatikiza nyumba 52 za adobe ndi nyumba 5 za tabik.Zidutswa zisanu ndi zitatu mpaka zisanu ndi zinayi za pepala zosefera zinayikidwa m’nyumba iliyonse, zogaŵidwa m’zitali zitatu za khoma (0.2, 1.2 ndi 2 m kuchokera pansi), ndipo lililonse la makoma atatuwo linasankhidwa motsatira koloko, kuyambira pa khomo lalikulu.Izi zidapereka zofananira zitatu pamtunda uliwonse wa khoma, monga momwe zimalimbikitsira kuyang'anira kasamalidwe ka mankhwala ophera tizilombo [43].Atangogwiritsa ntchito mankhwala ophera tizilombo, ofufuzawo anatolera pepala loseferayo n’kuliumitsa kuti lisakhale ndi dzuwa.Mukawuma, pepala la fyuluta lidakulungidwa ndi tepi yomveka bwino kuti ateteze ndi kusunga mankhwala ophera tizilombo pamtunda, ndiyeno atakulungidwa ndi zojambulazo za aluminium ndikusungidwa pa 7 ° C mpaka kuyesa.Mwa mapepala onse osefera 513 omwe adasonkhanitsidwa, nyumba 480 mwa nyumba 57 zidapezeka kuti ziyesedwe, mwachitsanzo, zosefera 8-9 kunyumba.Zitsanzo zoyesazo zidaphatikizanso mapepala osefera 437 ochokera ku nyumba 52 za adobe ndi mapepala 43 osefera ochokera ku nyumba 5 za tabik.Chitsanzocho chimagwirizana ndi kuchuluka kwa nyumba zamtundu wa anthu m’deralo (76.2% [138/181] adobe ndi 11.6% [21/181] tabika) zolembedwa m’kafukufuku wa khomo ndi khomo wa kafukufukuyu.Kusanthula mapepala a kusefera pogwiritsa ntchito Insecticide Quantification Kit (IQK™) ndi kutsimikizika kwake pogwiritsa ntchito HPLC akufotokozedwa mu Fayilo Yowonjezera 1. Mulingo wa mankhwala ophera tizilombo ndi 50 mg ai/m2, womwe umalola kulolerana kwa ± 20% (ie 40–60 mg ai). /m2).
Kuchulukirachulukira kwa AI kudatsimikiziridwa mu zitini 29 zokonzedwa ndi azachipatala.Tidayesa matanki okonzekera 1-4 patsiku, pafupifupi matanki 1.5 (osiyanasiyana: 1-4) okonzedwa tsiku lililonse kwa masiku 18.Kutsatizana kwa sampuli kunatsatira ndondomeko yotsatiridwa ndi ogwira ntchito zachipatala mu November 2016 ndi January 2017. Kupita patsogolo kwa tsiku ndi tsiku kuchokera;Januwale February.Mukangosakaniza bwino zomwe zikuchokera, 2 ml ya yankho idasonkhanitsidwa kuchokera pamwamba pa zomwe zili.Zitsanzo za 2 mL zidasakanizidwa mu labotale ndikupukutira kwa mphindi 5 ma subsamples awiri a 5.2 μL asanasonkhanitsidwe ndikuyesedwa pogwiritsa ntchito IQK ™ monga tafotokozera (onani Fayilo yowonjezera 1).
Kuyika kwa mankhwala ophera tizilombo kunayezedwa m'matangi anayi opopera omwe amasankhidwa kuti aimire zoyamba (ziro) zomwe zimagwira ntchito m'magulu apamwamba, otsika, ndi omwe amawafuna.Pambuyo kusakaniza kwa mphindi 15 zotsatizana, chotsani zitsanzo zitatu za 5.2 µL kuchokera pamwamba pa 2 mL vortex chitsanzo pa mphindi imodzi.Njira yothetsera vutoli mu thanki ndi 1.2 mg ai / ml ± 20% (ie 0.96-1.44 mg ai / ml), yomwe ili yofanana ndi kukwaniritsa cholinga chomwe chimaperekedwa ku pepala la fyuluta, monga tafotokozera pamwambapa.
Kuti mumvetsetse ubale womwe ulipo pakati pa ntchito zopopera mankhwala ndi kutumiza mankhwala, wofufuza (RG) adatsagana ndi ogwira ntchito yazaumoyo a IRS akumaloko panthawi yotumiza IRS m'nyumba 87 (nyumba 57 zomwe zili pamwambapa ndi 30 mwa nyumba 43 zomwe zidapopera mankhwala ophera tizilombo).Marichi 2016).Nyumba khumi ndi zitatu mwa izi 43 sizinaphatikizidwe pakuwunika: eni ake asanu ndi mmodzi adakana, ndipo nyumba zisanu ndi ziwiri zidasamalidwa pang'ono.Malo onse oti apopedwe (mamita sikweya) mkati ndi kunja kwa nyumbayo adayesedwa mwatsatanetsatane, ndipo nthawi yonse yomwe ogwira ntchito yazaumoyo akupopera (mphindi) adalembedwa mwachinsinsi.Zomwe zimalowetsazi zimagwiritsidwa ntchito powerengera kuchuluka kwa kupopera, komwe kumatanthauzidwa ngati malo opopera mphindi imodzi (m2 / min).Kuchokera pazidziwitso izi, chiŵerengero chowonera/chiyembekezero cha kupopera mbewu mankhwalawa chitha kuwerengedwanso ngati mulingo wofananira, ndi muyezo womwe ukuyembekezeka kukhala 19 m2/mphindi ± 10% pazowunikira zida zopopera [44].Pachiwerengero chowonedwa / choyembekezeredwa, kulekerera ndi 1 ± 10% (0.8-1.2).
Monga tafotokozera pamwambapa, nyumba 57 zinali ndi mapepala osefera pamakoma awo.Kuti muwone ngati kupezeka kwa mapepala osefera kunakhudza kuchuluka kwa kupopera kwa ogwira ntchito zaukhondo, mitengo yopopera m’nyumba 57yi inafananizidwa ndi mitengo yopopera m’nyumba 30 zochitiridwa mankhwala mu Marichi 2016 popanda pepala losefera.Kuchuluka kwa mankhwala ophera tizilombo kunkayezedwa m’nyumba zokhala ndi pepala losefera.
Anthu okhala m'nyumba 55 adalembedwa kuti azitsatira zofunikira zakuyeretsa m'nyumba za IRS zam'mbuyomu, kuphatikiza nyumba 30 zomwe zidapopera mu Marichi 2016 ndi nyumba 25 zomwe zidathiridwa mu Novembara 2016. 0–2 (0 = zinthu zonse kapena zambiri zimatsalira mnyumbamo; = zinthu zambiri zachotsedwa; 2 = nyumba yopanda kanthu).Zotsatira za kutsata kwa eni ake pamitengo yopopera komanso kuchuluka kwa mankhwala ophera tizilombo a moxa adawerengedwa.
Mphamvu yowerengera idawerengeredwa kuti izindikire kupatuka kwakukulu kuchokera pakuyembekezeka kwa alpha-cypermethrin yomwe imagwiritsidwa ntchito pa pepala losefera, ndikuwona kusiyana kwakukulu kwa kuchuluka kwa mankhwala ophera tizilombo ndi mitengo yopopera pakati pamagulu ophatikizidwa m'nyumba.Mphamvu zochepa zowerengera (α = 0.05) zidawerengeredwa pa chiwerengero chochepera cha nyumba zotsatiridwa pagulu lililonse lamagulu (ie, kukula kwachitsanzo chokhazikika) chotsimikizika poyambira.Mwachidule, kuyerekezera kuchuluka kwa mankhwala ophera tizilombo mu chitsanzo chimodzi pa katundu wosankhidwa 17 (otchedwa eni ake osagwirizana) anali ndi mphamvu ya 98.5% kuti azindikire kupatuka kwa 20% kuchokera ku 50 mg ai/m2, kumene kusiyana (SD = 10) kumaganiziridwa mopitilira muyeso kutengera zomwe zasindikizidwa kwina [37, 38].Kuyerekeza kuchuluka kwa mankhwala ophera tizilombo m'zitini za aerosol zosankhidwa kunyumba kuti zigwire bwino ntchito (n = 21)> 90%.
Kuyerekeza kwa zitsanzo ziwiri za mankhwala ophera tizilombo mu n = 10 ndi n = nyumba za 12 kapena kuchuluka kwa kupopera mankhwala mu n = 12 ndi n = nyumba za 23 kunapereka mphamvu zowerengera za 66.2% ndi 86.2% kuti zizindikire.Zomwe zimayembekezereka pakusiyana kwa 20% ndi 50 mg ai/m2 ndi 19 m2/min, motsatana.Mwachidziwitso, zinkaganiziridwa kuti padzakhala kusiyana kwakukulu mu gulu lirilonse la mlingo wa kupopera (SD = 3.5) ndi ndende ya mankhwala ophera tizilombo (SD = 10).Mphamvu yowerengera inali> 90% pakuyerekeza kofanana kwa mitengo yapopera pakati pa nyumba zokhala ndi pepala losefera (n = 57) ndi nyumba zopanda pepala losefera (n = 30).Kuwerengera mphamvu zonse kunachitika pogwiritsa ntchito pulogalamu ya SAMPSI mu pulogalamu ya STATA v15.0 [45]).
Zosefera zosonkhanitsidwa kuchokera mnyumbamo zidawunikiridwa ndikuyika deta ku multivariate negative binomial mix-effects model (MENBREG program mu STATA v.15.0) ndi malo a makoma mkati mwa nyumba (milingo itatu) ngati zotsatira zachisawawa.Beta radiation concentration.-cypermethrin io Ma Models adagwiritsidwa ntchito kuyesa kusintha komwe kumakhudzana ndi kutalika kwa khoma la nebulizer (miyezo itatu), kuchuluka kwa nebulization (m2 / min), tsiku lolemba IRS, ndi malo opereka chithandizo chamankhwala (magawo awiri).A generalized linear model (GLM) adagwiritsidwa ntchito kuyesa ubale pakati pa kuchuluka kwa alpha-cypermethrin pamapepala osefera omwe amaperekedwa kunyumba iliyonse komanso kuyika kwa njira yofananira mu tanki yopopera.Kuchulukitsa kwa mankhwala ophera tizilombo mu tanki yopopera nthawi yayitali kudawunikidwa mofananamo ndikuphatikiza mtengo woyambira (nthawi zero) monga njira yosinthira, kuyesa nthawi yolumikizana ya tank ID × nthawi (masiku).Mfundo za Outlier data x zimadziwika pogwiritsa ntchito lamulo la malire a Tukey, pomwe x
Kulondola kwa ai IQK ™ chemical quantification of alpha-cypermethrin concentration kunatsimikiziridwa poyerekezera miyeso ya mapepala a 27 fyuluta kuchokera ku nyumba zitatu za nkhuku zoyesedwa ndi IQK™ ndi HPLC (gold standard), ndipo zotsatira zake zinasonyeza kugwirizanitsa kwakukulu ( r = 0,93; p <0.001) (mkuyu 2).
Kulumikizana kwa kuchuluka kwa alpha-cypermethrin muzosefera zamapepala zomwe zasonkhanitsidwa kuchokera ku nyumba za nkhuku za post-IRS, zowerengedwa ndi HPLC ndi IQK ™ (n = 27 mapepala osefera ochokera ku nyumba zitatu za nkhuku)
IQK™ idayesedwa pamapepala osefera 480 otengedwa kuchokera ku nyumba za nkhuku 57.Pa pepala losefera, zomwe zili mu alpha-cypermethrin zidachokera ku 0.19 mpaka 105.0 mg ai/m2 (median 17.6, IQR: 11.06-29.78).Mwa izi, 10.4% yokha (50 / 480) inali mkati mwa chiwerengero cha 40-60 mg ai / m2 (mkuyu 3).Zambiri mwa zitsanzo (84.0% (403/480)) zinali ndi 60 mg ai/m2.Kusiyanitsa kwa chiwerengero chapakati panyumba pazitsulo zoyesera za 8-9 zomwe zimasonkhanitsidwa panyumba zinali dongosolo la kukula, ndi tanthauzo la 19.6 mg ai / m2 (IQR: 11.76-28.32, osiyanasiyana: 0. 60-67.45).Ndi 8.8% (5/57) yokha ya malo omwe adalandira kuchuluka kwa mankhwala ophera tizilombo;89.5% (51 / 57) inali pansi pa malire a chiwerengero cha zolinga, ndipo 1.8% (1/57) inali pamwamba pa malire a cholinga (mkuyu 4).
Kugawa pafupipafupi kwa kuchuluka kwa alpha-cypermethrin pa zosefera zomwe zasonkhanitsidwa kuchokera ku nyumba zothandizidwa ndi IRS (n = 57 nyumba).Mzere wowongoka umayimira chiwerengero cha cypermethrin ai (50 mg ± 20% ai / m2).
Kuphatikizika kwapakati kwa beta-cypermethrin av pamapepala osefera 8-9 kunyumba, kutengedwa kuchokera ku nyumba zokonzedwa ndi IRS (n = nyumba 57).Mzere wopingasa umayimira chiwerengero cha alpha-cypermethrin ai (50 mg ± 20% ai/m2).Mipiringidzo yolakwika imayimira malire apansi ndi apamwamba amitengo yoyandikana yapakati.
Zosefera zapakati zomwe zimaperekedwa ku zosefera zokhala ndi khoma kutalika kwa 0.2, 1.2 ndi 2.0 m zinali 17.7 mg ai/m2 (IQR: 10.70–34.26), 17.3 mg a .i./m2 (IQR: 11.43–26.91) ndi 17m2 mg .motsatira (IQR: 10.85–31.37) (ikuwonetsedwa mu Fayilo yowonjezera 2).Kuwongolera tsiku la IRS, mawonekedwe osakanikirana adawonetsa kusiyana kwakukulu pakati pa kutalika kwa khoma (z <1.83, p> 0.067) kapena kusintha kwakukulu ndi tsiku lopopera (z = 1.84 p = 0.070).Kuphatikizika kwapakati komwe kumaperekedwa ku nyumba za 5 za adobe sikunali kosiyana ndi ndende yapakatikati yomwe idaperekedwa ku nyumba 52 za adobe (z = 0.13; p = 0.89).
Kukhazikika kwa AI mu zitini 29 zokonzekera mwayekha za Guarany® aerosol zomwe zidatengedwa musanagwiritse ntchito IRS zimasiyanasiyana ndi 12.1, kuchokera pa 0.16 mg AI/mL mpaka 1.9 mg AI/mL pa chitini (Chithunzi 5).Ndi 6.9% (2/29) yokha ya zitini za aerosol zomwe zimakhala ndi AI mkati mwa mlingo womwe umafuna kuti ukhale wa 0.96-1.44 mg AI/ml, ndi 3.5% (1/29) ya zitini za aerosol zomwe zimakhala ndi AI> 1.44 mg AI/ml..
Avereji ya kuchuluka kwa alpha-cypermethrin ai idayezedwa mumitundu 29 yopopera.Mzere wopingasa umayimira ndondomeko yovomerezeka ya AI ya zitini za aerosol (0.96-1.44 mg / ml) kuti akwaniritse cholinga cha AI cha 40-60 mg / m2 m'nyumba ya nkhuku.
Mwa zitini 29 za aerosol zomwe zidayesedwa, 21 zidafanana ndi nyumba 21.Kuphatikizika kwapakati kwa ai komwe kumaperekedwa kunyumbako sikunaphatikizidwe ndi kuchuluka kwa matanki opopera omwe amagwiritsidwa ntchito pochiza nyumbayo (z = -0.94, p = 0.345), zomwe zidawonetsedwa pakulumikizana kochepa (rSp2 = -0.02) ( Chithunzi .6).).
Kulumikizana pakati pa ndende ya beta-cypermethrin AI pamapepala a fyuluta a 8-9 omwe amasonkhanitsidwa kuchokera ku nyumba zothandizidwa ndi IRS ndi kukhazikika kwa AI munjira zopopera zokonzekera kunyumba zomwe zimagwiritsidwa ntchito pochiza nyumba iliyonse (n = 21)
Kuchuluka kwa AI pazitsulo zazitsulo zinayi zomwe zimasonkhanitsidwa mwamsanga mutangogwedeza (nthawi 0) zimasiyana ndi 3.3 (0.68-2.22 mg AI / ml) (mkuyu 7).Pa thanki imodzi, mtengowo uli mkati mwa zomwe mukufuna, pa thanki imodzi, mtengo wake ndi woposa chandamale, pama tank ena awiriwo, mitengoyo ili pansi pa chandamale;Mankhwala ophera tizilombo adatsika kwambiri m'madziwe onse anayi panthawi yotsatizana ya 15-min yotsatira (b = -0.018 mpaka -0.084; z> 5.58; p <0.001).Poganizira zofunikira zoyambira za tanki, Tank ID x Nthawi (mphindi) nthawi yolumikizana sinali yofunika (z = -1.52; p = 0.127).Mu maiwe anayi, pafupifupi imfa ya mg ai/ml mankhwala ophera tizilombo anali 3.3% pa mphindi (95% CL 5.25, 1.71), kufika 49.0% (95% CL 25.69, 78.68) pambuyo 15 mphindi (mkuyu 7).
Pambuyo posakaniza bwino mayankho mu akasinja, mlingo wa mpweya wa alpha-cypermethrin ai unayesedwa.m'matangi anayi opopera mphindi imodzi kwa mphindi 15.Mzere woyimira bwino kwambiri ku data ukuwonetsedwa pankhokwe iliyonse.Kuwona (mfundo) kumayimira apakatikati a zigawo zitatu.
Malo apakati pa khoma panyumba iliyonse yothandizira mankhwala a IRS anali 128 m2 (IQR: 99.0-210.0, range: 49.1-480.0) ndipo nthawi yochuluka yogwiritsidwa ntchito ndi ogwira ntchito zachipatala inali maminiti a 12 (IQR: 8. 2-17.5, osiyanasiyana: 1.5) -36.6).) nyumba iliyonse inapoperapo mankhwala (n = 87).Kuphimba utsi kunkachitika m'nyumba za nkhuku izi kuyambira 3.0 mpaka 72.7 m2 / min (wapakatikati: 11.1; IQR: 7.90-18.00) (Chithunzi 8).Zogulitsa kunja sizinaphatikizidwe ndipo mitengo yopopera idayerekezedwa ndi kuchuluka kwa kutsitsi kwa WHO kwa 19 m2 / min ± 10% (17.1-20.9 m2 / min).Ndi 7.5% yokha (6/80) ya nyumba zomwe zinali motere;77.5% (62/80) anali otsika ndipo 15.0% (12/80) anali apamwamba.Palibe ubale womwe udapezeka pakati pa kuchuluka kwa AI komwe kumaperekedwa kunyumba ndikuwona kufalikira kwa kupopera (z = -1.59, p = 0.111, n = 52 nyumba).
Kuwona kuchuluka kwa kupopera (min/m2) m'nyumba za nkhuku zothandizidwa ndi IRS (n = 87).Mzere wolozera umayimira kulekerera kwa kulekerera kwa 19 m2 / min (± 10%) komwe kumatsimikiziridwa ndi zida za tanki yopopera.
80% ya nyumba 80 zinali ndi chiwongolero chowoneka / choyembekezeka chopopera kunja kwa 1 ± 10% kulolerana, ndi 71.3% (57/80) ya nyumba zotsika, 11.3% (9/80) kukhala zapamwamba, ndipo nyumba 16 zidagwera mkati. kulolerana pakati pa osiyanasiyana.Kugawidwa kwafupipafupi kwa ziwerengero zowonedwa/zoyembekezeredwa kumawonetsedwa mu Fayilo Yowonjezera 3.
Panali kusiyana kwakukulu pakati pa chiwerengero cha nebulization pakati pa ogwira ntchito zachipatala omwe amagwira ntchito nthawi zonse IRS: 9.7 m2 / min (IQR: 6.58-14.85, n = 68) motsutsana ndi 15.5 m2 / min (IQR: 13.07-21.17, n = 12) ).(z = 2.45, p = 0.014, n = 80) (monga momwe zasonyezedwera mu Fayilo Yowonjezera 4A) ndi chiŵerengero chowonedwa/choyembekezeredwa cha kupopera (z = 2.58, p = 0.010) (monga momwe zasonyezedwera mu Fayilo Yowonjezera 4B Onetsani) .
Kupatula kudwala, wogwira ntchito zachipatala m'modzi yekha adapopera nyumba 54 pomwe adayika pepala losefera.Kupopera kwapakati panyumba m'nyumbazi kunali 9.23 m2 / min (IQR: 6.57-13.80) poyerekeza ndi 15.4 m2 / min (IQR: 10.40-18.67) m'nyumba za 26 zopanda mapepala a fyuluta (z = -2.38, p = 0.017).).
Kutsatira kwapakhomo ndi lamulo loti asamuke m'nyumba zawo kaamba ka kutumiza kwa IRS kunali kosiyanasiyana: 30.9% (17/55) sanachoke m'nyumba zawo pang'ono ndipo 27.3% (15/55) sanachokere m'nyumba zawo;anawononga nyumba zawo.
Mapiritsi omwe amawonedwa m'nyumba zopanda kanthu (17.5 m2/mphindi, IQR: 11.00–22.50) nthawi zambiri anali apamwamba kuposa nyumba zopanda kanthu (14.8 m2/min, IQR: 10.29–18 .00) ndi nyumba zopanda kanthu (11.7 m2) )./ min, IQR: 7.86-15.36), koma kusiyana sikunali kofunika (z> -1.58; p> 0.114, n = 48) (kusonyezedwa mu Fayilo yowonjezera 5A).Zotsatira zofananazo zinapezedwa poganizira kusintha komwe kumakhudzana ndi kukhalapo kapena kusowa kwa pepala la fyuluta, zomwe sizinapezeke kuti ndizofunika kwambiri pa chitsanzo.
Pamagulu atatuwa, nthawi yokwanira yopopera nyumba siinali yosiyana pakati pa nyumba (z <-1.90, p> 0.057), pamene malo apakati anali osiyana: nyumba zopanda kanthu (104 m2 [IQR: 60.0-169, 0] m2) ]) ndizocheperako poyerekeza ndi nyumba zopanda kanthu (224 m2 [IQR: 174.0–284.0 m2]) ndi nyumba zopanda kanthu (132 m2 [IQR: 108.0–384.0 m2]) (z > 2 .17; p < 0.031, n = 48).Nyumba zopanda anthu zili pafupifupi theka la kukula (malo) a nyumba zomwe zilibe anthu kapena mulibemo.
Panyumba zochepa (n = 25) zokhala ndi data yotsatiridwa ndi mankhwala a AI, panalibe kusiyana pakati pa kuchuluka kwa AI komwe kumaperekedwa m'nyumba pakati pa magulu omvera awa (z <0.93, p > 0.351) , monga zafotokozedwera mu Fayilo Yowonjezera. 5B .Zotsatira zofananira zidapezedwa poyang'anira kupezeka / kusapezeka kwa pepala losefera ndikuwona kufalikira kwa kupopera (n = 22).
Kafukufukuyu akuwunika machitidwe ndi machitidwe a IRS mdera lakumidzi la Gran Chaco ku Bolivia, dera lomwe lili ndi mbiri yakale yopatsirana ma vector [20].Kuchuluka kwa alpha-cypermethrin ai yoperekedwa pa nthawi ya IRS kunkasiyana kwambiri pakati pa nyumba, pakati pa zosefera payekha m'nyumba, komanso pakati pa akasinja opopera omwe amakonzedwa kuti akwaniritse 50 mg ai/m2.8.8% yokha ya nyumba (10.4% ya zosefera) inali ndi ndende mkati mwa 40-60 mg ai/m2, ndipo ambiri (89.5% ndi 84% motsatana) anali ndi milingo pansi pa malire ovomerezeka otsika.
Chimodzi mwazinthu zomwe zingapangitse kuti alpha-cypermethrin atumizidwe m'nyumba ndikuchepetsa kolakwika kwa mankhwala ophera tizilombo komanso kuyimitsidwa kosagwirizana komwe kumakonzedwa m'matangi opopera [38, 46].Pakafukufuku wamakono, zomwe ochita kafukufuku awona za ogwira ntchito zachipatala adatsimikizira kuti amatsatira maphikidwe okonzekera mankhwala ophera tizilombo ndipo adaphunzitsidwa ndi SEDES kuti ayambe kusonkhezera mwamphamvu yankho pambuyo pa dilution mu thanki yopopera.Komabe, kusanthula kwazomwe zili m'madzimo kunawonetsa kuti kuchuluka kwa AI kumasiyana ndi 12, ndi 6.9% (2/29) yokha ya mayankho osungira omwe ali mkati mwazomwe mukufuna;Kuti mudziwe zambiri, mayankho omwe ali pamwamba pa thanki ya sprayer adawerengedwa mu labotale.Izi zikuwonetsa kuchepa kwa mzere wa alpha-cypermethrin ai wa 3.3% pamphindi mutatha kusakaniza ndi kutayika kwa ai kwa 49% pambuyo pa mphindi 15 (95% CL 25.7, 78.7).Kuchuluka kwa sedimentation chifukwa cha kuphatikizika kwa kuyimitsidwa kwa mankhwala ophera tizilombo komwe kumapangidwa pakusungunuka kwa ufa wonyezimira (WP) si zachilendo (mwachitsanzo, DDT [37, 47]), ndipo kafukufuku wapano akuwonetsanso izi za SA pyrethroid formulations.Kuyimitsidwa kumayang'ana kumagwiritsidwa ntchito kwambiri mu IRS ndipo, monga mankhwala onse ophera tizilombo, kukhazikika kwawo kwathupi kumatengera zinthu zambiri, makamaka kukula kwa tinthu tating'onoting'ono ndi zosakaniza zina.Sedimentation ingakhudzidwenso ndi kuuma kwathunthu kwa madzi omwe amagwiritsidwa ntchito pokonzekera slurry, chinthu chomwe chimakhala chovuta kulamulira m'munda.Mwachitsanzo, pa malo ofufuzawa, madzi amangopezeka ku mitsinje yapafupi yomwe imawonetsa kusintha kwa nyengo ndi dothi loyimitsidwa.Njira zowunikira kukhazikika kwa nyimbo za SA zikufufuzidwa [48].Komabe, mankhwala a subcutaneous akhala akugwiritsidwa ntchito bwino pofuna kuchepetsa matenda a m'banja ku Tri.tizilombo toyambitsa matenda m'madera ena a Latin America [49].
Kusakwanira kwa mankhwala ophera tizilombo kwanenedwanso m'mapulogalamu ena owongolera ma vector.Mwachitsanzo, mu pulogalamu ya visceral leishmaniasis control ku India, 29% yokha yamagulu opopera 51 adayang'anira njira zokonzekera bwino komanso zosakanizika za DDT, ndipo palibe omwe adadzaza matanki opopera monga momwe adalimbikitsira [50].Kuwunika kwa midzi ya ku Bangladesh kunawonetsa momwemonso: 42-43% yokha ya magulu a IRS adakonza mankhwala ophera tizilombo ndikudzaza zitini malinga ndi ndondomeko, pamene m'chigawo chimodzi chiwerengerocho chinali 7.7% [46].
Zosintha zomwe zawonedwa pakuchulukira kwa AI zomwe zimaperekedwa mnyumba nakonso sizosiyana.Ku India, 7.3% yokha (41 ya 560) ya nyumba zothandizidwa ndi zomwe zidalandira DDT, kusiyana pakati pa nyumba ndi pakati panyumba kumakhala kofanana [37].Ku Nepal, pepala losefera limatenga pafupifupi 1.74 mg ai/m2 (range: 0.0-17.5 mg/m2), yomwe ndi 7% yokha yazomwe zimapangidwira (25 mg ai/m2) [38].Kusanthula kwa HPLC kwa pepala la fyuluta kunasonyeza kusiyana kwakukulu mu deltamethrin ai yokhazikika pamakoma a nyumba ku Chaco, Paraguay: kuchokera ku 12.8-51.2 mg ai / m2 mpaka 4.6-61.0 mg ai / m2 padenga [33].Ku Tupiza, Bolivia, Chagas Control Programme inanena za kutumiza kwa deltamethrin m'nyumba zisanu pamagulu a 0.0-59.6 mg / m2, owerengedwa ndi HPLC [36].
Nthawi yotumiza: Apr-16-2024