Gushyiramoimiti yica udukokoInzitiramubu zo mu madirishya (ITNs) ku mfuruka zifunguye, amadirishya, n'inkuta mu ngo zidafite ingufu ni ingamba zishobora gufatwa mu kurwanya malariya.kwirinda imibukwinjira mu ngo, bigatera ingaruka mbi kandi zica ku batera malariya kandi bishobora kugabanya ikwirakwira rya malariya. Kubwibyo, twakoze ubushakashatsi ku ndwara mu ngo zo muri Tanzaniya kugira ngo dusuzume akamaro k'insinga ziterwa umuti wica udukoko (ITNs) mu kurinda indwara za malariya n'izitera indwara mu nzu.
Mu Karere ka Charinze, muri Tanzaniya, ingo 421 zashyizwe mu matsinda abiri ku buryo butunguranye. Kuva muri Kamena kugeza muri Nyakanga 2021, inzitiramubu zirimo deltamethrin na synergist zashyizwe ku mfuruka, mu madirishya no ku nkuta mu itsinda rimwe, mu gihe irindi tsinda ritabikoze. Nyuma yo gushyirwaho, mu mpera z'igihe kirekire cy'imvura (Kamena/Nyakanga 2022, umusaruro w'ibanze) no mu gihe gito cy'imvura (Mutarama/Gashyantare 2022, umusaruro w'inyongera), abagize urugo bose bitabiriye (bafite imyaka ≥amezi 6) bapimwe indwara ya malariya mu buryo bungana. Ibisubizo bya kabiri byagaragaye harimo umubare w'imibu yose kuri buri mutego mu ijoro (Kamena/Nyakanga 2022), ingaruka mbi nyuma y'ukwezi kumwe mu gihe cyo gushyirwaho inzitiramubu (Kanama 2021), no kuba hari imiti ikoreshwa mu gupima no gusiga inzitiramubu umwaka umwe nyuma yo gukoreshwa inzitiramubu (Kamena/Nyakanga 2022). Mu mpera z'igerageza, itsinda ryagenzuye ryahawe inzitiramubu.
Ubushakashatsi ntibwashoboye gufata umwanzuro bitewe n’uko ingero zitari zihagije bitewe n’uko bamwe mu baturage banze kwitabira. Hakenewe igerageza rinini ryagenzuwe mu buryo butaziguye, byaba byiza rikubiyemo gushyiraho ecran zo mu madirishya zavuwe n’umuti wica udukoko umara igihe kirekire, kugira ngo harebwe ubu buryo.
Amakuru y’ikwirakwizwa rya malariya yasesenguwe hakoreshejwe uburyo bwa buri gahunda, bivuze ko abantu bari bagiye mu rugendo mu byumweru bibiri mbere y’ubushakashatsi cyangwa bafashe imiti igabanya malariya bakuwe mu isesengura.
Kubera ko umubare w'imibu yafashwe mu gihe cy'isuzuma wari muto, ni bwo buryo bwo kugabanya umubare w'imibu yafashwe buri joro hakoreshejwe buri mutego bwakoreshejwe kugira ngo hamenyekane umubare w'imibu iri mu cyumba.
Mu ngo 450 zujuje ibisabwa zatoranijwe mu midugudu yose icyenda, icyenda ntizakuwemo kuko zitari zifite ibisenge cyangwa amadirishya bifunguye mbere y’uko bikorwa mu buryo butunguranye. Muri Gicurasi 2021, ingo 441 zakoreweho ibikorwa byoroshye byo mu buryo butunguranye hakurikijwe umudugudu: ingo 221 zashyizwe mu itsinda ry’ibikoresho by’ubuhumekero by’ubwenge (IVS), naho izindi 220 zigashyirwa mu itsinda ry’abagenzuzi. Amaherezo, ingo 208 mu zatoranijwe zarangije gushyiraho IVS, mu gihe 195 zagumye mu itsinda ry’abagenzuzi (Ishusho ya 3).
Ubushakashatsi bumwe na bumwe bwerekana ko ITS ishobora kuba ingirakamaro mu kurinda malariya mu bantu b’ingeri zimwe na zimwe, amazu yo guturamo, cyangwa iyo ikoreshejwe n’inzitiramibu. Byavuzwe ko kubona ibikoresho byo kurwanya malariya, cyane cyane inzitiramibu, ari bike, cyane cyane mu bana bari mu kigero cyo kujya mu ishuri.[46] Kuboneka guke kw’inzitiramibu mu ngo bituma ikoreshwa rike mu ngo, kandi abana bari mu kigero cyo kujya mu ishuri bakunze kwirengagizwa, bityo bikaba intandaro yo kwandura malariya igihe kirekire.[16, 47, 48] Tanzaniya irimo gushyira mu bikorwa gahunda zikomeje zo gukwirakwiza, harimo na gahunda yo gutanga inzitiramibu ku ishuri, kugira ngo bongere uburyo bwo kubona inzitiramibu ku bana bari mu kigero cyo kujya mu ishuri.[14, 49] Bitewe n’urwego ruto rwo kubona inzitiramibu (50%) mu gihe cy’ubushakashatsi n’uko iri tsinda rishobora guhura n’ingorane nyinshi zo kubona inzitiramibu, ITS ishobora kuba yarahaye iri tsinda uburinzi, bityo iziba icyuho cyo kwirinda ikoreshwa ry’inzitiramibu. Inyubako z’amazu zahoze zifitanye isano n’ubwiyongere bw’ubwandu bwa malariya; urugero, imiterere y’inkuta z’ibyondo n’imyobo mu bisenge bisanzwe byorohereza imibu kwinjira.[8] Ariko, nta bimenyetso bishyigikira iki gitekerezo; Isesengura ry’amatsinda y’ubushakashatsi hakurikijwe ubwoko bw’urukuta, ubwoko bw’igisenge, n’ikoreshwa rya mbere rya ITNs ryagaragaje ko nta tandukaniro riri hagati y’itsinda ry’abagenzura n’itsinda ry’abashinzwe isuku.
Nubwo ingo zikoresha uburyo bwo kurwanya imibu yo mu nzu (ITS) zari zifite imibu mike ya Anopheles yafashwe kuri buri mutego mu ijoro, itandukaniro ryari rito ugereranije n'ingo zidafite ITS. Igipimo gito cyo gufata mu ngo zikoresha ITS gishobora guterwa n'ubushobozi bwayo mu kurwanya ubwoko bw'imibu bw'ingenzi burya kandi bukara mu nzu (urugero, Anopheles gambiae [50]) ariko gishobora kuba kidakora neza mu kurwanya ubwoko bw'imibu bushobora kuba bukorera hanze (urugero, Anopheles africanus). Byongeye kandi, ITS ziriho ubu zishobora kuba zidafite pyrethroids na PBO nziza kandi iringaniye, bityo, zishobora kuba zidafite akamaro gahagije mu kurwanya Anopheles gambiae zirwanya pyrethroid, nk'uko bigaragara mu bushakashatsi bwakozwe mu gice cy'umurima [Odufuwa, buzaza]. Ibi bishobora kandi guterwa n'imbaraga nke z'ibarurishamibare. Kugira ngo hamenyekane itandukaniro rya 10% hagati y'itsinda rya ITS n'itsinda rishinzwe kurwanya rifite imbaraga 80% z'ibarurishamibare, ingo 500 zarakenewe kuri buri tsinda. Ikindi kandi, ubushakashatsi bwahuye n’ikirere kidasanzwe muri Tanzaniya muri uwo mwaka, aho ubushyuhe bwiyongeye kandi imvura igabanuka [51], byashoboraga kugira ingaruka mbi ku mibu ya Anopheles [52] no kurokoka kwayo [52] kandi byashoboraga gutuma umubare w’imibu muri rusange ugabanuka mu gihe cy’ubushakashatsi. Mu buryo bunyuranye, nta tandukaniro rinini ryagaragaye mu bucucike bwa Culex pipiens buri munsi mu mazu afite ITS ugereranije n’amazu adafite. Nkuko byavuzwe mbere [Odufuwa, igiye kuza], iki kibazo gishobora guterwa n’ikoranabuhanga ryihariye ryo kongeramo pyrethroids na PBO muri ITS, ibyo bikaba bigabanya ingaruka zabyo ku mibu ya Culex pipiens. Byongeye kandi, bitandukanye n’imibu ya Anopheles, Culex pipiens ishobora kwinjira mu nyubako inyuze mu nzu, nk’uko byagaragajwe mu bushakashatsi bwakozwe muri Kenya [24] n’ubushakashatsi bwakozwe n’udukoko muri Tanzaniya [53]. Gushyiraho inzugi zishobora kuba zidakora kandi bizongera ibyago byo kwangirika kw’imiti yica udukoko. Imibu ya Anopheles yinjirira cyane cyane mu ruziga [54], kandi ibikorwa binini bishobora kugira ingaruka zikomeye ku bucucike bw'imibu, nk'uko bigaragazwa n'icyitegererezo gishingiye ku makuru ya SFS [Odufuwa, igiye kuza].
Ingaruka mbi zavuzwe n'abatekinisiye n'abitabiriye zahuye n'ingaruka zizwi zo kwandura pyrethroid [55]. Ikigaragara ni uko ingaruka mbi nyinshi zavuzwe zakemutse mu masaha 72 nyuma yo kwandura, kuko umubare muto cyane (6%) w'abagize umuryango ari bo bitabiriye ubuvuzi, kandi abitabiriye bose bahawe ubuvuzi ku buntu. Umubare munini w'abatekinisiye 13 (65%) wagaragaye ko bananiwe gukoresha udupfukamunwa twatanzwe, bavuga ko hari ikibazo gikomeye ndetse n'isano rishobora kuba riterwa na COVID-19. Ubushakashatsi bw'ejo hazaza bushobora gusuzuma itegeko ryo kwambara udupfukamunwa.
Mu Karere ka Charinze, nta tandukaniro rigaragara ryagaragaye mu mubare w’abandura malariya cyangwa mu mibu yo mu nzu hagati y’ingo zifite n’izidafite imiti yica udukoko. Ibi bishobora kuba biterwa n’igishushanyo mbonera cy’ubushakashatsi, imiterere y’imiti yica udukoko n’ibisigazwa byayo, ndetse n’ubwiyongere bw’abitabira. Nubwo nta tandukaniro rigaragara ryagaragaye, igabanuka ry’udukoko two mu ngo ryagaragaye mu gihe cy’imvura ndende, cyane cyane mu bana bari mu kigero cy’ishuri. Umubare w’imibu ya Anopheles yo mu nzu nawo waragabanutse, bigaragaza ko hakenewe ubushakashatsi bwimbitse. Kubwibyo, kugira ngo hakomeze kwitabira, hasabwa igishushanyo mbonera gikozwe mu buryo bw’umwihariko, hamwe n’ubufatanye n’abaturage n’ubuvugizi.
Igihe cyo kohereza: Ugushyingo-21-2025