Maukonde okhala ndi pyrethroid clofenpyr (CFP) ndi pyrethroid piperonyl butoxide (PBO) akulimbikitsidwa m'mayiko omwe ali ndi matendawa kuti athe kuwongolera malungo omwe amafalitsidwa ndi udzudzu wosamva pyrethroid.CFP ndi proinsecticide yomwe imafuna kutsegulidwa ndi udzudzu cytochrome P450 monooxygenase (P450), ndipo PBO imapangitsa mphamvu ya pyrethroids poletsa zochita za ma enzyme mu udzudzu wosamva pyrethroid.Motero, P450 inhibition ndi PBO ingachepetse mphamvu ya maukonde a pyrethroid-CFP akagwiritsidwa ntchito m'nyumba imodzi monga maukonde a pyrethroid-PBO.
Mayesero awiri oyesera a cockpit adachitidwa kuti ayese mitundu iwiri yosiyana ya pyrethroid-CFP ITN (Interceptor® G2, PermaNet® Dual) yokha komanso kuphatikiza pyrethroid-PBO ITN (DuraNet® Plus, PermaNet® 3.0).Zotsatira za Entomological pakugwiritsa ntchito Pyrethroid resistance Vector populations kumwera kwa Benin.M'maphunziro onsewa, mitundu yonse ya ma mesh idayesedwa pamankhwala amodzi komanso awiri.Ma bioassays adachitidwanso kuti awone kukana kwa mankhwala kwa anthu omwe ali m'khumbi komanso kuphunzira kuyanjana pakati pa CFP ndi PBO.
Chiwerengero cha ma vector chinali tcheru ndi CFP koma chimawonetsa kukana kwambiri kwa pyrethroids, koma kukana kumeneku kunagonjetsedwera kuwonetseredwa kwa PBO.Kufa kwa ma vector kunachepetsedwa kwambiri m'misasa pogwiritsa ntchito maukonde a pyrethroid-CFP ndi maukonde a pyrethroid-PBO poyerekeza ndi zinyumba zogwiritsira ntchito maukonde awiri a pyrethroid-CFP (74% ya Interceptor® G2 vs. 85%, PermaNet® Dual 57% vs. 83% ), p <0.001).Kuwonekeratu ku PBO kunachepetsa kawopsedwe ka CFP m'mabotolo a bioassays, kutanthauza kuti izi zitha kukhala chifukwa cha kusagwirizana pakati pa CFP ndi PBO.Kufa kwa ma vector kunali kokulirapo m'nyumba zogwiritsa ntchito maukonde ophatikizika okhala ndi pyrethroid-CFP maukonde poyerekeza ndi nyumba zopanda maukonde a pyrethroid-CFP, komanso pamene maukonde a pyrethroid-CFP ankagwiritsidwa ntchito okha ngati maukonde awiri.Akagwiritsidwa ntchito limodzi, amafa kwambiri (83-85%).
Kafukufukuyu adawonetsa kuti mphamvu ya ma meshes a pyrethroid-CFP idachepetsedwa ikagwiritsidwa ntchito limodzi ndi pyrethroid-PBO ITN poyerekeza ndi kugwiritsa ntchito yokha, pomwe mphamvu ya ma mesh okhala ndi ma meshes a pyrethroid-CFP anali apamwamba.Zotsatirazi zikusonyeza kuti kuika patsogolo kugawidwa kwa ma netiweki a pyrethroid-CFP pamitundu ina ya maukonde kudzakulitsa zotsatira zowongolera vekitala muzochitika zofanana.
Masikito ophera tizilombo (ITNs) okhala ndi mankhwala ophera tizilombo a pyrethroid akhala njira yayikulu yothanirana ndi malungo pazaka makumi awiri zapitazi.Kuchokera mchaka cha 2004, pafupifupi maukonde opaka mankhwala ophera tizilombo okwana 2.5 biliyoni aperekedwa ku sub-Saharan Africa [1], zomwe zachititsa kuti chiwerengero cha anthu ogona pansi pa maukonde ophera tizilombo chiwonjezeke kuchoka pa 4% kufika pa 47% [2].Zotsatira za kukhazikitsidwa kumeneku zinali zazikulu.Zikuoneka kuti pafupifupi 2 biliyoni matenda a malungo ndi imfa 6.2 miliyoni analephereka padziko lonse pakati pa 2000 ndi 2021, ndi kusanthula chitsanzo kusonyeza kuti maukonde ophera tizilombo anali dalaivala chachikulu cha phindu limeneli [2, 3].Komabe, kupita patsogolo kumeneku kumabwera pamtengo wake: kuwonjezereka kwa kusinthika kwa pyrethroid resistance mu kuchuluka kwa malungo.Ngakhale maukonde ophera tizilombo a pyrethroid atha kuperekabe chitetezo ku malungo m'malo omwe ma vectors amawonetsa kukana kwa pyrethroid [4], kafukufuku wofananira amaneneratu kuti pamlingo wapamwamba kwambiri wa kukana, maukonde okhala ndi mankhwala ophera tizilombo adzachepetsa kufalikira kwa matenda [5]..Chifukwa chake, kukana kwa pyrethroid ndi chimodzi mwazowopsa kwambiri pakupititsa patsogolo kuwongolera malungo.
M’zaka zingapo zapitazi, mbadwo watsopano wa maukonde okhala ndi mankhwala ophera tizilombo, omwe amaphatikiza pyrethroids ndi mankhwala achiwiri, apangidwa kuti athandizire kuwongolera malungo ofalitsidwa ndi udzudzu wosamva pyrethroid.Kalasi yoyamba yatsopano ya ITN ili ndi synergist piperonyl butoxide (PBO), yomwe imapangitsa pyrethroids mwa kusokoneza ma enzyme ochotsa poizoni okhudzana ndi pyrethroid resistance, makamaka mphamvu ya cytochrome P450 monooxygenases (P450s) [6].Mabedi opangidwa ndi fluprone (CFP), mankhwala ophera tizirombo a azole okhala ndi njira yatsopano yolumikizira kupuma kwa ma cell, apezekanso posachedwa.Kutsatira kuwonetseratu kwabwino kwa entomological m'mayesero oyendetsa nyumba [7, 8], mndandanda wa mayesero oyendetsedwa mosasinthika (cRCT) adachitidwa kuti awunikire phindu la thanzi la maukondewa poyerekeza ndi maukonde ophera tizilombo pogwiritsa ntchito pyrethroids okha ndikupereka umboni wofunikira kuti udziwitse malingaliro azamalamulo ochokera ku World Health Organisation (WHO) [9].Kutengera umboni wa kuwongolera kwa miliri yochokera ku CRCTs ku Uganda [11] ndi Tanzania [12], WHO idavomereza maukonde ophera tizilombo a pyrethroid-PBO [10].The pyrethroid-CFP ITN inasindikizidwanso posachedwa pambuyo pa RCTs zofanana ku Benin [13] ndi Tanzania [14] anasonyeza kuti prototype ITN (Interceptor® G2) inachepetsa chiwerengero cha malungo a ana ndi 46% ndi 44%, motsatira.10].].
Kutsatira kuyesayesa kwatsopano kwa Global Fund ndi mabungwe ena akuluakulu a malungo kuti athane ndi kukana mankhwala ophera tizilombo mwa kufulumizitsa kukhazikitsa makoka atsopano [15], pyrethroid-PBO ndi pyrethroid-CFP mabedi akugwiritsidwa kale ntchito m'madera omwe akudwala.M'malo mankhwala ophera tizirombo.maukonde ogwiritsidwa ntchito omwe amagwiritsa ntchito pyrethroids okha.Pakati pa 2019 ndi 2022, kuchuluka kwa ma neti a udzudzu a PBO pyrethroid omwe amaperekedwa ku sub-Saharan Africa adakwera kuchokera pa 8% mpaka 51% [1], pomwe ma neti a udzudzu a PBO pyrethroid, kuphatikiza CFP pyrethroid nets, "maukonde apawiri" amayembekezeredwa udzudzu. ndi 56% ya katundu wotumizidwa.Lowani mumsika waku Africa pofika 2025[16].Monga umboni wa mphamvu ya maukonde a pyrethroid-PBO ndi pyrethroid-CFP akupitiriza kukula, maukondewa akuyembekezeka kupezeka kwambiri m'zaka zikubwerazi.Chifukwa chake, pakufunika kutero kudzaza mipata yokhudzana ndi kugwiritsa ntchito bwino maukonde okhala ndi mankhwala ophera tizirombo a m'badwo watsopano kuti akwaniritse zotsatira zake akadzakulitsidwa kuti agwiritse ntchito mokwanira.
Poganizira kuchuluka kwa ma neti a udzudzu a pyrethroid CFP ndi pyrethroid PBO, National Malaria Control Programme (NMCP) ili ndi funso limodzi lofufuza: Kodi mphamvu yake idzachepetsedwa - PBO ITN?Chifukwa cha nkhawayi ndikuti PBO imachita poletsa ma enzymes a udzudzu P450 [6], pomwe CFP ndi mankhwala ophera tizilombo omwe amafunikira kuyambitsa kudzera pa P450s [17].Choncho, akuganiza kuti pamene pyrethroid-CFP ITN ndi pyrethroid-CFP ITN amagwiritsidwa ntchito m'nyumba imodzi, kulepheretsa kwa PBO pa P450 kungachepetse mphamvu ya pyrethroid-CFP ITN.Kafukufuku wambiri wa labotale awonetsa kuti kuwonetseredwa kusanachitike kwa PBO kumachepetsa kawopsedwe kake ka CFP kwa ma vectors a udzudzu powonetsa mwachindunji ma bioassays [18,19,20,21,22].Komabe, pochita maphunziro pakati pa maukonde osiyanasiyana m'munda, kuyanjana pakati pa mankhwalawa kudzakhala kovuta kwambiri.Maphunziro omwe sanasindikizidwe adawunikira zotsatira zogwiritsa ntchito mitundu yosiyanasiyana ya maukonde ophera tizilombo pamodzi.Choncho, maphunziro a m'munda omwe amawunika momwe angagwiritsire ntchito maukonde ophera tizilombo a pyrethroid-CFP ndi pyrethroid-PBO m'banja lomwelo zidzathandiza kudziwa ngati kusagwirizana pakati pa mitundu iyi ya maukonde kumabweretsa vuto la ntchito ndikuthandizira kudziwa njira yabwino yogwiritsira ntchito. .kwa zigawo zake zogawidwa mofanana.
Nthawi yotumiza: Sep-21-2023