Kugabanuka vuba kwumutwaro wa malariya muri Côte d'Ivoire ahanini biterwa no gukoresha inshundura zica udukoko twangiza (LIN).Nyamara, iri terambere ryugarijwe no kurwanya udukoko twica udukoko, impinduka zimyitwarire mu baturage ba Anopheles gambiae, no kwandura malariya isigaye, bisaba ko hakenerwa ibindi bikoresho.Kubwibyo, intego yubu bushakashatsi kwari ugusuzuma akamaro ko gukoresha LLIN na Bacillus thuringiensis (Bti) no kuyigereranya na LLIN.
Ubushakashatsi bwakozwe kuva muri Werurwe 2019 kugeza Gashyantare 2020 hakoreshejwe intwaro ebyiri zo kwiga (LLIN + Bti ukuboko na LLIN gusa) mu karere k'ubuzima ka Korhogo mu majyaruguru ya Côte d'Ivoire.Mu itsinda rya LLIN + Bti, Anopheles larval ituye yavuwe hamwe na Bti buri byumweru bibiri hiyongereyeho LLIN.Inzitiramubu nini kandi zikuze zarakusanyirijwe hamwe zerekana imiterere yubwoko nubwoko hakoreshejwe uburyo busanzwe.Umunyamuryango Ann.Uruganda rwa Gambiya rwiyemeje gukoresha tekinoroji ya polymerase.Kwandura na Plasmodium An.Harasuzumwe kandi indwara ya malariya muri Gambiya ndetse n'abaturage baho.
Muri rusange, Anopheles spp.Ubucucike bunini bwari hasi mu itsinda rya LLIN + Bti ugereranije na LLIN yonyine itsinda 0.61 [95% CI 0.41–0.81] livre / dive (l / dive) 3.97 6.50; 95% CI 5.81–7.29 P <0.001).Muri rusange umuvuduko wa An.Indwara ya S. gambiae yarwaye yari 0.59 [95% CI 0.43–0,75] kuri buri muntu / nijoro mu itsinda rya LLIN + Bti ryonyine, ugereranije na 2.97 [95% CI 2.02–3.93] kuruma kumuntu / nijoro mumatsinda ya LLIN gusa (P <0.001).Anopheles gambiae sl izwi cyane cyane nkumubu wa Anopheles.Anopheles gambiae (ss) (95.1%; n = 293), ikurikirwa na Anopheles gambiae (4.9%; n = 15).Umubare w'amaraso y'umuntu mu bushakashatsi wari 80.5% (n = 389).EIR yo mu itsinda rya LLIN + Bti yari 1.36 yanduye ku muntu ku mwaka (ib / p / y), mu gihe EIR yo mu itsinda rya LLIN gusa yari 47,71 ib / p / y.Indwara ya malariya yagabanutse cyane kuva kuri 291.8 ‰ (n = 765) igera kuri 111.4 ‰ (n = 292) mu itsinda rya LLIN + Bti (P <0.001).
Guhuza LLIN na Bti byagabanije cyane indwara ya malariya.Ihuriro rya LLIN na Bti rishobora kuba uburyo butanga uburyo bwo kugenzura neza An.Gambiya nta malariya ifite.
Nubwo hari iterambere mu kurwanya malariya mu myaka mike ishize, umutwaro wa malariya uracyari ikibazo gikomeye muri Afurika yo munsi y'Ubutayu bwa Sahara [1].Ishami ry'Umuryango w'Abibumbye ryita ku Buzima (OMS) riherutse gutangaza ko mu mwaka wa 2023 hari miliyoni 249 zanduye malariya kandi abagera kuri 608.000 bapfa bazize malariya mu 2023 [2].OMS yo mu karere ka Afurika ifite 95% by'abanduye malariya ku isi na 96% by'abahitanwa na malariya, aho abagore batwite ndetse n'abana bari munsi y’imyaka 5 yibasiwe cyane [2, 3].
Urushundura rurerure rwica udukoko (LLIN) hamwe no gutera ibiti bisigaye mu ngo (IRS) byagize uruhare runini mu kugabanya umutwaro wa malariya muri Afurika [4].Kwiyongera kw'ibi bikoresho byo kurwanya malariya byatumye umubare wa malariya ugabanuka 37% ndetse n'impfu zigabanuka 60% hagati ya 2000 na 2015 [5].Icyakora, impinduka zagaragaye kuva mu mwaka wa 2015 zarahagaze biteye ubwoba cyangwa zihuta, aho impfu za malariya zikomeje kuba nyinshi mu buryo butemewe, cyane cyane muri Afurika yo munsi y'Ubutayu bwa Sahara [3].Ubushakashatsi bwinshi bwerekanye ko hagaragaye no gukwirakwira mu kurwanya indwara ya malariya ikomeye ya Anopheles yica udukoko dukoreshwa mu buzima rusange nk’inzitizi y’ejo hazaza ha LLIN na IRS [6,7,8].Byongeye kandi, impinduka mu myitwarire yo kuruma ya vector hanze na kare nijoro zishinzwe kwanduza malariya zisigaye kandi ni impungenge zikomeje kwiyongera [9, 10].Imipaka ya LLIN na IRS mu kugenzura ibice bishinzwe kwanduza ibisigisigi ni imbogamizi ikomeye mu bikorwa byo kurandura malariya muri iki gihe.Byongeye kandi, gukomeza kurwara malariya bisobanurwa n’imiterere y’ikirere n’ibikorwa by’abantu, bigira uruhare mu kurema ahantu nyaburanga [12].
Imicungire y’isoko nini (LSM) ni uburyo bw’ubworozi bushingiye ku bworozi bw’imiti bugamije kugabanya umubare w’ubworozi ndetse n’umubare w’inzitiramubu na pusi zirimo muri zo [13].LSM yasabwe nubushakashatsi bwinshi nkingamba zinyongera zo kurwanya malariya [14, 15].Mubyukuri, imikorere ya LSM itanga inyungu ebyiri zirwanya kurwara amoko ya virusi ya malariya haba mu nzu no hanze [4].Byongeye kandi, kurwanya vector hamwe na LSMs zishingiye kuri larvicide nka Bacillus thuringiensis israelensis (Bti) irashobora kwagura uburyo bwo kurwanya malariya.Mu mateka, LSM yagize uruhare runini mu kurwanya malariya muri Amerika, Burezili, Misiri, Alijeriya, Libiya, Maroc, Tuniziya na Zambiya [16,17,18].Nubwo LSM yagize uruhare runini mu kurwanya udukoko twangiza udukoko mu bihugu bimwe na bimwe byakuyeho malariya, LSM ntabwo yinjiye muri politiki yo kurwanya malariya muri Afurika kandi ikoreshwa gusa muri gahunda zo kurwanya virusi mu bihugu bimwe na bimwe byo munsi y’ubutayu bwa Sahara.bihugu [14,15,16,17,18,19].Impamvu imwe yabyo ni imyizerere ikwirakwizwa ko ahantu ho kororera ari henshi kandi bigoye kuyibona, bigatuma LSM ihenze cyane kuyishyira mubikorwa [4, 5, 6, 7, 8, 9, 10, 11, 13, 14].Kubera iyo mpamvu, Ishami ry'Umuryango w'Abibumbye ryita ku Buzima ryasabye imyaka ibarirwa muri za mirongo ko umutungo wakusanyirijwe mu kurwanya malariya ugomba kwibanda kuri LLIN na IRS [20, 21].Mu mwaka wa 2012, ni bwo Ishami ry'Umuryango w'Abibumbye ryita ku Buzima ryasabye guhuza LSM, cyane cyane ibikorwa bya Bti, kugira ngo byuzuze LLIN na IRS mu bice bimwe na bimwe byo muri Afurika yo munsi y'Ubutayu bwa Sahara [20].Kuva OMS yatanga iki cyifuzo, ubushakashatsi butandukanye bw’icyitegererezo bwakozwe ku bishoboka, imikorere n’igiciro cya biolarvicide muri Afurika yo munsi y’ubutayu bwa Sahara, byerekana akamaro ka LSM mu kugabanya ubwinshi bw’imibu ya Anopheles no kwanduza malariya ukurikije [22, 23].., 24].
Côte d'Ivoire iri mu bihugu 15 bifite malariya nyinshi ku isi [25].Ubwiyongere bwa malariya muri Côte d'Ivoire bugaragaza 3.0% by'umutwaro wa malariya ku isi hose, aho usanga umubare w'abantu banduye uri hagati ya 300 na 500 ku baturage 1000 [25].Nubwo igihe kirekire cyumye kuva mu Gushyingo kugeza Gicurasi, malariya ikwirakwira umwaka wose mu karere ka savanna gaherereye mu majyaruguru [26].Indwara ya malariya muri kano karere ifitanye isano no kuba hari umubare munini w'abatwara ibimenyetso bya Plasmodium falciparum [27].Muri kano karere, indwara ya malariya ikunze kugaragara ni Anopheles gambiae (SL).Umutekano waho.Umubu wa Anopheles gambiae ugizwe ahanini na Anopheles gambiae (SS), irwanya cyane udukoko twica udukoko bityo ikaba ifite ibyago byinshi byo kwandura malariya isigaye [26].Ikoreshwa rya LLIN rishobora kugira ingaruka nke mukugabanya kwandura malariya kubera kurwanya udukoko twica udukoko twaho bityo bikaba bikomeje kuba ikibazo gihangayikishije.Ubushakashatsi bwindege ukoresheje Bti cyangwa LLIN bwerekanye akamaro mukugabanya ubukana bwinzitiramubu mumajyaruguru ya Côte d'Ivoire.Icyakora, nta bushakashatsi bwibanze bwigeze busuzuma ingaruka ziterwa na Bti inshuro nyinshi hamwe na LLIN ku kwanduza malariya no kwandura malariya muri kano karere.Kubwibyo, ubu bushakashatsi bwari bugamije gusuzuma ingaruka ziterwa no gukoresha LLIN na Bti mugukwirakwiza malariya mugereranya itsinda rya LLIN + Bti nitsinda rya LLIN ryonyine mumidugudu ine yo mukarere ka majyaruguru ya Côte d'Ivoire.Byari byavuzwe ko gushyira mu bikorwa LSM ishingiye kuri Bti hejuru ya LLIN byongerera agaciro mukugabanya ubukana bw’imibu ya malariya ugereranije na LLIN yonyine.Ubu buryo bwahurijwe hamwe, bwibasira imibu ya Anopheles idakuze itwara imibu ya Bti hamwe na Anopheles ikuze itwara LLIN, irashobora kuba ingenzi mu kugabanya kwandura malariya mu turere twanduye cyane malariya, nk'imidugudu yo mu majyaruguru ya Cote d'Ivoire.Kubwibyo, ibyavuye muri ubu bushakashatsi birashobora gufasha kumenya niba washyira LSM muri gahunda yo kurwanya malariya y’igihugu (NMCPs) mu bihugu byo munsi y’ubutayu bwa Sahara.
Ubu bushakashatsi bwakorewe mu midugudu ine y’ishami rya Napieldougou (nanone izwi ku izina rya Napier) mu karere ka Sanhogo y’isuku mu majyaruguru ya Côte d'Ivoire (Ishusho 1).Imidugudu iri kwigwa: 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) na Nambatiurkaha (9 ° 18 ′ 36 ″ N, 5 ° 31 ′ 22 ″ E).Abaturage ba Napierledougou mu 2021 bavugaga ko ari abaturage 31.000, kandi intara igizwe n'imidugudu 53 ifite ibigo nderabuzima bibiri [28].Mu ntara ya Napyeledougou, aho malariya ari yo iza ku isonga mu gusura abaganga, mu bitaro no mu rupfu, LLIN yonyine niyo ikoreshwa mu kurwanya inzitizi za Anopheles [29].Imidugudu uko ari ine yo mu matsinda yombi y’ubushakashatsi ikorerwa n’ikigo nderabuzima kimwe, hasuzumwe inyandiko z’amavuriro z’indwara ya malariya muri ubu bushakashatsi.
Ikarita ya Côte d'Ivoire yerekana aho biga.(Ikarita yerekana ikarita na software: amakuru ya GADM na ArcMap 10.6.1.
Indwara ya Malariya mu baturage b’ikigo nderabuzima cya Napier yageze kuri 82.0% (2038) (amakuru ya mbere ya Bti).Muri iyo midugudu uko ari ine, ingo zikoresha PermaNet® 2.0 LLIN gusa, zatanzwe na NMCP yo muri Cote d'Ivoire muri 2017, zikaba zifite 80% [25, 26, 27, 28, 30].Imidugudu ni iy'akarere ka Korhogo, ikaba ikorera mu Nama Nkuru ya Gisirikare ya Cote d'Ivoire kandi ikaboneka umwaka wose.Buri mudugudu uko ari ine ufite nibura ingo 100 kandi hafi y’abaturage bangana, kandi ukurikije igitabo cy’ubuzima (inyandiko y'akazi ya Minisiteri y’ubuzima ya Cote d'Ivoire), buri mwaka havugwa indwara nyinshi za malariya.Malariya iterwa ahanini na Plasmodium falciparum (P. falciparum) kandi yanduza abantu na Plasmodium.gambiae yandura kandi imibu ya Anopheles na Anopheles nili mu karere [28].Urwego rwibanze An.gambiae igizwe ahanini numubu wa Anopheles.gambiae ss ifite inshuro nyinshi za mutation ya kdr (intera yumurongo: 90.70-100%) hamwe ninshuro iringaniye ya ace-1 alleles (intera yumurongo: 55.56-95%) [29].
Impuzandengo yimvura nubushyuhe buri mwaka kuva kuri 1200 kugeza 1400 mm na 21 kugeza 35 ° C, naho ubuhehere bugereranije (RH) bugera kuri 58%.Aka gace k’ubushakashatsi gafite ikirere cyo muri Sudani gifite ibihe byamezi 6 yumunsi (Ugushyingo kugeza Mata) nigihe cyamezi 6 (Gicurasi kugeza Ukwakira).Aka karere karimo zimwe mu ngaruka z’imihindagurikire y’ikirere, nko gutakaza ibimera ndetse n’igihe kirekire cyumye, kirangwa no gukama kw’amazi (ubutayu, umuceri w’umuceri, ibyuzi, ibyuzi) bishobora kuba ubuturo bw’inzitiramubu za Anopheles; .Umubu [26].
Ubushakashatsi bwakorewe mu itsinda rya LLIN + Bti, rihagarariwe n'imidugudu ya Kakologo na Nambatiurkaha, no mu itsinda rya LLIN gusa, rihagarariwe n'imidugudu ya Kolekaha na Lofinekaha.Mugihe cyubu bushakashatsi, abantu muriyi midugudu yose bakoreshaga gusa PermaNet® 2.0 LLIN.
Imikorere ya LLIN (PermaNet 2.0) ifatanije na Bti kurwanya imibu ya Anopheles no kwandura malariya yasuzumwe mu rubanza rwateganijwe (RCT) hakoreshejwe intwaro ebyiri zo kwiga: itsinda rya LLIN + Bti (itsinda rivura) n'itsinda rya LLIN ryonyine (itsinda rishinzwe kugenzura ).Imyenda ya LLIN + Bti ihagarariwe na Kakologo na Nambatiourkaha, naho Kolékaha na Lofinékaha bagizwe nk'intugu za LLIN gusa.Muri iyo midugudu uko ari ine, abaturage baho bakoresha LLIN PermaNet® 2.0 yakiriwe na Coryte d'Ivoire NMCP muri 2017. Bikekwa ko uburyo bwo gukoresha PermaNet® 2.0 ari bumwe mu midugudu itandukanye kuko bakiriye umuyoboro mu buryo bumwe..Mu itsinda rya LLIN + Bti, Anopheles larval ituye yavuwe hamwe na Bti buri byumweru bibiri hiyongereyeho LLIN isanzwe ikoreshwa nabaturage.Ahantu hatuwe mu midugudu no muri kilometero 2 uvuye hagati ya buri mudugudu bavuwe hakurikijwe ibyifuzo by’umuryango w’ubuzima ku isi na NMCP ya Côte d'Ivoire [31].Ibinyuranye, itsinda rya LLIN ryonyine ntabwo ryakiriye imiti ya Bti ivura mugihe cyo kwiga.
Ubwoko bwa Bti (Vectobac WG, 37.4% wt; ubufindo nimero 88–916-PG; 3000 International Toxicity Units IU / mg; Valent BioScience Corp, USA) yakoreshejwe ku gipimo cya 0.5 mg / L..Koresha sprayer ya 16L hamwe nimbunda ya fiberglass spray hamwe nintoki hamwe na nozzle ishobora guhinduka umuvuduko wa ml 52 kumasegonda (3.1 L / min).Gutegura nebulizer irimo 10 L y'amazi, ingano ya Bti ivanze muguhagarikwa ni 0.5 mg / L × 10 L = 5 mg.Kurugero, kubice bifite amazi yashushanyije ya 10 L, ukoresheje spray ya 10 L kugirango uvure urugero rwamazi, ingano ya Bti igomba kuvangwa ni 0.5 mg / L × 20 L = 10 mg.10 mg Bti yapimwe mu murima akoresheje igipimo cya elegitoroniki.Ukoresheje spatula, tegura igituba uvanga ingano ya Bti mu ndobo ya 10 L.Uyu muti watoranijwe nyuma yikigeragezo cyimikorere ya Bti kurwanya instars zitandukanye za Anopheles spp.na Culex spp.mubihe bisanzwe mubice bitandukanye, ariko bisa nubushakashatsi bugezweho [32].Igipimo cyo gukoresha ihagarikwa rya liviside hamwe nigihe cyo gusaba kuri buri bworozi cyabazwe hashingiwe ku kigereranyo cy’amazi yagenewe kororoka [33].Koresha Bti ukoresheje intoki.Nebulizers ihindurwa kandi igeragezwa mugihe cyimyitozo ya buri muntu no mubice bitandukanye kugirango Bti itangwe neza.
Kugirango ubone igihe cyiza cyo kuvura ibibanza byororerwa byororerwa, itsinda ryerekanye gutera idirishya.Idirishya rya spray nigihe cyigihe ibicuruzwa bikoreshwa kugirango bigerweho neza: muri ubu bushakashatsi, idirishya rya spray ryatangiye kuva kumasaha 12 kugeza ibyumweru 2, bitewe no gukomera kwa Bti.Ikigaragara ni uko gufata Bti na livre aho zororerwa bisaba igihe runaka kuva 7h00 kugeza 18h00.Muri ubu buryo, ibihe by'imvura nyinshi birashobora kwirindwa mugihe imvura bivuze guhagarika gutera no gutangira bukeye niba ikirere gifatanije.Gutera amatariki n'amatariki nyayo nibihe biterwa nikirere cyagaragaye.Kugirango uhindure imashini zipakurura igipimo cya Bti cyifuzwa, buri mutekinisiye yatojwe kugenzura neza no gushyiraho sprayer nozzle no gukomeza umuvuduko.Calibration irangizwa no kugenzura ko umubare nyawo wo kuvura Bti ukoreshwa neza kuri buri gace.Kuvura aho inzara iba buri byumweru bibiri.Ibikorwa bya Larvicidal bikorwa bikorwa ku nkunga yinzobere enye zifite uburambe kandi zahuguwe neza.Ibikorwa bya Larvicidal nabitabiriye bagenzurwa nabashinzwe uburambe.Kuvura Larvicidal byatangiye muri Werurwe 2019 mugihe cyizuba.Mubyukuri, ubushakashatsi bwibanze bwerekanye ko igihe cyizuba aricyo gihe gikwiye cyo guterwa na liviside bitewe n’ahantu ho kororera no kugabanuka kwinshi [27].Kurwanya liswi mugihe cyizuba biteganijwe ko birinda gukurura imibu mugihe cyizuba.Ibiro bibiri (02) bya Bti bigura amadolari ya Amerika 99.29 yemerera itsinda ry’inyigisho ryakira imiti mu bice byose.Mu itsinda rya LLIN + Bti, gutabara kwa liviside byamaze umwaka wose, kuva muri Werurwe 2019 kugeza Gashyantare 2020. Abantu 22 bose bavuwe na liviside babaye mu itsinda rya LLIN + Bti.
Ingaruka zishobora guterwa (nko kwishongora, kuzunguruka cyangwa gutemba izuru) byakurikiranwe hakoreshejwe ubushakashatsi bwakozwe ku giti cya Bti biolarvicide nebulizers ndetse n’abaturage bo mu rugo bitabiriye itsinda rya LIN + Bti.
Ubushakashatsi bwakozwe mu ngo bwakorewe mu ngo 400 (ingo 200 kuri buri tsinda ryiga) hagamijwe kugereranya ijanisha ry’imikoreshereze ya LLIN mu baturage.Iyo usuzumye ingo, hakoreshwa uburyo bwo kubaza ibibazo.Ikwirakwizwa rya LLIN ryagabanijwe mu matsinda atatu: imyaka 15.Ikibazo cyujujwe kandi gisobanurwa mu rurimi rwa Senoufo rwaho umuyobozi w'urugo cyangwa undi muntu mukuru urengeje imyaka 18.
Ingano ntoya y'urugo rwabajijwe yabazwe hakoreshejwe formula yasobanuwe na Vaughan na Morrow [34].
n ingano yicyitegererezo, e ni intera yamakosa, t nikintu cyumutekano gikomoka kurwego rwicyizere, naho p ni igipimo cyababyeyi babaturage bafite ikiranga.Buri kintu cyigice gifite agaciro gahoraho, so (t) = 1.96;Ingano ntarengwa y'urugo muri ibi bihe mubushakashatsi yari ingo 384.
Mbere yubushakashatsi bugezweho, ubwoko butandukanye bwimiturire ya Anopheles yinzitane mumatsinda ya LLIN + Bti na LLIN bwamenyekanye, bwatoranijwe, busobanurwa, bushingiye kuri geore.Koresha kaseti kugirango upime ubunini bwa koloni.Ubucucike bw’inzitiramubu bwapimwe buri kwezi mu mezi 12 ahantu 30 hatoranijwe ku bworozi buri mudugudu, hamwe n’ubworozi 60 kuri buri tsinda.Hariho ibice 12 by'icyitegererezo kuri buri gice cyo kwiga, bihuye na 22 Bti ivura.Icyari kigamijwe guhitamo ahantu 30 kororoka kuri buri mudugudu kwari ugufata umubare uhagije w’ibibanza byakusanyirizwagamo imidugudu hamwe n’ibice by’inyigisho kugira ngo bigabanye kubogama.Ibinyomoro byakusanyirijwe mu kwibiza ikiyiko cya ml 60 [35].Bitewe nuko pepiniyeri zimwe ari nto cyane kandi zidakabije, birakenewe gukoresha indobo nto itari indobo isanzwe ya OMS (ml 350).Igiteranyo cya 5, 10 cyangwa 20 byakozwe mubibanza byashyizwemo umuzenguruko wa m 10.Kumenyekanisha morfologiya yerekana liswi zegeranijwe (urugero: Anopheles, Culex na Aedes) byakorewe mu murima [36].Ibinyomoro byegeranijwe byagabanijwemo ibyiciro bibiri bishingiye ku cyiciro cyiterambere: intanga zo mu ntangiriro (icyiciro cya 1 n'icya 2) na lisansi itinze (icyiciro cya 3 n'icya 4) [37].Ibinyomoro byabaruwe na genera kandi kuri buri cyiciro cyiterambere.Nyuma yo kubara, inzitiramubu zongera gusubizwa aho zororerwa kandi zuzuzwa ubwinshi bwazo n'amazi yaturutse hiyongeraho amazi y'imvura.
Ahantu ho kororera hafatwaga nkibyiza niba byibuze liswi imwe cyangwa pupa yubwoko bwose bw imibu.Ubucucike bunini bwagenwe no kugabanya umubare wa livre zo mu bwoko bumwe n'umubare w'amazi.
Buri bushakashatsi bwamaze iminsi ibiri ikurikiranye, kandi buri mezi abiri, imibu ikuze yakusanyirijwe mu ngo 10 zatoranijwe ku bushake muri buri mudugudu.Mu bushakashatsi bwose, buri tsinda ry’ubushakashatsi ryakoze ubushakashatsi ku miryango 20 mu minsi itatu ikurikiranye.Umubu wafashwe ukoresheje imitego isanzwe yidirishya (WT) hamwe na pyrethrum spray imitego (PSC) [38, 39].Ubwa mbere, amazu yose yo muri buri mudugudu yari afite nimero.Amazu ane muri buri mudugudu yahise atoranywa nk'ahantu ho gukusanya imibu ikuze.Muri buri nzu yatoranijwe ku bushake, imibu yakusanyirijwe mu cyumba kinini.Ibyumba byo kuryamamo byatoranijwe bifite inzugi nidirishya kandi byaraye bibaye.Ibyumba byo kuryamo bikomeza gufungwa mbere yo gutangira akazi no mugihe cyo gukusanya imibu kugirango wirinde imibu gusohoka mucyumba.WT yashyizwe muri buri dirishya rya buri cyumba cyo kuraramo nk'icyitegererezo cy'umubu.Bukeye bwaho, imibu yinjiye mu kazi ivuye mu cyumba cyo kuraramo yakusanyirijwe hagati ya 06:00 na 08:00 za mu gitondo.Kusanya imibu uva aho ukorera ukoresheje umunwa hanyuma ubibike mu gikombe cy'impapuro zishobora gutwarwa n'igice kibisi.Inzitiramubu.Umubu uruhukiye mucyumba kimwe cyafashwe ako kanya nyuma yo gukusanya WT ukoresheje PSC ishingiye kuri pyrethroid.Nyuma yo gukwirakwiza impapuro zera hasi mucyumba cyo kuraramo, funga imiryango nidirishya hanyuma utere umuti wica udukoko (ibikoresho bikora: 0,25% transfluthrin + 0,20% permethrine).Nyuma yiminota 10 kugeza kuri 15 nyuma yo gutera, kura uburiri muburiri bwavuwe, koresha teweri kugirango utoragure imibu iyo ari yo yose yaguye kumpapuro yera, hanyuma ubibike mu isahani ya Petri yuzuye ubwoya bw'ipamba bwuzuye amazi.Umubare wabantu baraye mubyumba byatoranijwe nabyo byanditswe.Imibu yegeranijwe yimurirwa vuba muri laboratoire kugirango ikorwe neza.
Muri laboratoire, imibu yose yakusanyirijwe hamwe yamenyekanye ku bwoko no ku bwoko [36].Intanga ngore.gambiae SL ukoresheje microscope ikuraho binocular hamwe nigitonyanga cyamazi yamenetse ashyirwa kumurongo wikirahure [35].Imiterere y'uburinganire yasuzumwe gutandukanya abagore benshi n'abagore badafite ishingiro hashingiwe ku mitsi y'intanga ngore na tracheal, ndetse no kumenya igipimo cy'uburumbuke n'imyaka ya physiologiya [35].
Umubare ugereranije ugenwa no gusuzuma inkomoko y'ibiryo byamaraso byegeranijwe.gambiae na enzyme ihujwe na immunosorbent assay (ELISA) ukoresheje amaraso yabantu, amatungo (inka, intama, ihene) hamwe ninkoko zinkoko [40].Indwara ya Entomologiya (EIR) yabazwe ukoresheje An.Ikigereranyo cy'abagore ba SL muri Gambiya [41] Byongeye, An.Kwandura Plasmodium gambiae byagenwe no gusesengura umutwe nigituza cyigitsina gore cyinshi ukoresheje uburyo bwa circsporozoite antigen ELISA (CSP ELISA) [40].Hanyuma, hariho abanyamuryango ba Ann.gambiae yamenyekanye mu gusesengura amaguru, amababa n'inda ikoresheje tekinoroji ya polymerase (PCR).
Amakuru y’ubuvuzi kuri malariya yabonetse mu gitabo cy’ubuvuzi cy’ikigo nderabuzima cya Napyeledugou, gikubiyemo imidugudu ine yose yashyizwe muri ubu bushakashatsi (ni ukuvuga Kakologo, Kolekaha, Lofinekaha na Nambatiurkaha).Isubiramo ry’abanditsi ryibanze ku nyandiko kuva muri Werurwe 2018 kugeza Gashyantare 2019 no kuva muri Werurwe 2019 kugeza Gashyantare 2020. Amakuru y’ubuvuzi kuva muri Werurwe 2018 kugeza Gashyantare 2019 agaragaza imibare y’ibanze cyangwa mbere ya Bti, mu gihe amakuru y’ubuvuzi kuva muri Werurwe 2019 kugeza Gashyantare 2020 agereranya pre-Bti amakuru yo gutabara.Amakuru nyuma ya Bti intervention.Amakuru y’amavuriro, imyaka n’umudugudu wa buri murwayi mu matsinda y’inyigisho ya LLIN + Bti na LLIN yakusanyirijwe mu gitabo cy’ubuzima.Kuri buri murwayi, amakuru nk'inkomoko y'umudugudu, imyaka, gusuzuma, na patologiya yaranditswe.Mu manza zasuzumwe muri ubu bushakashatsi, malariya yemejwe n’ikizamini cyihuse cyo gusuzuma (RDT) na / cyangwa microscopi ya malariya nyuma yo gutanga imiti ivura indwara ya artemisinin (ACT) n’ushinzwe ubuzima.Indwara ya Malariya yagabanyijwemo amatsinda atatu (ni ukuvuga imyaka 15).Buri mwaka indwara ya malariya ku baturage 1000 yagereranijwe no kugabanya ubwiyongere bwa malariya ku baturage 1000 ku baturage bo mu mudugudu.
Amakuru yakusanyirijwe muri ubu bushakashatsi yinjijwe kabiri mu bubiko bwa Microsoft Excel hanyuma yinjizwa muri porogaramu ifunguye R [42] verisiyo 3.6.3 yo gusesengura imibare.Porogaramu ya ggplot2 ikoreshwa mugushushanya ibibanza.Icyitegererezo rusange cyumurongo ukoresheje Poisson regression cyakoreshejwe mukugereranya ubwinshi bwikigereranyo kandi bivuze umubare w’inzitiramubu kuri buri muntu nijoro hagati yitsinda ryiga.Ibipimo bifatika (RR) byifashishijwe mu kugereranya ubucucike bwa livre hamwe nigipimo cyo kuruma imibu ya Culex na Anopheles.Gambiya SL yashyizwe hagati yitsinda ryombi ryifashishije itsinda rya LLIN + Bti nkibanze.Ingano yingirakamaro yagaragajwe nkibipimo bitandukanijwe na 95% intera yicyizere (95% CI).Ikigereranyo (RR) cyikizamini cya Poisson cyakoreshejwe mu kugereranya ibipimo n’igipimo cya malariya mbere na nyuma yo gutabara kwa Bti muri buri tsinda ryiga.Urwego rw'akamaro rwakoreshejwe ni 5%.
Porotokole y’ubushakashatsi yemejwe na komite y’igihugu ishinzwe imyitwarire y’ubushakashatsi muri Minisiteri y’ubuzima n’ubuzima rusange bwa Côte d'Ivoire (N / Ref: 001 // MSHP / CNESVS-kp), ndetse n’akarere k’ubuzima mu karere n’ubuyobozi ya Korhogo.Mbere yo gukusanya inzitiramubu n'abantu bakuru, umukono wabimenyeshejwe wabonetse kubitabiriye ubushakashatsi murugo, ba nyirubwite, cyangwa / cyangwa abawurimo.Amakuru yumuryango nubuvuzi ntabwo azwi kandi ni ibanga kandi araboneka gusa kubashinzwe iperereza.
Harasuwe ibibanza 1198 byo guturamo.Muri izi mbuga zicyari cyakoreweho ubushakashatsi mu gace k’ubushakashatsi, 52.5% (n = 629) bari mu itsinda rya LLIN + Bti naho 47.5% (n = 569) bari mu itsinda rya LLIN gusa (RR = 1.10 [95% CI 0 .98–1.24 ], P = 0.088).Muri rusange, ahantu nyaburanga hatuwe hashyizwe mu bwoko 12, muri bwo igice kinini cy’ahantu hatuwe ni imirima yumuceri (24.5%, n = 294), hagakurikiraho kuvoma umuyaga (21.0%, n = 252) nububumbyi (8.3).%, n = 99), inkombe z'umugezi (8.2%, n = 100), icyuzi (7.2%, n = 86), icyuzi (7.0%, n = 84), pompe y'amazi yo mu mudugudu (6.8%, n = 81), Ibicapo by'inono (4.8%, n = 58), ibishanga (4.0%, n = 48), ibibindi (5.2%, n = 62), ibyuzi (1.9%, n = 23) n'amariba (0.9%, n = 11) .).
Muri rusange, inzitiramubu 47,274 zegeranijwe zivuye mu bushakashatsi, hamwe na 14.4% (n = 6,796) mu itsinda rya LLIN + Bti ugereranije na 85,6% (n = 40,478) mu itsinda rya LLIN ryonyine ((RR = 5.96) [95% CI 5.80–6.11], P ≤ 0.001).Izi liswi zigizwe na genera eshatu z imibu, ubwoko bwiganje ni Anopheles.(48.7%, n = 23,041), hagakurikiraho Culex spp.(35.0%, n = 16,562) na Aedes spp.(4.9%, n = 2340).Pupae yari igizwe na 11.3% by'isazi zidakuze (n = 5344).
Muri rusange impuzandengo yubucucike bwa Anopheles spp.inzara.Muri ubu bushakashatsi, umubare w'inzara kuri buri kantu wari 0,61 [95% CI 0.41–0.81] L / kwibiza mu itsinda rya LLIN + Bti na 3.97dosiye 1: Igicapo S1).Impuzandengo yubucucike bwa Anopheles spp.Itsinda LLIN ryonyine ryikubye inshuro 6.5 kurenza itsinda rya LLIN + Bti (HR = 6.49; 95% CI 5.80–7.27; P <0.001).Nta mibu ya Anopheles yagaragaye mugihe cyo kuvura.Larvae yakusanyirijwe mu itsinda rya LLIN + Bti guhera muri Mutarama, bihuye no kuvura Bti ya makumyabiri.Mu itsinda rya LLIN + Bti, habayeho kugabanuka gukabije mubyiciro byambere na nyuma yubucucike.
Mbere yo gutangira kuvura Bti (Werurwe), ubucucike buri hagati y’imibu ya Anopheles bwambere bwagereranijwe ni 1,28 [95% CI 0.22-22.35] L / kwibiza mu itsinda rya LLIN + Bti na 1.37 [95% CI 0.36– 2.36] l / kwibira mu itsinda rya LLIN + Bti.l / kwibiza./ kwibiza gusa ukuboko kwa LLIN (Ishusho 2A).Nyuma yo gushyira mu bikorwa imiti ya Bti, ubucucike buri hagati y’imibu ya Anopheles yo mu itsinda rya LLIN + Bti muri rusange bwaragabanutse buhoro buhoro kuva kuri 0.90 [95% CI 0.19–1.61] bugera kuri 0.10 [95% CI - 0.03–0.18] l / kwibiza.Intangiriro yambere Anopheles ubucucike bwagumye hasi mumatsinda ya LLIN + Bti.Mu itsinda rya LLIN gusa, ihindagurika mubwinshi bwa Anopheles spp.Ibinyomoro byambere byaragaragaye bifite ubucucike buri hagati ya 0.23 [95% CI 0.07–0.54] L / kwibira kugeza kuri 2.37 [95% CI 1.77-22.98] L / kwibiza.Muri rusange, ubucucike buri hagati yinzoka zo mu bwoko bwa Anopheles zo mu itsinda rya LLIN gusa zari hejuru cyane ku mibare kuri 1.90 –0.47]) l / kwibiza.+ Itsinda rya Bti (RR = 5.04; 95% CI 4.36–5.85; P <0.001).
Imihindagurikire yubucucike bwa Anopheles.Inzitiramubu hakiri kare (A) na nyuma yinzitane (B) mumatsinda yubushakashatsi kuva muri Werurwe 2019 kugeza Gashyantare 2020 mukarere ka Napier, mumajyaruguru ya Côte d'Ivoire.LLIN: urumogi rurerure rwica udukoko Bti: Bacillus thuringiensis, Isiraheli TRT: kuvura;
Impuzandengo yubucucike bwa Anopheles spp.inzara.gutinda mu itsinda rya LLIN + Bti.Mbere yo kuvura Bti ubucucike bwari 2.98 [95% CI 0.26-5.60] L / dip, mugihe ubucucike mu itsinda rya LLIN bwonyine bwari 1.46 [95% CI 0.26-22.65] l / kumunsi Nyuma yo gusaba Bti, ubucucike bwatinze- instar Anopheles larvae mumatsinda ya LLIN + Bti yagabanutse kuva kuri 0.22 [95% CI 0.04–0.40] igera kuri 0.03 [95% CI 0.00–0.06] L / kwibiza (Ishusho 2B).Mu itsinda rya LLIN gusa, ubucucike bwa lisiti ya Anopheles yatinze bwiyongereye kuva kuri 0.35 [95% CI - 0.15-0.76] bugera kuri 2.77Ubucucike buri hagati ya lisiti ya Anopheles yatinze mu itsinda rya LLIN gusa yari 2.07 [95% CI 1.84-22.29] L / kwibiza, inshuro icyenda hejuru ya 0.23 [95% CI 0.11–0.36] l / kwibiza muri LLIN.+ Itsinda rya Bti (RR = 8.80; 95% CI 7.40–10.57; P <0.001).
Impuzandengo yubucucike bwa Culex spp.Indangagaciro zari 0.33 [95% CI 0.21–0.45] L / kwibiza mu itsinda rya LLIN + Bti na 2.67 [95% CI 2.23–3.10] L / kwibiza mu itsinda rya LLIN gusa (dosiye y'inyongera 2: Ishusho S2).Impuzandengo yubucucike bwa Culex spp.Itsinda LLIN ryonyine ryari hejuru cyane kurenza LLIN + Bti (HR = 8.00; 95% CI 6.90–9.34; P <0.001).
Impuzandengo yubucucike bwubwoko Culex Culex spp.Mbere yo kuvurwa, Bti l / dip yari 1.26 [95% CI 0.10-22.42] l / kwibiza mu itsinda rya LLIN + Bti na 1.28 [95% CI 0.37-22.36] mu itsinda ryonyine LLIN (Ishusho 3A).Nyuma yo gukoresha imiti ya Bti, ubucucike bwa livre ya Culex yo hambere bwaragabanutse kuva 0.07 [95% CI - 0.001–0.] Bugera kuri 0.25 [95% CI 0.006–0.51] L / kwibiza.Nta livre ya Culex yakusanyirijwe ahantu hatuwe havuwe na Bti guhera mu Kuboza.Ubucucike bwa livre ya Culex yo hambere yagabanutse kugera kuri 0.21 [95% CI 0.14–0.28] L / kwibiza mu itsinda rya LLIN + Bti, ariko yari hejuru mu itsinda rya LLIN gusa kuri 1.30 [95% CI 1.10– 1.50] l / kwibiza.guta / d.Ubucucike bwa livre ya Culex yo hambere mu itsinda rya LLIN ryonyine bwikubye inshuro 6 ugereranije nitsinda LLIN + Bti (RR = 6.17; 95% CI 5.11–7.52; P <0.001).
Impinduka muburinganire bwa Culex spp.inzara.Ubuzima bwambere (A) nubuzima bwambere (B) mubigeragezo mumatsinda yubushakashatsi kuva muri Werurwe 2019 kugeza Gashyantare 2020 mukarere ka Napier, mumajyaruguru ya Côte d'Ivoire.Urushundura rurerure rwica udukoko LLIN, Bti Bacillus thuringiensis Isiraheli, kuvura Trt
Mbere yo kuvura Bti, ubucucike buri hagati ya lisiti ya Culex yatinze mu itsinda rya LLIN + Bti hamwe nitsinda rya LLIN ryari 0.97 [95% CI 0.09–1.85] na 1.60 [95% CI - 0.16–3.37] l / kwibiza bikurikije (Ishusho. 3B)).Hagati yubucucike bwubwoko butinze bwa Culex nyuma yo gutangira kuvura Bti.Ubucucike mu itsinda rya LLIN + Bti bwaragabanutse buhoro buhoro kandi buri munsi ugereranije no mu itsinda rya LLIN gusa, ryagumye hejuru cyane.Ubucucike buri hagati yimisemburo ya Culex yatinze yari 0.12 [95% CI 0.07–0.15] L / kwibiza mumatsinda ya LLIN + Bti na 1.36 [95% CI 1.11–1.61] L / kwibiza mumatsinda LLIN gusa.Ubucucike buri hagati ya Culex yatinze cyane yari hejuru cyane mumatsinda ya LLIN gusa kuruta mu itsinda rya LLIN + Bti (RR = 11.19; 95% CI 8.83–14.43; P <0.001).
Mbere yo kuvura Bti, ubucucike buri hagati ya pupae kuri ladybug bwari 0.59 [95% CI 0.24–0.94] mu itsinda rya LLIN + Bti na 0.38 [95% CI 0.13–0.63] muri LLIN gusa (Ishusho 4).Muri rusange ubucucike bw'abana bwari 0,10 [95% CI 0.06–0.14] mu itsinda rya LLIN + Bti na 0.84 [95% CI 0,75–0.92] mu itsinda rya LLIN ryonyine.Ubuvuzi bwa Bti bwagabanije cyane ubucucike buri hagati yitsinda rya LLIN + Bti ugereranije nitsinda LLIN ryonyine (OR = 8.30; 95% CI 6.37–11.02; P <0.001).Mu itsinda rya LLIN + Bti, nta pupa yakusanyijwe nyuma yUgushyingo.
Impinduka mubucucike buri hagati ya pupae.Ubushakashatsi bwakozwe kuva muri Werurwe 2019 kugeza Gashyantare 2020 mu karere ka Napier mu majyaruguru ya Côte d'Ivoire.Urushundura rurerure rwica udukoko LLIN, Bti Bacillus thuringiensis Isiraheli, kuvura Trt
Imibu ikuze yose hamwe 3456 yakusanyirijwe mu bushakashatsi.Umubu ni ubwoko 17 bwubwoko 5 (Anopheles, Culex, Aedes, Eretmapodite) (Imbonerahamwe 1).Indwara ya malariya An.gambiae sl niyo moko menshi cyane afite igipimo cya 74.9% (n = 2587), agakurikirwa na An.gambiae sl.funestus (2,5%, n = 86) na Null (0.7%, n = 24).Ubutunzi bwa Anna.gambiae sl mu itsinda rya LLIN + Bti (10.9%, n = 375) yari munsi ugereranije no mu itsinda rya LLIN ryonyine (64%, n = 2212).Nta mahoro.nli abantu bashizwe hamwe na LLIN gusa.Ariko, An.gambiae na An.funestus yari ahari mumatsinda ya LLIN + Bti hamwe na LLIN wenyine.
Mu bushakashatsi bwatangiye mbere yo gusaba Bti ahakorerwa ubworozi (amezi 3), muri rusange umubare rusange w’imibu nijoro nijoro ku muntu (b / p / n) mu itsinda rya LLIN + Bti wagereranijwe ko ari 0.83 [95% CI 0.50–1.17] , mu gihe mu itsinda rya LLIN + Bti yari 0,72 mu itsinda rya LLIN gusa [95% CI 0.41–1.02] (Ishusho 5).Mu itsinda rya LLIN + Bti, kwangiza imibu ya Culex byagabanutse kandi bikomeza kuba hasi nubwo hejuru ya 1.95 [95% CI 1.35-22.54] bpp muri Nzeri nyuma yo gusaba Bti ya 12.Nyamara, mu itsinda rya LLIN gusa, ikigereranyo cyo kurwara imibu cyiyongereye buhoro buhoro mbere yo kugera muri Nzeri kuri 11.33 [95% CI 7.15–15.50] bp / n.Muri rusange umubare w’inzitiramubu wagabanutse cyane mu itsinda rya LLIN + Bti ugereranije n’itsinda rya LLIN ryonyine igihe icyo ari cyo cyose mu gihe cyo kwiga (HR = 3.66; 95% CI 3.01–4.49; P <0.001).
Ibipimo by’inzitiramubu mu gace k’ubushakashatsi bw’akarere ka Napier mu majyaruguru ya Côte d'Ivoire kuva muri Werurwe 2019 kugeza Gashyantare 2020 LLIN Urumogi rurerure rwica udukoko, Bti Bacillus thuringiensis Isiraheli, Kuvura Trt, kuruma b / p / ijoro / umuntu / ijoro
Anopheles gambiae nindwara ya malariya ikunze kugaragara mubice byo kwiga.Bite umuvuduko wa An.Ku murongo fatizo, abagore bo muri Gambiya bari bafite b / p / n agaciro ka 0,64 [95% CI 0.27–1.00] mu itsinda rya LLIN + Bti na 0,74 [95% CI 0.30–1.17] mu itsinda LLIN gusa (Ishusho 6) .Mugihe cyo gutabara kwa Bti, ibikorwa byo kuruma cyane byagaragaye muri Nzeri, bihuye n’amasomo ya cumi na kabiri yo kuvura Bti, hamwe na 1.46 [95% CI 0.87-22.05] b / p / n mu itsinda rya LLIN + Bti na a impinga ya 9 .65 [95% CI 0.87-22.05] w / n 5.23–14.07] Itsinda rya LLIN gusa.Muri rusange umuvuduko wa An.Umubare w'abanduye muri Gambiya wagabanutse cyane mu itsinda rya LLIN + Bti (0.59 [95% CI 0.43–0,75] b / p / n) ugereranije no mu itsinda rya LLIN ryonyine (2.97 [95% CI 2, 02–3.93] b / p / oya).(RR = 3.66; 95% CI 3.01–4.49; P <0.001).
Anna yihuta.gambiae sl, ishami ryubushakashatsi mukarere ka Napier, mumajyaruguru ya Cote d'Ivoire, kuva muri Werurwe 2019 kugeza Gashyantare 2020 LLIN yica udukoko twica udukoko tumaze igihe kirekire, Bti Bacillus thuringiensis Isiraheli, kuvura Trt, kuruma b / p / ijoro / umuntu / ijoro
Amps 646 yose.Gambiya yaciwe.Muri rusange, ijanisha ryumutekano waho.Igipimo cy’uburinganire muri Gambiya muri rusange cyari> 70% mugihe cyo kwiga, usibye Nyakanga, mugihe itsinda rya LLIN ryonyine ryakoreshejwe (Idosiye yinyongera 3: Ishusho S3).Nyamara, impuzandengo yuburumbuke mu gice cy’ubushakashatsi yari 74.5% (n = 481).Mu itsinda rya LLIN + Bti, igipimo cy’uburinganire cyagumye ku rwego rwo hejuru, hejuru ya 80%, usibye muri Nzeri, igihe igipimo cy’uburinganire cyagabanutse kugera kuri 77.5%.Nyamara, itandukaniro riri hagati yuburumbuke bwagaragaye ryagaragaye mu itsinda rya LLIN gusa, aho umubare muto ugereranyije ugereranyije ni 64.5%.
Kuva 389 Ann.Ubushakashatsi bwakozwe ku bice bitandukanye by’amaraso byaturutse muri Gambiya bwerekanye ko 80.5% (n = 313) bakomoka ku bantu, 6.2% (n = 24) by’abagore banywa amaraso avanze (abantu n’urugo) na 5.1% (n = 20) banywa amaraso .ibiryo biva mu matungo (inka, intama n'ihene) na 8.2% (n = 32) by'icyitegererezo cyasesenguwe byari bibi ku ifunguro ry'amaraso.Mu itsinda rya LLIN + Bti, umubare w’abagore bahabwa amaraso y’abantu wari 25.7% (n = 100) ugereranije na 54.8% (n = 213) mu itsinda rya LLIN gusa (Idosiye yinyongera 5: Imbonerahamwe S5).
Amps 308 yose.P. gambiae yapimwe kugirango hamenyekane abagize ubwoko bwubwoko bwanduye na P. falciparum (dosiye yinyongera 4: Imbonerahamwe S4).Ibinyabuzima bibiri “bifitanye isano” bibana ahantu ho kwigwa, aribyo An.gambiae ss (95.1%, n = 293) na An.coluzzii (4.9%, n = 15).Anopheles gambiae ss yari hasi cyane mumatsinda ya LLIN + Bti kuruta mu itsinda rya LLIN ryonyine (66.2%, n = 204) (RR = 2.29 [95% CI 1.78-22.97], P <0.001).Umubare nk'uwo w'imibu ya Anopheles wabonetse mu itsinda rya LLIN + Bti (3,6%, n = 11) no mu itsinda rya LLIN gusa (1.3%, n = 4) (RR = 2.75 [95% CI 0.81–11 .84], P = .118).Ikwirakwizwa rya Plasmodium falciparum muri An.SL muri Gambiya yari 11.4% (n = 35).Ibipimo byanduye bya plasmodium falciparum.Umubare w'abanduye muri Gambiya wagabanutse cyane mu itsinda rya LLIN + Bti (2,9%, n = 9) ugereranije no mu itsinda rya LLIN ryonyine (8.4%, n = 26) (RR = 2.89 [95% CI 1. 31–7.01 ], P = 0.006).).Ugereranije n'umubu wa Anopheles, imibu ya Anopheles gambiae yari ifite umubare munini w’ubwandu bwa Plasmodium kuri 94.3% (n = 32).coluzzii gusa 5.7% (n = 5) (RR = 6.4 [95% CI 2.47–21.04], P <0.001).
Hakozwe ubushakashatsi ku bantu 2,435 bo mu ngo 400.Ikigereranyo cy'ubucucike ni abantu 6.1 kuri buri rugo.Igipimo cya nyiri LLIN mu ngo cyari 85% (n = 340), ugereranije na 15% (n = 60) kumiryango idafite LLIN (RR = 5.67 [95% CI 4.29–7.59], P <0.001) (Idosiye yinyongera 5 : Imbonerahamwe S5)..Gukoresha LLIN byari 40.7% (n = 990) mu itsinda rya LLIN + Bti ugereranije na 36.2% (n = 882) mu itsinda rya LLIN ryonyine (RR = 1.12 [95% CI 1.02–1.23], P = 0.013).Ikigereranyo cyo gukoresha net muri rusange murwego rwo kwiga cyari 38.4% (n = 1842).Umubare w'abana bari munsi yimyaka itanu ukoresheje interineti wasaga mumatsinda yombi yo kwiga, aho ikoreshwa rya neti rya 41.2% (n = 195) mumatsinda ya LLIN + Bti na 43.2% (n = 186) mumatsinda LLIN gusa.(HR = 1.05 [95% CI 0.85–1.29], P = 0.682).Mu bana bafite hagati yimyaka 5 na 15, nta tandukaniro ryigeze riba mubiciro byo gukoresha neti hagati ya 36.3% (n = 250) mumatsinda ya LLIN + Bti na 36.9% (n = 250) mumatsinda ya LLIN gusa (RR = 1. 02 [ 95% CI 1.02–1.23], P = 0.894).Ariko, abafite hejuru yimyaka 15 bakoresheje inshundura zo kuryama 42.7% (n = 554) gake cyane mumatsinda ya LLIN + Bti kurenza 33.4% (n = 439) mumatsinda ya LLIN gusa (RR = 1.26 [95% CI 1.11–1.43 ], P <0.001).
Indwara z’amavuriro 2,484 zanditswe mu kigo nderabuzima cya Napier hagati ya Werurwe 2018 na Gashyantare 2020. Indwara ya malariya y’amavuriro mu baturage muri rusange yari 82.0% by’abanduye indwara zose z’ubuvuzi (n = 2038).Buri mwaka umubare w'abanduye malariya muri kariya gace ni 479.8 ‰ na 297.5 ‰ mbere na nyuma yo kuvura Bti (Imbonerahamwe 2).
Igihe cyo kohereza: Nyakanga-01-2024