Igabanuka riherutse ry’umubare w’indwara ya malariya muri Côte d'Ivoire riterwa ahanini n’ikoreshwa ry’insinga zica udukoko zimara igihe kirekire (LIN). Ariko, iri terambere ribangamiwe no kudakoresha imiti yica udukoko, impinduka mu myitwarire mu miterere ya Anopheles gambiae, ndetse n’ikwirakwizwa rya malariya risigaye, bikaba ngombwa ko hakenerwa izindi mashini. Kubwibyo, intego y’ubu bushakashatsi kwari ukureba uburyo ikoreshwa rya LLIN na Bacillus thuringiensis (Bti) hamwe no kubigereranya na LLIN.
Ubushakashatsi bwakozwe kuva muri Werurwe 2019 kugeza muri Gashyantare 2020 mu matsinda abiri y’ubushakashatsi (LLIN + Bti arm na LLIN only arm) mu karere k’ubuzima ka Korhogo mu majyaruguru ya Côte d'Ivoire. Mu itsinda rya LLIN + Bti, ahantu hatuwe n’udukoko twa Anopheles twavurwaga na Bti buri byumweru bibiri hiyongereyeho LLIN. Imibu ya larval n’iy’abantu bakuru yakusanyijwe kandi ikamenyekana mu buryo bw’imiterere yayo hakurikijwe ubwoko n’ubwoko bwayo hakoreshejwe uburyo busanzwe. Umunyamuryango Ann. Ikigo cya Gambia cyagenwe hakoreshejwe ikoranabuhanga rya polymerase chain reaction. Kwandura Plasmodium An. Nabyo byarapimwe ku cyorezo cya malariya muri Gambia no mu baturage baho.
Muri rusange, ubucucike bw'udukoko twa Anopheles spp. bwari buri hasi mu itsinda rya LLIN + Bti ugereranije n'itsinda rya LLIN ryonyine ryari 0.61 [95% CI 0.41–0.81] udukoko/kwibira (l/kwibira) 3.97 [95% CI 3.56–4 .38] l/kwibira (RR = 6.50; 95% CI 5.81–7.29 P < 0.001). Umuvuduko rusange wo kurumwa na An. Indwara yo kurumwa na S. gambiae yari 0.59 [95% CI 0.43–0.75] kuri buri muntu/ijoro mu itsinda rya LLIN + Bti ryonyine, ugereranije n'udukoko twa 2.97 [95% CI 2.02–3. 93] kuri buri muntu/ijoro mu itsinda rya LLIN ryonyine (P < 0.001). Anopheles gambiae sl izwi cyane cyane nk'umubu wa Anopheles. Anopheles gambiae (ss) (95.1%; n = 293), hagakurikiraho Anopheles gambiae (4.9%; n = 15). Igipimo cy'amaraso y'umuntu mu gace kakoreweho ubushakashatsi cyari 80.5% (n = 389). EIR y'itsinda rya LLIN + Bti yari 1.36 yanduye kuri buri muntu ku mwaka (ib/p/y), mu gihe EIR y'itsinda rya LLIN gusa yari 47.71 ib/p/y. Umubare wa malariya wagabanutse cyane uva kuri 291.8‰ (n = 765) ugera kuri 111.4‰ (n = 292) mu itsinda rya LLIN + Bti (P < 0.001).
Guhuza LLIN na Bti byagabanyije cyane ikwirakwizwa rya malariya. Guhuza LLIN na Bti bishobora kuba uburyo bwiza bwo kurwanya An neza. Igihugu cya Gambia nta malariya kirimo.
Nubwo habayeho intambwe 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 hari abantu miliyoni 249 banduye malariya n'impfu ziterwa na malariya zisaga 608.000 ku isi mu 2023 [2]. Akarere ka Afurika ka OMS gafite 95% by'abarwayi ba malariya ku isi na 96% by'impfu za malariya, aho abagore batwite n'abana bari munsi y'imyaka 5 bibasiwe cyane [2, 3].
Inzitiramibu zica udukoko (LLIN) zimara igihe kirekire hamwe no gutera imiti ikoreshwa mu nzu (IRS) byagize uruhare runini mu kugabanya umutwaro wa malariya muri Afurika [4]. Kwaguka kw'izi mashini zirwanya malariya byatumye umubare w'abandura malariya ugabanukaho 37% ndetse n'impfu zigabanukaho 60% hagati ya 2000 na 2015 [5]. Ariko, intera yagaragaye kuva mu 2015 yahagaze mu buryo buteye ubwoba cyangwa ndetse yihuta, aho impfu za malariya zikomeje kuba nyinshi ku buryo butemerwa, cyane cyane muri Afurika yo munsi y'ubutayu bwa Sahara [3]. Ubushakashatsi bwinshi bwagaragaje ko kugaragara no gukwirakwira kw'ubudahangarwa bw'imiti yica udukoko mu ndwara za malariya zikoreshwa mu buzima rusange nk'imbogamizi ku musaruro wa LLIN na IRS mu gihe kizaza [6,7,8]. Byongeye kandi, impinduka mu myitwarire yo kurumwa n'imiti hanze no mu ijoro ryakeye ni zo zitera kwandura malariya isigaye kandi ni ikibazo gikomeye [9, 10]. Imbogamizi za LLIN na IRS mu kugenzura imiti ituma malariya isigara ni imbogamizi ikomeye mu bikorwa byo kurwanya malariya ubu [11]. Byongeye kandi, kuba malariya ikomeza kubaho bisobanurwa n'imiterere y'ikirere n'ibikorwa bya muntu, bigira uruhare mu kurema aho ibihumyo biba [12].
Gucunga aho ibihumyo bituruka (LSM) ni uburyo bwo kororera mu kurwanya udukoko duto duto bugamije kugabanya umubare w’aho bikura ndetse n’umubare w’udusimba tw’imibu n’udukoko turi muri two [13]. LSM yasabwe n’ubushakashatsi bwinshi nk’ingamba ziyongera zo kurwanya malariya [14, 15]. Mu by’ukuri, gukora neza kwa LSM bitanga inyungu ebyiri ku kurumwa n’ubwoko bw’udukoko duto dutera malariya haba mu nzu no hanze [4]. Byongeye kandi, kurwanya udukoko duto dukoresheje LSM zishingiye kuri larvicide nka Bacillus thuringiensis israelensis (Bti) bishobora kwagura uburyo bwo kurwanya malariya. Mu mateka, LSM yagize uruhare runini mu kurwanya malariya muri Leta Zunze Ubumwe za Amerika, Brezili, Misiri, Alijeriya, Libiya, Maroc, Tuniziya na Zambiya [16,17,18]. Nubwo LSM yagize uruhare runini mu kurwanya udukoko duto duto mu bihugu bimwe na bimwe byakuyeho malariya, LSM ntiyigeze yinjizwa cyane muri politiki n’ibikorwa byo kurwanya malariya muri Afurika kandi ikoreshwa gusa muri gahunda zo kurwanya udukoko duto mu bihugu bimwe byo munsi y’ubutayu bwa Sahara. ibihugu [14,15,16,17,18,19]. Impamvu imwe ni ukwemera gukwirakwira ko ahantu ho kororera ari henshi cyane kandi bigoye kuhabona, bigatuma LSM ihenda cyane kuyishyira mu bikorwa [4, 5, 6, 7, 8, 9, 10, 11, 13, 14]. Kubwibyo, Umuryango Mpuzamahanga wita ku Buzima wasabye mu myaka ibarirwa muri za mirongo ko inkunga ikusanyirizwa mu kurwanya malariya igomba kwibanda kuri LLIN na IRS [20, 21]. Kugeza mu 2012 ni bwo Umuryango Mpuzamahanga wita ku Buzima watanze inama yo guhuza LSM, cyane cyane ingamba za Bti, nk'inyongera kuri LLIN na IRS mu bice bimwe na bimwe byo munsi y'ubutayu bwa Sahara [20]. Kuva OMS itanga iyi nama, ubushakashatsi bwinshi bw'igerageza bwakozwe ku buryo bworoshye, imikorere n'ikiguzi cy'imiti yica udukoko mu bihugu byo munsi y'ubutayu bwa Sahara, bigaragaza ko LSM ikora neza mu kugabanya ubucucike bw'imibu ya Anopheles n'uburyo bwo kwandura malariya mu buryo bungana na [22, 23]. . , 24].
Côte d'Ivoire iri mu bihugu 15 bifite umuvuduko munini wa malariya ku isi [25]. Ubusanzwe malariya muri Côte d'Ivoire ingana na 3.0% by'umuvuduko wa malariya ku isi, aho umubare w'abayirwaye ubarirwa hagati ya 300 na 500 ku baturage 1000 [25]. Nubwo hari igihe kirekire cy'izuba kuva mu Gushyingo kugeza muri Gicurasi, malariya ikwirakwira umwaka wose mu karere k'amajyaruguru y'igihugu [26]. Kwandura malariya muri aka karere bifitanye isano no kuba hari umubare munini w'abanduye Plasmodium falciparum badafite ibimenyetso [27]. Muri aka karere, umuvuduko wa malariya ukunze kugaragara cyane ni Anopheles gambiae (SL). Umutekano mu gace. Imibu ya Anopheles gambiae igizwe ahanini na Anopheles gambiae (SS), irwanya cyane imiti yica udukoko bityo ikaba ifite ibyago byinshi byo kwandura malariya isigaye [26]. Gukoresha LLIN bishobora kugira ingaruka nke ku kugabanya kwandura malariya bitewe no kudakoresha imiti yica udukoko mu gace bityo bikaba ari ikibazo gikomeye. Ubushakashatsi bwakozwe hakoreshejwe Bti cyangwa LLIN bwagaragaje ko bufite akamaro mu kugabanya ubucucike bw’udukoko dutera imibu mu majyaruguru ya Côte d'Ivoire. Ariko, nta bushakashatsi bwakozwe mbere bwagaragaje ingaruka zo gukoresha Bti kenshi hamwe na LLIN ku ikwirakwizwa rya malariya no ku bwiyongere bwa malariya muri aka karere. Kubwibyo, ubu bushakashatsi bwari bugamije gusuzuma ingaruka zo gukoresha LLIN na Bti hamwe ku ikwirakwizwa rya malariya hagereranyijwe itsinda rya LLIN + Bti n’itsinda rya LLIN ryonyine mu midugudu ine yo mu majyaruguru ya Côte d'Ivoire. Byari byitezwe ko gushyira mu bikorwa LSM ishingiye kuri Bti hejuru ya LLIN byakongera agaciro mu kugabanya ubucucike bw’imibu ya malariya ugereranije na LLIN yonyine. Ubu buryo buhuriweho, bugamije imibu idakuze ya Anopheles itwara Bti n’imibu ikuze ya Anopheles itwara LLIN, bushobora kuba ingenzi mu kugabanya ikwirakwizwa rya malariya mu turere twanduye malariya cyane, nko mu midugudu yo mu majyaruguru ya Côte d'Ivoire. Kubwibyo, ibyavuye muri ubu bushakashatsi bishobora gufasha gufata icyemezo cyo gushyira LSM muri gahunda z’igihugu zo kurwanya malariya (NMCPs) mu bihugu byo munsi y’ubutayu bwa Sahara.
Ubu bushakashatsi bwakorewe mu midugudu ine y’ishami rya Napieldougou (izwi kandi nka Napier) mu gace k’isuku ka Korhogo mu majyaruguru ya Côte d'Ivoire (Ishusho ya 1). Imidugudu iri kwigwaho: 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 babarirwaga mu baturage 31.000, kandi iyi ntara igizwe n’imidugudu 53 ifite ibigo nderabuzima bibiri [28]. Mu ntara ya Napyeledougou, aho malariya ari yo mpamvu ikomeye yo kujya kwa muganga, kujya mu bitaro no gupfa, LLIN yonyine ni yo ikoreshwa mu kugenzura icyorezo cya Anopheles [29]. Imidugudu yose uko ari ine mu matsinda yombi y’ubushakashatsi ikorerwamo n’ikigo nderabuzima kimwe, aho inyandiko z’ubuvuzi bw’abarwayi ba malariya zasuzumwe muri ubu bushakashatsi.
Ikarita ya Côte d'Ivoire igaragaza agace k'ubushakashatsi. (Inkomoko y'ikarita na porogaramu: Amakuru ya GADM na ArcMap 10.6.1. Urushundura rw'udukoko rwa LLIN rumara igihe kirekire, Bti Bacillus thuringiensis israelensis
Icyorezo cya malariya mu baturage bitabiriye Ikigo Nderabuzima cya Napier cyageze kuri 82.0% (abantu 2038 banduye) (amakuru yabanjirije Bti). Mu midugudu yose uko ari ine, ingo zikoresha PermaNet® 2.0 LLIN gusa, yakwirakwijwe na NMCP yo muri Ivory Coast mu 2017, aho umubare w’abayirwaye ugera kuri 80% [25, 26, 27, 28, 30]. Imidugudu iri mu karere ka Korhogo, gakorera nk'ahantu ho kugenzura Inama Nkuru ya Gisirikare ya Ivory Coast kandi ikaba igenzurwa n’abaturage umwaka wose. Buri mudugudu muri iyi ine ufite nibura ingo 100 n’abaturage bagera kuri bamwe, kandi nk'uko bigaragara mu bubiko bw’ubuzima (inyandiko y’akazi ya Minisiteri y’Ubuzima yo muri Ivory Coast), abantu benshi barwaye malariya baravugwa buri mwaka. Malariya iterwa ahanini na Plasmodium falciparum (P. falciparum) kandi yandurira abantu na Plasmodium. Gambiae kandi yandurira na Anopheles na Anopheles nili mibu muri ako karere [28]. Inzu yo mu gace An. gambiae igizwe ahanini n’imibu ya Anopheles. Gambiae ss ifite inshuro nyinshi z'impinduka za kdr (intera y'impinduka: 90.70–100%) n'inshuro iri hagati ya aleli za ace-1 (intera y'impinduka: 55.56–95%) [29].
Impuzandengo y'imvura n'ubushyuhe buri hagati ya mm 1200 na 1400 na 21 kugeza kuri 35, naho ubushyuhe (RH) bugera kuri 58%. Aka gace k’ubushakashatsi gafite ikirere nk’icya Sudani gifite igihe cy’izuba cy’amezi 6 (Ugushyingo kugeza Mata) n’igihe cy’imvura cy’amezi 6 (Gicurasi kugeza Ukwakira). Aka karere karimo guhura n’ingaruka zimwe na zimwe z’imihindagurikire y’ikirere, nko gutakaza ibimera n’igihe cy’izuba kirekire, kirangwa no kuma kw’amazi (ibibaya, imirima y’umuceri, ibidendezi, ibidendezi) bishobora kuba ahantu ho gutura inyenzi z’imibu ya Anopheles. Imibu [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. Mu gihe cy'ubu bushakashatsi, abantu bo muri iyo midugudu yose bakoreshaga PermaNet® 2.0 LLIN gusa.
Ubuhanga bwa LLIN (PermaNet 2.0) hamwe na Bti mu kurwanya imibu ya Anopheles n'ikwirakwizwa rya malariya bwasuzumwe mu igerageza ryakozwe ku buryo butaziguye (RCT) hakoreshejwe ibice bibiri by'ubushakashatsi: itsinda rya LLIN + Bti (itsinda rivura) n'itsinda rya LLIN ryonyine (itsinda rigenzura). Amaboko ya LLIN + Bti ahagarariwe na Kakologo na Nambatiourkaha, mu gihe Kolékaha na Lofinékaha byakozwe nk'ibitugu bya LLIN gusa. Mu midugudu yose uko ari ine, abaturage bo muri ako gace bakoresha LLIN PermaNet® 2.0 yakiriwe na NMCP yo muri Ivory Coast mu 2017. Bikekwa ko uburyo bwo gukoresha PermaNet® 2.0 ari bumwe mu midugudu itandukanye kuko yakiriye umuyoboro mu buryo bumwe. Mu itsinda rya LLIN + Bti, ahantu hatuwe n'udukoko twa Anopheles twavurwaga na Bti buri byumweru bibiri hiyongereyeho LLIN yamaze gukoreshwa n'abaturage. Ahantu hatuwe n'ibinyabutabire mu midugudu no mu ntera ya kilometero 2 uvuye hagati muri buri mudugudu havuwe hakurikijwe inama z'Umuryango Mpuzamahanga wita ku Buzima na NMCP yo muri Côte d'Ivoire [31]. Mu buryo bunyuranye, itsinda rya LLIN ryonyine ntiryahawe ubuvuzi bwa Bti butera ibinyabutabire mu gihe cy'ubushakashatsi.
Ubwoko bwa Bti bushobora gutatanywa n'amazi (Vectobac WG, 37.4% wt; umubare w'ibice 88–916-PG; 3000 International Toxicity Units IU/mg; Valent BioScience Corp, USA) bwakoreshejwe ku gipimo cya 0.5 mg/L. . Koresha sprayer ya litiro 16 n'imbunda ya fiberglass spray imbunda ifite umugozi n'umunwa ushobora guhindurwa hamwe n'umuvuduko w'amazi wa mililitiro 52 ku isegonda (3.1 L/min). Kugira ngo utegure nebulizer irimo litiro 10 z'amazi, ingano ya Bti ivangwa mu cyuma ni 0.5 mg/L × 10 L = 5 mg. Urugero, ku gace gafite amazi ya litiro 10, hakoreshejwe sprayer ya litiro 10 kugira ngo ivure ingano y'amazi, ingano ya Bti igomba gukurwamo ni 0.5 mg/L × 20 L = 10 mg. 10 mg Bti yapimwe mu murima hakoreshejwe igipimo cy'ikoranabuhanga. Ukoresheje spatula, tegura ururenda uvanga iyi Bti mu ndobo ya litiro 10. Iyi dose yatoranijwe nyuma y'igerageza ry'ikoreshwa rya Bti mu miterere itandukanye ya Anopheles spp. na Culex spp. mu miterere karemano mu gace gatandukanye, ariko gasa n'agace k'ubushakashatsi bwa none [32]. Igipimo cyo gukoresha larvicide suspension n'igihe cyo kuyikoresha kuri buri hantu ho kororera cyabazwe hashingiwe ku ngano y'amazi yagereranyijwe aho kororera [33]. Shyira Bti ukoresheje icyuma gipima intoki. Nebulizers zirapimwa kandi zikageragezwa mu myitozo ya buri muntu no mu duce dutandukanye kugira ngo harebwe ko Bti itangwa neza.
Kugira ngo haboneke igihe cyiza cyo kuvura ahantu ho kororera ibinyabihu, itsinda ryagaragaje uburyo bwo gutera imiti mu madirishya. Idirishya ryo gutera imiti ni igihe gikoreshwa kugira ngo haboneke umusaruro mwiza: muri ubu bushakashatsi, idirishya ryo gutera imiti ryari hagati y'amasaha 12 n'ibyumweru 2, bitewe n'uko Bti ikomeza. Uko bigaragara, gufata Bti n'ibinyabihu aho byororokera bisaba igihe kuva saa moya kugeza saa kumi n'ebyiri z'umugoroba. Muri ubu buryo, ibihe by'imvura nyinshi bishobora kwirindwa iyo imvura ivuze guhagarika gutera imiti no kongera gutangira umunsi ukurikiyeho niba ikirere gihuye. Amatariki yo gutera imiti n'amatariki n'amasaha nyayo biterwa n'ikirere cyagaragaye. Kugira ngo hamenyekane uburyo bwo gutera imiti mu mufuka kugira ngo hamenyekane igipimo cyifuzwa cyo gutera imiti mu maguru, buri mutekinisiye ahugurwa kugenzura no gushyiraho umunwa w'imashini yo gutera imiti no gukomeza umuvuduko. Gupima birangira hagenzurwa ko ingano nyayo y'imiti ya Bti ikoreshwa ku rugero rumwe kuri buri gice cy'ubutaka. Kuvura aho ibinyabihu biba buri byumweru bibiri. Ibikorwa byo kwica imiti bikorwa ku nkunga y'inzobere enye zifite uburambe kandi zahuguwe neza. Ibikorwa byo kwica imiti n'abitabiriye bagenzurwa n'abagenzuzi b'inararibonye. Uburyo bwo kuvura indwara zo mu bwoko bwa larvicidal bwatangiye muri Werurwe 2019 mu gihe cy'izuba. Mu by'ukuri, ubushakashatsi bwakozwe mbere bwagaragaje ko igihe cy'izuba ari cyo gihe cyiza cyo kuvura indwara zo mu bwoko bwa larvicidal bitewe n'uko ahantu hororokera haguma hameze neza ndetse no kugabanuka k'ubwinshi bwazo [27]. Gusuzuma inziba mu gihe cy'izuba byitezwe ko birinda gukurura imibu mu gihe cy'izuba. Ibiro bibiri (02) bya Bti bigura $99.29 by'Amerika bituma itsinda ryiga rihabwa ubuvuzi rikwirakwira ahantu hose. Mu itsinda rya LLIN+Bti, uburyo bwo kuvura indwara zo mu bwoko bwa larvicidal bwamaze umwaka wose, kuva muri Werurwe 2019 kugeza muri Gashyantare 2020. Abantu 22 bose hamwe bavuwe indwara zo mu bwoko bwa larvicidal mu itsinda rya LLIN+Bti.
Ingaruka mbi zishobora kubaho (nk'ubushye, isereri cyangwa izuru riva) zagenzuwe binyuze mu bushakashatsi bwakorewe ku giti cyazo ku miti igabanya ubukana bwa Bti n'abaturage bo mu ngo bitabiriye itsinda rya LIN + Bti.
Ubushakashatsi ku ngo bwakozwe mu ngo 400 (ingo 200 kuri buri tsinda ry’ubushakashatsi) kugira ngo hamenyekane ijanisha ry’ikoreshwa rya LLIN mu baturage. Mu gupima ingo, hakoreshwa uburyo bwo gupima ibibazo. Uburyo ikoreshwa rya LLIN ryagabanijwemo amatsinda atatu y’imyaka: imyaka 15. Ikibazo cyuzuye kandi gisobanurwa mu rurimi rwa Senoufo ku mukuru w’urugo cyangwa undi muntu mukuru urengeje imyaka 18.
Ingano nto y'urugo rwakoreweho ubushakashatsi yabazwe hakoreshejwe formula yasobanuwe na Vaughan na Morrow [34].
n ni ingano y'icyitegererezo, e ni intera y'ikosa, t ni ikintu cy'umutekano gikomoka ku rwego rw'icyizere, naho p ni igipimo cy'ababyeyi b'abaturage bafite ikirango cyatanzwe. Buri gice cy'igice gifite agaciro gahoraho, bityo (t) = 1.96; Ingano nto y'urugo muri iki gihe mu bushakashatsi yari ingo 384.
Mbere y'igerageza ririho ubu, ubwoko butandukanye bw'aho imbu za Anopheles ziba mu matsinda ya LLIN+Bti na LLIN zarabonetse, zigapimwa, zigasobanurwa, zigashyirwamo ibirango. Koresha kaseti yo gupima ingano y'aho imbu zariraga. Ubucucike bw'imbu zarapimwe buri kwezi mu gihe cy'amezi 12 ahantu 30 hatoranijwe mu buryo butunguranye kororokera kuri buri mudugudu, ku hantu hose hororokera 60 kuri buri itsinda ry'ubushakashatsi. Hari ingero 12 z'imbu zapimwe kuri buri gace k'ubushakashatsi, bihuye n'ubuvuzi 22 bwa Bti. Intego yo guhitamo ahantu 30 hororokera kuri buri mudugudu kwari ugufata ahantu hahagije ho gukusanya imbu mu midugudu no mu bice by'ubushakashatsi kugira ngo bigabanye ubwiyongere. Imbu zakusanyijwe hifashishijwe ikiyiko cya mililitiro 60 [35]. Kubera ko hari ahantu ho kororera ari hato cyane kandi hato, ni ngombwa gukoresha indobo nto itari indobo isanzwe ya OMS (mililitiro 350). Hakozwe ahantu hororokera 5, 10 cyangwa 20 hakozwe ahantu hororokera ingano ya metero 10, uko bikurikirana. Gutahura ingirangingo zakusanyijwe (urugero: Anopheles, Culex na Aedes) byakozwe mu murima [36]. Ingirangingo zakusanyijwe zagabanijwemo ibice bibiri hashingiwe ku cyiciro cy'imikurire: ingirangingo za mbere z'imikurire (icyiciro cya 1 n'icya 2) n'ingirangingo za nyuma z'imikurire (icyiciro cya 3 n'icya 4) [37]. Ingirangingo zabazwe hakurikijwe ubwoko no kuri buri cyiciro cy'imikurire. Nyuma yo kubara, ingirangingo z'imibu zoherezwa aho zororokera hanyuma zikongera ku rugero rwazo rw'umwimerere hamwe n'amazi y'imvura.
Ahantu ho kororokera hafatwaga nk'aho hari nibura inkeri imwe cyangwa pupa imwe y'ubwoko ubwo aribwo bwose bw'imibu. Ubucucike bw'inkeri bwagenwaga hagabanywa umubare w'inkeri zo mu bwoko bumwe n'umubare w'inkeri zo mu bwoko bumwe.
Buri bushakashatsi bwamaze iminsi ibiri yikurikiranya, kandi buri mezi abiri, imibu ikuze yatoranywaga mu ngo 10 zatoranywaga mu buryo butunguranye muri buri mudugudu. Mu bushakashatsi bwose, buri tsinda ry’ubushakashatsi ryakoze ubushakashatsi ku ngo 20 mu minsi itatu yikurikiranya. Imibu yafashwe hakoreshejwe imitego isanzwe yo mu madirishya (WT) n’imitego yo gutera pyrethrum (PSC) [38, 39]. Mbere na mbere, amazu yose muri buri mudugudu yari afite imibare. Hanyuma amazu ane muri buri mudugudu yatoranywaga mu buryo butunguranye nk’ahantu ho gukusanyiriza imibu ikuze. Muri buri nzu yatoranijwe mu buryo butunguranye, imibu yatoranywaga mu cyumba kinini cyo kuraramo. Ibyumba byatoranijwe bifite inzugi n’amadirishya kandi byarimo abantu ijoro ryabanjirije iryo. Ibyumba biguma bifunze mbere yo gutangira akazi no mu gihe cyo gukusanya imibu kugira ngo hirindwe ko imibu isohoka mu cyumba. WT yashyizwe muri buri dirishya rya buri cyumba nk’ahantu ho gufatira imibu. Umunsi ukurikiyeho, imibu yinjiraga aho bakorera iturutse mu byumba yatoranijwe hagati ya saa kumi n’ebyiri na saa mbiri za mu gitondo. Kuramo imibu aho ukorera ukoresheje agakoresho ko ku munwa hanyuma uyibike mu gikombe cy’impapuro gitwikiriwe n’igice kibisi. Urushundura rw’imibu. Imibu iruhukiye mu cyumba kimwe yafashwe ako kanya nyuma yo gukusanya WT hakoreshejwe PSC ishingiye kuri pyrethroid. Nyuma yo gusiga amashuka yera hasi mu cyumba cyo kuraramo, funga inzugi n'amadirishya hanyuma utere umuti wica udukoko (ibintu bikora: 0.25% transfluthrin + 0.20% permethrin). Hafi iminota 10 kugeza kuri 15 nyuma yo gutera umuti, kura igitambaro cyo ku buriri mu cyumba cyo kuraramo cyavuwe, koresha udupira two gufata imibu yose yaguye ku mashuka yera, hanyuma uyibike mu isahani ya Petri yuzuyemo ubwoya bw'ipamba butwikiriwe n'amazi. Umubare w'abantu baraye mu byumba byatoranijwe nawo waranditswe. Imibu yakusanyijwe yimurirwa vuba muri laboratwari yo mu kigo kugira ngo ikomeze gutunganywa.
Muri laboratwari, imibu yose yakusanyijwe yamenyekanye mu buryo bw’imiterere yayo hakurikijwe ubwoko n’ubwoko bwayo [36]. Intanga za Anna. gambiae SL hakoreshejwe mikorosikopi yo gukata darubini hamwe n’igitonyanga cy’amazi yaciwe gishyirwa ku kirahuri [35]. Imiterere y’uburinganire yapimwe kugira ngo hatandukanye abagore babyara benshi n’abagore bavutse mbere hashingiwe ku miterere y’intanga n’imitsi yo mu nda, ndetse no kumenya igipimo cy’uburumbuke n’imyaka y’umubiri [35].
Igipimo cy’uko amaraso yakuwe mu maraso gipimwa hakoreshejwe uburyo bwa enzyme-linked immunosorbent assay (ELISA) hakoreshejwe amaraso y’abantu, amatungo (inka, intama, ihene) n’inkoko zicumbikiye [40]. Ubwandu bw’udukoko (EIR) bwabazwe hakoreshejwe uburyo bwa An. Igereranya ry’abagore barwaye indwara ya SL muri Gambia [41] Byongeye kandi, An. Kwandura Plasmodium gambiae byagaragajwe hakoreshejwe uburyo bwa circumsporozoite antigen ELISA (CSP ELISA) [40]. Hanyuma, hari abanyamuryango ba Ann. gambiae bagaragajwe hakoreshejwe uburyo bwa polymerase chain reaction (PCR) [34].
Amakuru y’ubuvuzi kuri malariya yavuye mu bubiko bw’isuzumabumenyi bw’ikigo nderabuzima cya Napyeledugou, gikubiyemo imidugudu ine yose iri muri ubu bushakashatsi (ni ukuvuga Kakologo, Kolekaha, Lofinekaha na Nambatiurkaha). Isuzuma ry’ubwanditsi 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 amakuru y’ibanze cyangwa mbere yo gutera Bti, mu gihe amakuru y’ubuvuzi kuva muri Werurwe 2019 kugeza Gashyantare 2020 agaragaza amakuru y’ibanze mbere yo gutera Bti. Amakuru nyuma yo gutera Bti. Amakuru y’ubuvuzi, imyaka n’umudugudu bya buri murwayi mu matsinda y’ubushakashatsi ya LLIN+Bti na LLIN yakusanyijwe mu bubiko bw’ubuzima. Kuri buri murwayi, amakuru nk’inkomoko y’umudugudu, imyaka, isuzumabumenyi, n’indwara yabyo yanditswe. Mu manza zasuzumwe muri ubu bushakashatsi, malariya yemejwe hakoreshejwe ikizamini cyihuse cyo gusuzuma indwara (RDT) cyangwa microscopy ya malariya nyuma yo guhabwa umuti uvanze wa artemisinin (ACT) n’umuganga. Abanduye malariya bagabanyijwemo ibyiciro bitatu by'imyaka (ni ukuvuga imyaka 15). Umubare w'abandura malariya buri mwaka ku baturage 1000 wagenwe hagabanywa umubare w'abanduye malariya ku baturage 1000 ukurikije abaturage bo mu mudugudu.
Amakuru yakusanyijwe muri ubu bushakashatsi yashyizwe mu bubiko bwa Microsoft Excel hanyuma yinjizwa muri porogaramu ya R [42] verisiyo ya 3.6.3 ifunguye kugira ngo hakoreshwe isesengura ry’ibarurishamibare. Pake ya ggplot2 ikoreshwa mu gushushanya ibishushanyo. Imiterere rusange ikoresha Poisson regression yakoreshejwe mu kugereranya ubucucike bw’udukoko n’umubare w’udukoko twarumwe n’imibu kuri buri muntu mu ijoro hagati y’amatsinda y’ubushakashatsi. Ibipimo by’ikigereranyo (RR) byakoreshejwe mu kugereranya ubucucike bw’udukoko n’umubare w’udukoko twarumwe n’imibu ya Culex na Anopheles. Gambia SL yashyizwe hagati y’amatsinda abiri y’ubushakashatsi hakoreshejwe itsinda rya LLIN + Bti nk’ishingiro. Ingano z’ingaruka zagaragajwe nk’ibipimo by’amahirwe n’intera z’icyizere cya 95% (95% CI). Igipimo (RR) cy’ikizamini cya Poisson cyakoreshejwe mu kugereranya ibipimo n’umubare w’ubwiyongere bwa malariya mbere na nyuma y’uburyo Bti ifatwa muri buri tsinda ry’ubushakashatsi. Urwego rw’uburemere rwakoreshejwe rwari 5%.
Iyi gahunda y’ubushakashatsi yemejwe na Komite y’Igihugu ishinzwe Imyitwarire mu Bushakashatsi ya Minisiteri y’Ubuzima n’Ubuzima Rusange ya Côte d'Ivoire (N/Ref: 001//MSHP/CNESVS-kp), ndetse n’akarere k’ubuzima n’ubuyobozi bwa Korhogo. Mbere yo gutoragura imbu n’abantu bakuru, hashyizweho umukono ku burenganzira bw’abakoreweho ubushakashatsi mu ngo, ba nyir’inzu, n’abayituyemo. Amakuru y’umuryango n’ay’ubuvuzi ni ibanga kandi aboneka gusa ku bashinzwe iperereza bagenwe.
Ahantu hose ho kwibamo ibiraro hasuwe 1198. Muri ibi bice byasuzumwe mu gace k’ubushakashatsi, 52.5% (n = 629) byari ibyo mu itsinda rya LLIN + Bti naho 47.5% (n = 569) byari ibyo mu itsinda rya LLIN gusa (RR = 1.10 [95% CI 0 .98–1.24], P = 0.088). Muri rusange, aho ibimera byo mu gace byashyizwe mu moko 12, muri yo igice kinini cy’aho ibimera byo mu gace byari imirima y’umuceri (24.5%, n = 294), hagakurikiraho amazi y’inkubi y’umuyaga (21.0%, n = 252) n’ibumba (8.3). %, n = 99), inkombe y'uruzi (8.2%, n = 100), ikidendezi (7.2%, n = 86), ikidendezi (7.0%, n = 84), pompe y'amazi yo mu mudugudu (6.8%, n = 81), Ibishushanyo by'ibinono (4.8%, n = 58), ibishanga (4.0%, n = 48), imiyoboro (5.2%, n = 62), ibidendezi (1.9%, n = 23) n'amariba (0.9%, n = 11).
Muri rusange, imbuyu z'imibu 47.274 zakusanyijwe mu gace kakoreweho ubushakashatsi, aho igipimo cya 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 mbuyu zigizwe n'ubwoko butatu bw'imibu, ubwoko bwiganjemo ni Anopheles. (48.7%, n = 23.041), hagakurikiraho Culex spp. (35.0%, n = 16.562) na Aedes spp. (4.9%, n = 2340). Pupae zigizwe na 11.3% by'isazi zitarakura (n = 5344).
Ubucucike rusange bw'inkoko za Anopheles spp.. Muri ubu bushakashatsi, umubare w'inkoko kuri buri gikombe wari 0.61 [95% CI 0.41–0.81] L/kwinjira mu itsinda rya LLIN + Bti na 3.97 [95% CI 3.56–4.38] L /kwinjira mu itsinda rya LLIN gusa (ni ngombwa). dosiye ya 1: Ishusho S1). Ubucucike bw'inkoko za Anopheles spp. Itsinda rya LLIN ryonyine ryari hejuru inshuro 6.5 ugereranije n'itsinda rya LLIN + Bti (HR = 6.49; 95% CI 5.80–7.27; P < 0.001). Nta mibu ya Anopheles yabonetse mu gihe cyo kuvurwa. Inkoko zakusanyijwe mu itsinda rya LLIN + Bti guhera muri Mutarama, bihuye n'ubuvuzi bwa makumyabiri bwa Bti. Mu itsinda rya LLIN + Bti, habayeho kugabanuka gukomeye k'ubucucike bw'inkoko mu ntangiriro no mu mpera z'ikiciro.
Mbere y'uko imiti ya Bti itangira (Werurwe), impuzandengo y'ubucucike bw'imibu ya Anopheles ya mbere yagaragaye ko yari 1.28 [95% CI 0.22–2.35] L/kwibira mu itsinda rya LLIN + Bti na 1.37 [95% CI 0.36–2.36] l/kwibira mu itsinda rya LLIN + Bti. l/kwibira. /kwibira gusa ukuboko kwa LLIN (Ishusho ya 2A). Nyuma yo gukoresha imiti ya Bti, impuzandengo y'ubucucike bw'imibu ya Anopheles ya mbere mu itsinda rya LLIN + Bti muri rusange yagabanutse buhoro buhoro kuva kuri 0.90 [95% CI 0.19–1.61] kugera kuri 0.10 [95% CI – 0.03–0.18] l/kwibira. Ubucucike bw'imibu ya Anopheles ya mbere ya mbere bwakomeje kuba buke mu itsinda rya LLIN + Bti. Mu itsinda rya LLIN gusa, ihindagurika ry'ubwinshi bwa Anopheles spp. Imbuto zo mu ntangiriro zagaragaye zifite ubucucike buri hagati ya 0.23 [95% CI 0.07–0.54] L/kwibira kugeza kuri 2.37 [95% CI 1.77–2.98] L/kwibira. Muri rusange, ubucucike bw’imbuto zo mu ntangiriro za Anopheles mu itsinda rya LLIN gusa bwari hejuru kuri 1.90 [95% CI 1.70–2.10] L/kwibira, mu gihe ubucucike bw’imbuto zo mu ntangiriro za Anopheles mu itsinda rya LLIN bwari 0.38 [95% CI 0.28–0.47]) l/kwibira. + itsinda rya Bti (RR = 5.04; 95% CI 4.36–5.85; P < 0.001).
Impinduka mu bucucike bw'udusimba twa Anopheles. Inzitiramibu zo mu ntangiriro (A) n'izo mu mpera (B) mu itsinda ry'ubushakashatsi kuva muri Werurwe 2019 kugeza muri Gashyantare 2020 mu karere ka Napier, mu majyaruguru ya Côte d'Ivoire. LLIN: urushundura rumara igihe kirekire Bti: Bacillus thuringiensis, Isirayeli TRT: uburyo bwo kuvura;
Impuzandengo y'ubucucike bw'uturemangingo twa Anopheles spp. mu myaka ya nyuma mu itsinda rya LLIN + Bti. Ubucucike bwa Bti mbere yo kuvurwa bwari 2.98 [95% CI 0.26–5.60] L/kwinjira, mu gihe ubucucike mu itsinda rya LLIN ryonyine bwari 1.46 [95% CI 0.26–2.65] l/umunsi Nyuma yo gukoresha Bti, ubucucike bw'uturemangingo twa Anopheles twa nyuma mu itsinda rya LLIN + Bti bwagabanutse kuva kuri 0.22 [95% CI 0.04–0.40] bugera kuri 0.03 [95% CI 0.00–0.06] L/kwinjira (Ishusho ya 2B). Mu itsinda rya LLIN gusa, ubucucike bw'udusimba twa Anopheles twa nyuma bwiyongereye kuva kuri 0.35 [95% CI - 0.15-0.76] kugera kuri 2.77 [95% CI 1.13-4.40] l/kwibira hamwe n'impinduka zimwe na zimwe mu bucucike bw'udusimba bitewe n'itariki yo gufatiraho ingero. Ubucucike bw'udusimba twa Anopheles twa nyuma mu itsinda rya LLIN gusa bwari 2.07 [95% CI 1.84–2.29] L/kwibira, inshuro icyenda zirenze 0.23 [95% CI 0.11–0. 36] l/kwibira muri LLIN. + itsinda rya Bti (RR = 8.80; 95% CI 7.40–10.57; P < 0.001).
Impuzandengo y'ubucucike bwa Culex spp. Ingano yari 0.33 [95% CI 0.21–0.45] L/dip mu itsinda rya LLIN + Bti na 2.67 [95% CI 2.23–3.10] L/dip mu itsinda rya LLIN gusa (idosiye y'inyongera ya 2: Ishusho S2). Impuzandengo y'ubucucike bwa Culex spp. Itsinda rya LLIN ryonyine ryari hejuru cyane ugereranije n'itsinda rya LLIN + Bti (HR = 8.00; 95% CI 6.90–9.34; P < 0.001).
Impuzandengo y'ubucucike bw'ubwoko bwa Culex Culex spp. Mbere yo kuvurwa, Bti l/dip yari 1.26 [95% CI 0.10–2.42] l/dip mu itsinda rya LLIN + Bti na 1.28 [95% CI 0.37–2.36] mu itsinda rimwe rukumbi rya LLIN (Ishusho ya 3A). Nyuma yo gukoresha uburyo bwo kuvura Bti, ubucucike bw'udusimba twa Culex twa mbere bwagabanutse kuva kuri 0.07 [95% CI - 0.001–0.] kugera kuri 0.25 [95% CI 0.006–0.51] L/dip. Nta dusimba twa Culex twakusanyijwe mu dusimba twavuwe na Bti guhera mu Kuboza. Ubucucike bw'udusimba twa Culex twa mbere bwagabanutse bugera kuri 0.21 [95% CI 0.14–0.28] L/kwinjira mu itsinda rya LLIN + Bti, ariko bwari bwinshi mu itsinda rya LLIN gusa kuri 1.30 [95% CI 1.10– 1.50] l/kwinjira. 1/d. Ubucucike bw'udusimba twa Culex twa mbere mu itsinda rya LLIN gusa bwari hejuru inshuro 6 ugereranyije n'itsinda rya LLIN + Bti (RR = 6.17; 95% CI 5.11–7.52; P < 0.001).
Impinduka mu bucucike bw'udukoko twa Culex spp.. Igerageza ry'ubuzima bwa mbere (A) n'ubuzima bwa mbere (B) mu itsinda ry'ubushakashatsi kuva muri Werurwe 2019 kugeza Gashyantare 2020 mu karere ka Napier, mu majyaruguru ya Côte d'Ivoire. Urushundura rw'udukoko rumara igihe kirekire LLIN, Bti Bacillus thuringiensis Isirayeli, uburyo bwo kuvura Trt
Mbere yo kuvurwa na Bti, impuzandengo y’ubucucike bw’utunyangingo twa Culex two mu itsinda rya LLIN + Bti n’itsinda rya LLIN yari 0.97 [95% CI 0.09–1.85] na 1.60 [95% CI – 0.16–3.37] l/kwinjira mu mazi hakurikijwe uko bikwiye (Ishusho ya 3B)). Ubucucike bw’ubwoko bwa Culex bwo mu bwoko ... Ubucucike bw'ibihumyo bya Culex bya nyuma bwari hejuru cyane mu itsinda rya LLIN gusa ugereranyije n'itsinda rya LLIN + Bti (RR = 11.19; 95% CI 8.83–14.43; P < 0.001).
Mbere yo kuvurwa na Bti, impuzandengo y'ubucucike bw'udukoko kuri buri nyoni yari 0.59 [95% CI 0.24–0.94] mu itsinda rya LLIN + Bti na 0.38 [95% CI 0.13–0.63] mu itsinda rya LLIN gusa (Ishusho ya 4). Ubucucike bw'udukoko muri rusange 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 gusa. Kuvurwa na Bti byagabanyije cyane ubucucike bw'udukoko muri itsinda rya LLIN + Bti ugereranije n'itsinda rya LLIN ryonyine (OR = 8.30; 95% CI 6.37–11.02; P < 0.001). Mu itsinda rya LLIN + Bti, nta tukoko twakusanyijwe nyuma y'Ugushyingo.
Impinduka mu bucucike bw'udukoko tw'inkoko. Ubushakashatsi bwakozwe kuva muri Werurwe 2019 kugeza muri Gashyantare 2020 mu karere ka Napier mu majyaruguru ya Côte d'Ivoire. Urushundura rw'udukoko rumara igihe kirekire LLIN, Bti Bacillus thuringiensis Isirayeli, uburyo bwo kuvura indwara ya Trt
Imibu ikuze 3456 yakusanyijwe mu gace kakoreweho ubushakashatsi. Imibu iri mu moko 17 y’ubwoko 5 (Anopheles, Culex, Aedes, Eretmapodites) (Imbonerahamwe ya 1). Mu mikorobe ya malariya, An. gambiae sl ni yo yari iboneka cyane ifite igipimo cya 74.9% (n = 2587), ikurikirwa na An. gambiae sl. funestus (2.5%, n = 86) na An null (0.7%, n = 24). Ubukire bwa Anna. gambiae sl mu itsinda rya LLIN + Bti (10.9%, n = 375) bwari hasi ugereranyije n’itsinda rya LLIN ryonyine (64%, n = 2212). Nta mahoro. Imibu yashyizwe mu itsinda rya LLIN gusa. Ariko, An. gambiae na An. funestus byari mu itsinda rya LLIN + Bti ndetse n’itsinda rya LLIN ryonyine.
Mu bushakashatsi bwatangiye mbere yo gukoresha Bti aho itera imbere (amezi 3), impuzandengo rusange y'imibu ya nijoro kuri buri muntu (b/p/n) mu itsinda rya LLIN + Bti yagereranyijwe kuba 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 ya 5). Mu itsinda rya LLIN + Bti, ibyangiritse ku mubu wa Culex byaragabanutse bikomeza kuba bike nubwo byari hejuru ya 1.95 [95% CI 1.35–2.54] bpp muri Nzeri nyuma yo gukoresha Bti ku nshuro ya 12. Ariko, mu itsinda rya LLIN gusa, impuzandengo y'urumogi rwiyongereye buhoro buhoro mbere yuko rugera ku rwego rwo hejuru muri Nzeri kuri 11.33 [95% CI 7.15–15.50] bp/n. Muri rusange umubare w’abantu barumwe n’imibu wari muto cyane mu itsinda rya LLIN + Bti ugereranije n’itsinda rya LLIN ryonyine igihe icyo ari cyo cyose mu bushakashatsi (HR = 3.66; 95% CI 3.01–4.49; P < 0.001).
Igipimo cy'imibu iruma mu gace k'ubushakashatsi mu karere ka Napier mu majyaruguru ya Côte d'Ivoire kuva muri Werurwe 2019 kugeza Gashyantare 2020 LLIN Urushundura rumara igihe kirekire rwica udukoko, Bti Bacillus thuringiensis Isirayeli, Uburyo bwo kuvura, kurumwa n'udukoko mu ijoro/abantu/ijoro
Anopheles gambiae ni yo ndwara ikunze kugaragara cyane mu gace k’ubushakashatsi. Umuvuduko wo kuruma wa An. Mu ntangiriro, abagore bo muri Gambia bari bafite ibipimo bya b/p/n bya 0.64 [95% CI 0.27–1.00] mu itsinda rya LLIN + Bti na 0.74 [95% CI 0.30–1.17] mu itsinda rya LLIN gusa (Ishusho ya 6). Mu gihe cyo gutera umuti wa Bti, igikorwa cyo kuruma kinini cyagaragaye muri Nzeri, gihuye n’icyiciro cya cumi na kabiri cy’ubuvuzi bwa Bti, aho hagaragaye 1.46 [95% CI 0.87–2.05] b/p/n mu itsinda rya LLIN + Bti n’igipimo cya 9 .65 [95% CI 0.87–2.05] w/n 5.23–14.07] LLIN gusa. Umuvuduko rusange wo kuruma wa An. Igipimo cy'ubwandu muri Gambia cyari gito cyane mu itsinda rya LLIN + Bti (0.59 [95% CI 0.43–0.75] b/p/n) ugereranyije n'itsinda rya LLIN ryonyine (2.97 [95% CI 2, 02–3.93] b/p/no). (RR = 3.66; 95% CI 3.01–4.49; P < 0.001).
Umuvuduko w'urumo rwa Anna. gambiae sl, ishami ry'ubushakashatsi mu karere ka Napier, mu majyaruguru ya Cote d'Ivoire, kuva muri Werurwe 2019 kugeza Gashyantare 2020 Urusobe rw'imiti rumara igihe kirekire ruvurwa n'udukoko rwa LLIN, Bti Bacillus thuringiensis Isirayeli, Uburyo bwo kuvura indwara ya Trt, kurumwa n'inkoko nijoro/ umuntu/ijoro
Amasasu 646 yose hamwe. Gambiya yaraciwemo ibice. Muri rusange, igipimo cy’umutekano wo mu gace. Igipimo cy’ubusumbane muri Gambiya muri rusange cyari >70% mu gihe cyose cy’ubushakashatsi, usibye Nyakanga, ubwo itsinda rya LLIN ryakoreshejwe gusa (Inyandiko y’inyongera ya 3: Ishusho S3). Ariko, igipimo cy’uburumbuke mu gace k’ubushakashatsi cyari 74.5% (n = 481). Mu itsinda rya LLIN + Bti, igipimo cy’ubusumbane cyagumye ku rwego rwo hejuru, hejuru ya 80%, usibye muri Nzeri, ubwo igipimo cy’ubusumbane cyagabanutse kigera kuri 77.5%. Ariko, itandukaniro mu gipimo cy’uburumbuke cyagaragaye mu itsinda rya LLIN gusa, aho igipimo cy’uburumbuke kiri hasi cyane cyagereranyijwe kikaba 64.5%.
Kuva kuri 389 Ann. Inyigo yakozwe ku maraso ku giti cyayo yo muri Gambia yasanze 80.5% (n = 313) ari iy'abantu, 6.2% (n = 24) by'abagore bariye amaraso avanze (y'abantu n'ayo mu rugo) na 5.1% (n = 20) bariye amaraso. Ibiryo by'amatungo (inka, intama n'ihene) na 8.2% (n = 32) by'ibipimo byasesenguwe byari bibi ku ifunguro ry'amaraso. Mu itsinda rya LLIN + Bti, umubare w'abagore bahawe amaraso y'abantu wari 25.7% (n = 100) ugereranije na 54.8% (n = 213) mu itsinda rya LLIN gusa (Inyandiko y'inyongera ya 5: Imbonerahamwe S5).
Amperes 308. P. gambiae yapimwe kugira ngo hamenyekane amoko y’ubwoko n’ubwandu bwa P. falciparum (Inyandiko y’inyongera ya 4: Imbonerahamwe S4). Hari "amoko abiri afitanye isano" mu gace k’ubushakashatsi, ari yo An. gambiae ss (95.1%, n = 293) na An. coluzzii (4.9%, n = 15). Anopheles gambiae ss yari hasi cyane mu itsinda rya LLIN + Bti ugereranyije n’itsinda rya LLIN ryonyine (66.2%, n = 204) (RR = 2.29 [95% CI 1.78–2.97], P < 0.001). Igice kimwe cy’imibu ya Anopheles cyabonetse mu itsinda rya LLIN + Bti (3.6%, n = 11) n’itsinda rya LLIN gusa (1.3%, n = 4) (RR = 2.75 [95% CI 0.81–11 .84], P = .118). Ubwiyongere bw’ubwandu bwa Plasmodium falciparum muri An. SL muri Gambia bwari 11.4% (n = 35). Igipimo cy’ubwandu bwa Plasmodium falciparum. Igipimo cy’ubwandu muri Gambia cyari gito cyane mu itsinda rya LLIN + Bti (2.9%, n = 9) ugereranyije n’itsinda rya LLIN ryonyine (8.4%, n = 26) (RR = 2.89 [95% CI 1. 31–7.01], P = 0.006).). Ugereranije n'imibu ya Anopheles, imibu ya Anopheles gambiae yari ifite igipimo kinini cy'ubwandu bwa Plasmodium ku kigero cya 94.3% (n=32). Coluzzii ni 5.7% gusa (n= 5) (RR = 6.4 [95% CI 2.47–21.04], P < 0.001).
Abantu 2.435 baturutse mu ngo 400 bakoreweho ubushakashatsi. Impuzandengo y'ubucucike ni abantu 6.1 kuri buri rugo. Igipimo cy'umutungo wa LLIN mu ngo cyari 85% (n = 340), ugereranije na 15% (n = 60) ku ngo zidafite LLIN (RR = 5.67 [95% CI 4.29–7.59], P < 0.001) (Idosiye y'inyongera ya 5: Imbonerahamwe S5). . Imikoreshereze ya LLIN yari 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). Igipimo rusange cy'imikoreshereze rusange mu gace k'ubushakashatsi cyari 38.4% (n = 1842). Igipimo cy'abana bari munsi y'imyaka itanu bakoresha interineti cyari kimwe mu matsinda yombi y'ubushakashatsi, aho igipimo cy'ikoreshwa ryacyo cyari 41.2% (n = 195) mu itsinda rya LLIN + Bti na 43.2% (n = 186) mu itsinda rya LLIN gusa. (HR = 1.05 [95% CI 0.85–1.29], P = 0.682). Mu bana bari hagati y'imyaka 5 na 15, nta tandukaniro ryagaragaye mu gipimo cy'ikoreshwa ryacyo hagati ya 36.3% (n = 250) mu itsinda rya LLIN + Bti na 36.9% (n = 250) mu itsinda rya LLIN gusa (RR = 1. 02 [95% CI 1.02–1.23], P = 0.894). Ariko, abarengeje imyaka 15 bakoresheje inzitiramibu ku kigero cya 42.7% (n = 554) gake cyane mu itsinda rya LLIN + Bti ugereranyije na 33.4% (n = 439) mu itsinda rya LLIN gusa (RR = 1.26 [95% CI 1.11–1.43], P <0.001).
Abantu 2,484 bagaragaye mu Kigo Nderabuzima cya Napier hagati ya Werurwe 2018 na Gashyantare 2020. Ubusanzwe malariya yo mu bwoko bwa “clinical malaria” yari 82.0% by’abantu bose barwaye indwara (n = 2038). Igipimo cya malariya yagaragaye buri mwaka muri aka gace k’ubushakashatsi cyari 479.8‰ na 297.5‰ mbere na nyuma yo kuvurwa na Bti (Imbonerahamwe ya 2).
Igihe cyo kohereza: Nyakanga-01-2024