Imiti yica udukoko igira uruhare runini mu buhinzi bwo mu cyaro, ariko gukoresha cyane cyangwa gukoresha nabi bishobora kugira ingaruka mbi kuri politiki yo kurwanya malariya; Ubu bushakashatsi bwakorewe mu baturage bahinzi bo mu majyepfo ya Côte d'Ivoire kugira ngo hamenyekane imiti yica udukoko ikoreshwa n’abahinzi baho n’uburyo ibyo bifitanye isano n’imyumvire y’abahinzi kuri malariya. Gusobanukirwa ikoreshwa ryica udukoko birashobora gufasha guteza imbere gahunda yo gukangurira kurwanya imibu no gukoresha imiti yica udukoko.
Ubushakashatsi bwakorewe mu ngo 1.399 zo mu midugudu 10. Abahinzi bakoreweho ubushakashatsi ku myigire yabo, uburyo bwo guhinga (urugero, umusaruro w’ibihingwa, imiti yica udukoko), imyumvire ya malariya, n’ingamba zitandukanye zo kurwanya imibu mu rugo bakoresheje. Imibereho myiza yubukungu (SES) ya buri rugo isuzumwa hashingiwe kumitungo yateganijwe mbere. Imibare mibare hagati yimihindagurikire itandukanye irabaze, yerekana ibintu byingenzi bishobora guteza ingaruka.
Urwego rw'abahinzi rwiga rufitanye isano cyane n'imibereho yabo (p <0.0001). Ingo nyinshi (88.82%) zemeraga ko imibu ari yo mpamvu nyamukuru itera malariya kandi ubumenyi bwa malariya bwari bufitanye isano n’urwego rwo hejuru (OR = 2.04; 95% CI: 1.35, 3.10). Gukoresha ibikorerwa mu ngo byari bifitanye isano cyane n’imibereho y’ubukungu n’ubukungu, urwego rw’uburezi, gukoresha inshundura zanduza imiti yica udukoko hamwe nudukoko twangiza ubuhinzi (p <0.0001). Abahinzi basanze bakoresha udukoko twangiza pyrethroide mu ngo kandi bagakoresha iyo miti irinda ibihingwa.
Ubushakashatsi bwacu bugaragaza ko urwego rw’uburezi rukomeje kuba ikintu cy’ingenzi kigira uruhare mu kumenya abahinzi kumenya imiti yica udukoko no kurwanya malariya. Turasaba ko itumanaho ryiza rigamije kugera ku burezi, harimo imibereho myiza y’ubukungu, kuboneka, no kugera ku bicuruzwa bikomoka ku miti igenzurwa hagamijwe guteza imbere imicungire y’imiti yica udukoko hamwe n’ingamba ziterwa n’indwara ziterwa na virusi.
Ubuhinzi nisoko nyamukuru yubukungu mubihugu byinshi bya Afrika yuburengerazuba. Muri 2018 na 2019, Côte d'Ivoire ni yo yabaye iyambere ku isi mu gukora imbuto za kakao na cashew ndetse ikaba iya gatatu mu bihugu bitanga ikawa muri Afurika [1], serivisi z’ubuhinzi n’ibicuruzwa bingana na 22% by’umusaruro rusange w’igihugu (GDP) [2] . Nka ba nyir'ubutaka bwinshi mu buhinzi, abafite imishinga mito mu cyaro ni bo bagize uruhare runini mu iterambere ry'ubukungu bw'urwego [3]. Igihugu gifite imbaraga nyinshi mu buhinzi, hamwe na hegitari miliyoni 17 z’ubutaka n’imihindagurikire y’ibihe bifasha gutandukanya ibihingwa no guhinga ikawa, cakao, imbuto za cashew, reberi, ipamba, ibiti, imikindo, imyumbati, umuceri n'imboga [2]. Ubuhinzi bukomeye bugira uruhare mu gukwirakwiza udukoko, cyane cyane binyuze mu kongera imiti yica udukoko mu kurwanya udukoko [4], cyane cyane mu bahinzi bo mu cyaro, kurinda ibihingwa no kongera umusaruro w’ibihingwa [5], no kurwanya imibu [6]. Icyakora, gukoresha mu buryo budakwiye imiti yica udukoko ni imwe mu mpamvu nyamukuru zitera kurwanya udukoko twangiza udukoko twangiza indwara, cyane cyane mu bice by’ubuhinzi aho imibu n’udukoko twangiza imyaka dushobora guhura n’igitutu cyo guhitamo imiti yica udukoko [7,8,9,10]. Gukoresha imiti yica udukoko birashobora gutera umwanda bigira ingaruka ku ngamba zo kurwanya ibinyabuzima ndetse n’ibidukikije bityo bikaba bisaba kwitabwaho [11, 12, 13, 14, 15].
Imiti yica udukoko n’abahinzi yakozwe kera [5, 16]. Urwego rw'uburezi rwerekanye ko ari ikintu cy'ingenzi mu gukoresha neza imiti yica udukoko [17, 18], nubwo imiti yica udukoko ikoreshwa n’abahinzi akenshi iterwa nuburambe cyangwa ibyifuzo by’abacuruzi [5, 19, 20]. Inzitizi z’amafaranga ni imwe mu mbogamizi zikunze kugaragara zibuza kubona imiti yica udukoko cyangwa imiti yica udukoko, bigatuma abahinzi bagura ibicuruzwa bitemewe cyangwa bitagikoreshwa, akenshi usanga bihenze kuruta ibicuruzwa byemewe n'amategeko [21, 22]. Ibintu nk'ibi bigaragara no mu bindi bihugu byo muri Afurika y'Iburengerazuba, aho amafaranga make ari impamvu yo kugura no gukoresha imiti yica udukoko idakwiye [23, 24].
Muri Cote d'Ivoire, imiti yica udukoko ikoreshwa cyane ku bihingwa [25, 26], bigira ingaruka ku buhinzi n’abaturage ba virusi ya malariya [27, 28, 29, 30]. Ubushakashatsi bwakorewe mu turere twa malariya bwerekanye isano iri hagati y’imibereho myiza y’ubukungu n’imyumvire ya malariya n’ingaruka zandura, ndetse no gukoresha inshundura zanduza imiti yica udukoko (ITN) [31,32,33,34,35,36,37]. N'ubwo ubu bushakashatsi bwakozwe, imbaraga zo gushyiraho politiki yihariye yo kurwanya imibu zibangamiwe no kubura amakuru ajyanye no gukoresha imiti yica udukoko mu cyaro ndetse n’ibintu bigira uruhare mu gukoresha imiti yica udukoko. Ubu bushakashatsi bwasuzumye imyizerere ya malariya n’ingamba zo kurwanya imibu mu ngo z’ubuhinzi i Abeauville, mu majyepfo ya Côte d'Ivoire.
Ubushakashatsi bwakorewe mu midugudu 10 yo mu ishami rya Abeauville mu majyepfo ya Côte d'Ivoire (Ishusho 1). Intara ya Agbowell ifite abaturage 292.109 mu buso bwa kilometero kare 3.850 kandi ni yo ntara ituwe cyane mu karere ka Anyebi-Tiasa [38]. Ifite ikirere gishyuha hamwe n'ibihe bibiri by'imvura (Mata kugeza Nyakanga na Ukwakira kugeza Ugushyingo) [39, 40]. Ubuhinzi nicyo gikorwa nyamukuru muri kariya karere kandi bukorwa nabahinzi bato n’amasosiyete manini y’inganda. Izi mbuga 10 zirimo Aboud Boa Vincent (323.729.62 E, 651.821.62 N), Aboud Kuassikro (326.413.09 E, 651.573.06 N), Aboud Mandek (326.413.09 E, 651573.06N) Abude) (330633.05E, 652372.90N), 342372.90N) 664971.70N, Damojiang (374.039.75 E, 661.579.59 N), Gesigie 1 (363.140.15 E, 634,256.47 N), Lovezzi 1 (351.545.32 E 642, 062.37 N), Ofa (350 924.31 E, 654 607.17 N), Ofon E, 657 302.17 N) na Oji (uburebure bwa 363.990.74 iburasirazuba, uburebure 648.587.44 mumajyaruguru).
Ubushakashatsi bwakozwe hagati ya Kanama 2018 na Werurwe 2019 bitabiriye ingo z'abahinzi. Umubare w'abatuye muri buri mudugudu wabonetse mu ishami rya serivisi ryaho, kandi abantu 1.500 batoranijwe ku rutonde. Abitabiriye amahugurwa bahagarariwe bari hagati ya 6% na 16% by'abatuye umudugudu. Ingo zashyizwe mu bushakashatsi ni iyo miryango y'abahinzi yemeye kuyitabira. Ubushakashatsi bwibanze bwakozwe mu bahinzi 20 kugirango harebwe niba ibibazo bimwe na bimwe bigomba kwandikwa. Ibibazo byabajijwe noneho byuzuzwa nabakusanyije kandi bahembwa amakuru muri buri mudugudu, byibuze umwe muribo yashakishijwe mumudugudu nyirizina. Iri hitamo ryemeje ko buri mudugudu wagira byibuze uwakusanyije amakuru wari umenyereye ibidukikije kandi avuga ururimi rwaho. Muri buri rugo, ikiganiro imbona nkubone cyakozwe n'umukuru w'urugo (se cyangwa nyina) cyangwa, niba umutware w'urugo adahari, undi muntu mukuru urengeje imyaka 18. Ikibazo cyarimo ibibazo 36 bigabanijwemo ibice bitatu: (1) Imiterere y’imibereho n’imibereho n’ubukungu by’urugo (2) Imikorere y’ubuhinzi no gukoresha imiti yica udukoko (3) Kumenya malariya no gukoresha imiti yica udukoko mu kurwanya imibu [reba Umugereka 1].
Imiti yica udukoko twavuzwe n’abahinzi yanditswe ku mazina y’ubucuruzi kandi ishyirwa mu bikorwa n’ibikoresho bikora hamwe n’amatsinda y’imiti ikoresheje indangagaciro ya Coryte d'Ivoire [41]. Imibereho n'imibereho ya buri rugo yasuzumwe no kubara igipimo cy'umutungo [42]. Umutungo wo murugo wahinduwe mubihinduka bitandukanye [43]. Ibipimo bibi bifatika bifitanye isano nubukungu bwimibereho (SES), mugihe ibipimo byiza bifitanye isano na SES yo hejuru. Amanota y'umutungo yegeranijwe kugirango atange amanota yose kuri buri rugo [35]. Ukurikije amanota yose, ingo zagabanijwemo ibice bitanu byubukungu nubukungu, kuva mubukene kugeza kubakire [reba dosiye yinyongera 4].
Kugirango umenye niba impinduka zitandukanye cyane muburyo bwimibereho yubukungu, umudugudu, cyangwa urwego rwuburezi bwabatware bimiryango, ikizamini cya chi-kare cyangwa ikizamini cya Fisher gishobora gukoreshwa, nkuko bikwiye. Ingero zo gusubira inyuma zashyizwe hamwe n’ibihinduka bikurikira: urwego rw’uburezi, imibereho y’ubukungu n’ubukungu (byose byahinduwe mu buryo butandukanye), umudugudu (ushyizwemo n’ibihinduka bitandukanye), ubumenyi buhanitse ku bijyanye na malariya no gukoresha imiti yica udukoko mu buhinzi, no gukoresha imiti yica udukoko mu ngo (umusaruro ukoresheje icupa rya spray). cyangwa igiceri); urwego rw'uburezi, imibereho-ubukungu n'imidugudu, bigatuma abantu bamenya malariya. Moderi ivanze yo gusubira inyuma yakozwe hakoreshejwe R pack ya lme4 (imikorere ya Glmer). Isesengura mibare ryakozwe muri R 4.1.3 (https://www.r-project.org) na Stata 16.0 (StataCorp, Sitasiyo ya Koleji, TX).
Mu biganiro 1.500 byakozwe, 101 ntibakuwe mu isesengura kubera ko ikibazo kituzuye. Umubare munini w'ingo zabajijwe ni muri Grande Maury (18.87%) naho hasi muri Ouanghi (2.29%). Imiryango 1399 yakoreweho ubushakashatsi yashyizwe mu isesengura ihagarariye abaturage 9.023. Nkuko bigaragara mu mbonerahamwe ya 1, 91,71% by'abatware b'urugo ni abagabo naho 8.29% ni abagore.
Abayobozi b'ingo bagera kuri 8.86% baturutse mu bihugu duturanye nka Benin, Mali, Burkina Faso na Gana. Amoko ahagarariwe cyane ni Abi (60.26%), Malinke (10.01%), Krobu (5.29%) na Baulai (4,72%). Nkuko byari byitezwe ku cyitegererezo cy’abahinzi, ubuhinzi nisoko yonyine yinjiza abahinzi benshi (89.35%), kakao nicyo gihingwa gikunze guhingwa mu ngo zabajijwe; Imboga, ibihingwa byibiribwa, umuceri, reberi hamwe n ibihingwa nabyo bihingwa ahantu hato ugereranije nubutaka. Abakuru b'ingo basigaye ni abacuruzi, abahanzi n'abarobyi (Imbonerahamwe 1). Inshamake y'ibiranga urugo kumudugudu itangwa muri dosiye yinyongera [reba dosiye yinyongera 3].
Icyiciro cy'uburezi nticyatandukanijwe n'uburinganire (p = 0.4672). Abenshi mu babajijwe bafite amashuri abanza (40.80%), bakurikirwa n’ayisumbuye (33.41%) no kutamenya gusoma (17.97%). 4,64% bonyine ni bo binjiye muri kaminuza (Imbonerahamwe 1). Mu bagore 116 babajijwe, abarenga 75% bafite nibura amashuri abanza, naho abandi ntibigeze biga ku ishuri. Urwego rw'uburezi rw'abahinzi ruratandukanye cyane mu midugudu (Ikizamini nyacyo cya Fisher, p <0.0001), kandi urwego rw'uburezi rw'abayobozi b'ingo rufitanye isano ryiza n'imibereho yabo (Ikizamini nyacyo cya Fisher, p <0.0001). Mubyukuri, urwego rwimibereho myiza yubukungu rwiganjemo abahinzi bize cyane, naho ubundi, quintile yo hasi yubukungu nubukungu igizwe nabahinzi batazi gusoma no kwandika; Ukurikije umutungo wose, ingero ntangarugero zigabanijwemo ibice bitanu byubutunzi: kuva mubukene (Q1) kugeza kubakire (Q5) [reba dosiye yinyongera 4].
Hariho itandukaniro rikomeye muburyo bw'ishyingirwa ry'abakuru b'imiryango y'ibyiciro bitandukanye (p <0.0001): 83,62% ni umwe, 16.38% ni abagore benshi (kugeza kubashakanye 3). Nta tandukaniro rikomeye ryabonetse hagati yubutunzi n'umubare w'abashakanye.
Abenshi mu babajijwe (88.82%) bemezaga ko imibu ari imwe mu mpamvu zitera malariya. 1.65% bonyine ni bo basubije ko batazi igitera malariya. Izindi mpamvu zagaragaye zirimo kunywa amazi yanduye, guhura nizuba, imirire mibi numunaniro (Imbonerahamwe 2). Ku rwego rw'imidugudu muri Grande Maury, ingo nyinshi zabonaga kunywa amazi yanduye ari byo bitera malariya (itandukaniro rishingiye ku mibare hagati y'imidugudu, p <0.0001). Ibimenyetso bibiri by'ingenzi bya malariya ni ubushyuhe bwo hejuru bw'umubiri (78.38%) no guhumura amaso (72.07%). Abahinzi bavuze kandi kuruka, kubura amaraso na pallor (reba Imbonerahamwe 2 hepfo).
Mu ngamba zo gukumira malariya, ababajijwe bavuze ikoreshwa ry'imiti gakondo; icyakora, iyo urwaye, ubuvuzi bwa biomedical na gakondo bwa malariya bwafatwaga nkuburyo bwiza (80.01%), hamwe nibyifuzo bijyanye nubukungu nubukungu. Isano rikomeye (p <0.0001). ). Hafi ya kimwe cya kabiri cyingo zikoresha impuzandengo irenga 30.000 XOF kumwaka kuvura malariya (bifitanye isano na SES; p <0.0001). Hashingiwe ku kigereranyo cy’ibiciro bitaziguye, ingo zifite ubuzima buke mu mibereho n’ubukungu byashobokaga gukoresha XOF 30.000 (hafi US $ 50) mu kuvura malariya kurusha ingo zifite imibereho myiza y’ubukungu. Byongeye kandi, benshi mu babajijwe bemezaga ko abana (49,11%) bakunze kwibasirwa na malariya kurusha abantu bakuru (6.55%) (Imbonerahamwe 2), iki gitekerezo kikaba gikunze kugaragara mu ngo zo muri quintile ikennye cyane (p <0.01).
Ku kurwara imibu, benshi mu bitabiriye amahugurwa (85,20%) bavuze ko bakoresheje inshundura zanduza imiti yica udukoko, bakaba barazibonye mu gihe cyo gukwirakwiza igihugu cya 2017. Abakuze n’abana bavuzwe ko basinziriye munsi y’inzitiramubu zivura udukoko mu ngo 90.99%. Inshuro zikoreshwa mu rugo inshundura zanduye zica udukoko zari hejuru ya 70% mu midugudu yose usibye umudugudu wa Gessigye, aho ingo 40% zonyine zavuze ko zikoresha inshundura zanduye. Impuzandengo y'imitego yo kuryama yica udukoko ifitwe nurugo yari ifitanye isano kandi nubunini bwurugo (Coefficient ya Pearson r = 0.41, p <0.0001). Ibisubizo byacu byerekanye kandi ko ingo zifite abana bari munsi yumwaka 1 zishobora gukoresha inshundura zica udukoko murugo ugereranije ningo zidafite abana cyangwa abana bakuru (ikigereranyo kidasanzwe (OR) = 2.08, 95% CI: 1.25–3.47 ).
Usibye gukoresha inshundura zanduza imiti yica udukoko, abahinzi banabajijwe ubundi buryo bwo kurwanya imibu mu ngo zabo no ku bicuruzwa by’ubuhinzi bikoreshwa mu kurwanya udukoko twangiza imyaka. 36.24% gusa mubitabiriye amahugurwa bavuze gutera imiti yica udukoko mu ngo zabo (isano ikomeye kandi nziza na SES p <0.0001). Ibikoresho bivura imiti byaturutse ku bicuruzwa icyenda by’ubucuruzi kandi byatangwaga ahanini ku masoko yaho ndetse n’abacuruzi bamwe na bamwe mu buryo bwa fumigating coil (16,10%) hamwe n’udukoko twica udukoko (83,90%). Ubushobozi bw'abahinzi bwo kuvuga amazina y’imiti yica udukoko twatewe ku mazu yabo bwiyongereye n’urwego rw’uburezi (12.43%; p <0.05). Ibicuruzwa bikomoka ku buhinzi byakoreshejwe byaguzwe bwa mbere muri kanseri hanyuma bivangwa mu gutera imiti mbere yo kubikoresha, hamwe n’igice kinini cyagenewe ibihingwa (78.84%) (Imbonerahamwe 2). Umudugudu wa Amangbeu ufite umubare muto w'abahinzi bakoresha imiti yica udukoko mu ngo zabo (0,93%) n'ibihingwa (16.67%).
Umubare ntarengwa w’ibicuruzwa byica udukoko (spray cyangwa coil) wasabwaga kuri buri rugo ni 3, kandi SES yari ifitanye isano n’umubare w’ibicuruzwa byakoreshejwe (Ikizamini nyacyo cya Fisher p <0.0001, nyamara rimwe na rimwe wasangaga ibicuruzwa birimo ibintu bimwe) ; ibikoresho bikora munsi yizina ryubucuruzi butandukanye. Imbonerahamwe 2 irerekana inshuro buri cyumweru ikoreshwa ryica udukoko mu bahinzi ukurikije imibereho yabo.
Pyrethroide ni umuryango wimiti ugaragara cyane murugo (48,74%) hamwe nubuhinzi (54,74%). Ibicuruzwa bikozwe muri buri muti wica udukoko cyangwa ufatanije nindi miti yica udukoko. Ihuriro rusange ry’udukoko twica udukoko ni karbamate, organofosifate na pyrethroide, mugihe neonicotinoide na pyrethroide bikunze kugaragara mu miti yica udukoko twangiza ubuhinzi (Umugereka 5). Igishushanyo cya 2 cyerekana igipimo cy’imiryango itandukanye y’imiti yica udukoko ikoreshwa n’abahinzi, bose bakaba barashyizwe mu cyiciro cya II (icyago giciriritse) cyangwa icyiciro cya III (hazard nkeya) ukurikije ishyirahamwe ry’ubuzima ku isi ryita ku miti yica udukoko [44]. Igihe kimwe, byagaragaye ko igihugu cyakoreshaga udukoko twica udukoko, tugamije ubuhinzi.
Kubijyanye nibikoresho bikora, propoxur na deltamethrin nibicuruzwa bikunze gukoreshwa mugihugu no mumurima. Inyandiko yinyongera 5 ikubiyemo amakuru arambuye kubicuruzwa bivura imiti bikoreshwa nabahinzi murugo no mubihingwa byabo.
Abahinzi bavuze ubundi buryo bwo kurwanya imibu, harimo n’abafana b’ibabi (pêpê mu rurimi rwaho Abbey), gutwika amababi, gusukura aho hantu, gukuraho amazi ahagaze, gukoresha imiti yica imibu, cyangwa gukoresha amabati kugira ngo wirinde imibu.
Ibintu bifitanye isano nubumenyi bwabahinzi kuri malariya no gutera udukoko twica udukoko (analyse ya logistique).
Aya makuru yerekanaga isano iri hagati yo gukoresha udukoko twica udukoko two mu rugo hamwe n’abahanuzi batanu: urwego rw’uburezi, SES, ubumenyi bw’imibu nkimpamvu nyamukuru itera malariya, ikoreshwa rya ITN, n’ikoreshwa ry’udukoko twangiza udukoko. Igishushanyo cya 3 cyerekana ORs zitandukanye kuri buri gihindagurika. Iyo bishyizwe hamwe numudugudu, abahanuzi bose bagaragaje ishyirahamwe ryiza nogukoresha imiti yica udukoko mu ngo (usibye ubumenyi bwimpamvu nyamukuru zitera malariya, yari ifitanye isano no gukoresha imiti yica udukoko (OR = 0.07, 95% CI: 0.03, 0.13). )) (Ishusho 3). Muri aba bahanuzi beza, igishimishije ni ugukoresha imiti yica udukoko mu buhinzi. Abahinzi bakoresheje imiti yica udukoko ku bihingwa wasangaga 188% bakoresha imiti yica udukoko murugo (95% CI: 1.12, 8.26). Nyamara, ingo zifite ubumenyi buhanitse ku bijyanye no kwandura malariya ntizakunze gukoresha imiti yica udukoko mu rugo. Abantu bafite amashuri yisumbuye bakunze kumenya ko imibu ari yo nyirabayazana wa malariya (OR = 2.04; 95% CI: 1.35, 3.10), ariko nta shyirahamwe ry’ibarurishamibare ryari rifite SES ndende (OR = 1.51; 95% CI) : 0.93, 2.46).
Nk’uko byatangajwe n'umukuru w'urugo, umubare w’umubu ugera ku gihe cy’imvura kandi nijoro ni igihe cyo kurumwa cyane n’umubu (85,79%). Igihe abahinzi babazwaga ku myumvire yabo ku ngaruka ziterwa no gutera udukoko twangiza udukoko twangiza malariya, 86.59% bemeje ko imibu isa naho itera kurwanya udukoko. Kudashobora gukoresha ibikomoka ku miti ihagije kubera kutaboneka bifatwa nkimpamvu nyamukuru yo kudakora neza cyangwa gukoresha nabi ibicuruzwa, bifatwa nkizindi mpamvu zigena. By'umwihariko, aba nyuma bahujwe no kwiga amashuri yo hasi (p <0.01), kabone niyo bagenzura SES (p <0.0001). 12.41% gusa by'ababajijwe basanze kurwanya imibu ari imwe mu mpamvu zishobora gutera udukoko.
Hariho isano ryiza hagati yinshuro zikoreshwa mu kwica udukoko murugo no kumva ko kurwanya imibu kurwanya udukoko (p <0.0001): raporo zerekana ko imibu irwanya udukoko twatewe ahanini no gukoresha imiti yica udukoko mu rugo inshuro 3-3 mu cyumweru. Inshuro 4 (90.34%). Usibye inshuro nyinshi, ingano y’imiti yica udukoko yakoreshejwe nayo yari ifitanye isano n’imyumvire y’abahinzi ku kurwanya imiti yica udukoko (p <0.0001).
Ubu bushakashatsi bwibanze ku myumvire y'abahinzi kuri malariya no gukoresha imiti yica udukoko. Ibisubizo byacu byerekana ko uburezi n'imibereho myiza yubukungu bigira uruhare runini mumyitwarire nubumenyi kuri malariya. Nubwo benshi mu bayobozi b'urugo biga mu mashuri abanza, kimwe n'ahandi, umubare w'abahinzi batize urakomeye [35, 45]. Iki kintu gishobora gusobanurwa n’uko nubwo abahinzi benshi batangiye kwiga, benshi muri bo bagomba kuva mu ishuri kugira ngo batunge imiryango yabo binyuze mu bikorwa by’ubuhinzi [26]. Ahubwo, iki kintu cyerekana ko isano iri hagati yimibereho yubukungu nuburezi ningirakamaro mugusobanura isano iri hagati yimibereho yubukungu nubushobozi bwo gukora kumakuru.
Mu turere twinshi twa malariya-yanduye, abayitabiriye bamenyereye ibitera n'ibimenyetso bya malariya [33,46,47,48,49]. Muri rusange biremewe ko abana bashobora kwandura malariya [31, 34]. Uku kumenyekana gushobora kuba gufitanye isano no kwandura abana nuburemere bwibimenyetso bya malariya [50, 51].
Abitabiriye amahugurwa bavuze ko bakoresheje impuzandengo ya 30.000. Ibintu nko gutakaza umusaruro no gutwara abantu ntabwo byaganiriweho.
Kugereranya imiterere yubukungu nubuhinzi byerekana ko abahinzi bafite imibereho myiza yubukungu n’ubukungu bakoresha amafaranga menshi kurusha abahinzi bakize. Ibi birashobora kuba kubera ko ingo zifite imibereho mike yubukungu nubukungu zibona ibiciro biri hejuru (bitewe nuburemere bwazo mubukungu bwurugo muri rusange) cyangwa kubera inyungu zijyanye nakazi ka leta nabikorera (nkuko bimeze kumiryango ikize). ): Kubera ubwishingizi bw'ubuzima buhari, inkunga yo kuvura malariya (ugereranije n'ibiciro byose) irashobora kuba munsi cyane ugereranije n'amafaranga y'ingo zidafite inyungu mu bwishingizi [52]. Mubyukuri, byavuzwe ko ingo zikize cyane zikoresha imiti ivura imiti ugereranije nimiryango ikennye cyane.
Nubwo abahinzi benshi babona ko imibu ari yo nyirabayazana wa malariya, bake ni bo bonyine bakoresha imiti yica udukoko (binyuze mu gutera no guhumeka) mu ngo zabo, bisa n’ibyavuye muri Kameruni na Gineya ya Ekwatoriya [48, 53]. Kutita ku mibu ugereranije n’udukoko twangiza imyaka biterwa n’ubukungu bw’ibihingwa. Kugabanya ibiciro, uburyo buhendutse nko gutwika amababi murugo cyangwa kwirukana imibu ukoresheje intoki. Uburozi bugaragara bushobora nanone kuba impamvu: impumuro y'ibicuruzwa bimwe na bimwe bya shimi hamwe no kutamererwa neza nyuma yo gukoresha bituma abakoresha bamwe birinda kubikoresha [54]. Ikoreshwa ryinshi ry’udukoko mu ngo (85,20% by’ingo zavuzwe ko zikoresheje) nazo zigira uruhare mu gukoresha imiti yica udukoko twangiza imibu. Kuba hari inshundura zivura udukoko twangiza udukoko mu rugo nabyo bifitanye isano cyane no kuba hari abana bari munsi y’umwaka 1, bikaba bishoboka ko biterwa n’amavuriro atwite ku bagore batwite bahabwa inshundura zatewe n’udukoko mu gihe cyo kugisha inama mbere yo kubyara [6].
Pyrethroide nudukoko tw’udukoko twangiza udukoko twica udukoko twica udukoko [55] kandi dukoreshwa n’abahinzi mu kurwanya udukoko n’imibu, bitera impungenge z’ukwiyongera kw’udukoko twica udukoko [55, 56, 57,58,59]. Iki kintu gishobora gusobanura kugabanuka kw’imibu ku miti yica udukoko tureba abahinzi.
Urwego rwo hejuru mu mibereho n'ubukungu ntirwajyanye no kurushaho kumenya malariya n'imibu nk'impamvu yabyo. Bitandukanye n’ubushakashatsi bwakozwe na Ouattara na bagenzi be mu mwaka wa 2011, abantu bakize usanga bashoboye kumenya neza ibitera malariya kuko bafite amakuru yoroshye kuri televiziyo na radiyo [35]. Isesengura ryacu ryerekana ko urwego rwamashuri makuru arirwo ruteganya kumva neza malariya. Ubu bushakashatsi bwemeza ko uburezi bukomeje kuba ikintu cy'ingenzi mu bumenyi bw'abahinzi kuri malariya. Impamvu imibereho yubukungu idafite ingaruka nke nuko imidugudu ikunze gusangira televiziyo na radio. Icyakora, imibereho myiza yubukungu igomba kwitabwaho mugihe dushyira mubikorwa ingamba zo gukumira malariya murugo.
Imibereho yo mu rwego rwo hejuru mu mibereho n'ubukungu bwo mu rwego rwo hejuru yari ifitanye isano no gukoresha imiti yica udukoko two mu rugo (spray cyangwa spray). Igitangaje ni uko ubushobozi bwabahinzi bwo kumenya imibu nkimpamvu nyamukuru itera malariya bwagize ingaruka mbi kuri moderi. Uyu muhanuzi yari afitanye isano no gukoresha imiti yica udukoko iyo yegeranijwe mu baturage bose, ariko ifitanye isano no gukoresha imiti yica udukoko iyo ishyizwe hamwe numudugudu. Igisubizo cyerekana akamaro k'ingaruka zo kurya abantu ku myitwarire ya muntu no gukenera gushyira ingaruka zidasanzwe mu isesengura. Ubushakashatsi bwacu bugaragaza ku nshuro ya mbere ko abahinzi bafite uburambe bwo gukoresha imiti yica udukoko mu buhinzi bishoboka cyane kurusha abandi gukoresha imiti yica udukoko hamwe na coil nk'ingamba zo kurwanya malariya.
Mu gusubiramo ubushakashatsi bwibanze ku ngaruka z’imibereho myiza y’ubukungu n’imyitwarire y’abahinzi ku miti yica udukoko [16, 60, 61, 62, 63], ingo zikize zavuze ko impinduka nyinshi n’inshuro zikoreshwa mu kwica udukoko. Ababajijwe bemeza ko gutera imiti myinshi yica udukoko aribwo buryo bwiza bwo kwirinda imibu itera kurwanya, ibyo bikaba bihuye n’impungenge zagaragaye ahandi [64]. Niyo mpamvu, ibicuruzwa byo mu rugo bikoreshwa n’abahinzi bifite imiti imwe mu mazina atandukanye y’ubucuruzi, bivuze ko abahinzi bagomba gushyira imbere ubumenyi bwa tekiniki ku bicuruzwa n'ibiyigize. Hagomba kandi kwitabwaho ku kumenyekanisha abadandaza, kuko ari imwe mu ngingo nyamukuru zigenewe abaguzi bica udukoko [17, 24, 65, 66, 67].
Kugira ingaruka nziza ku miti yica udukoko mu baturage bo mu cyaro, politiki n’ibikorwa bigomba kwibanda ku kunoza ingamba z’itumanaho, hitawe ku nzego z’uburezi n’imikorere y’imyitwarire mu rwego rwo kurwanya umuco n’ibidukikije, ndetse no gutanga imiti yica udukoko twangiza. Abantu bazagura bashingiye kubiciro (uko bashoboye) hamwe nubwiza bwibicuruzwa. Iyo ubuziranenge bumaze kuboneka ku giciro cyiza, icyifuzo cyo guhindura imyitwarire mugura ibicuruzwa byiza giteganijwe kwiyongera cyane; Wigishe abahinzi ibijyanye no gusimbuza imiti yica udukoko kugira ngo ucike urunigi rwo kurwanya udukoko twica udukoko kandi usobanure neza ko gusimburwa bidasobanura ihinduka ry’ibicuruzwa (kubera ko ibicuruzwa bitandukanye bifite ibice bimwe bikora), ahubwo bitandukanya ibintu bikora. Ubu burezi bushobora kandi gushyigikirwa nibicuruzwa byiza byanditse binyuze muburyo bworoshye, busobanutse.
Kubera ko imiti yica udukoko ikoreshwa cyane n’abahinzi bo mu cyaro mu Ntara ya Abbotville, gusobanukirwa n’ubumenyi buke bw’abahinzi n’imyumvire yo gukoresha imiti yica udukoko mu bidukikije bigaragara ko ari ngombwa kugira ngo habeho gahunda nziza yo gukangurira abaturage. Ubushakashatsi bwacu bwemeza ko uburezi bukomeje kuba ikintu gikomeye mu gukoresha neza imiti yica udukoko n'ubumenyi kuri malariya. Imibereho yubukungu bwumuryango nayo yafatwaga nkigikoresho cyingenzi cyo gusuzuma. Usibye urwego rw'imibereho myiza y'abaturage n'urwego rw'uburezi rw'umuyobozi w'urugo, ibindi bintu nk'ubumenyi kuri malariya, gukoresha imiti yica udukoko mu kurwanya udukoko, ndetse no kumva ko imibu irwanya udukoko bigira ingaruka ku myumvire y'abahinzi ku bijyanye no gukoresha udukoko.
Uburyo bushingiye kubisubizo nkibibazo birashobora kwibukwa no kubogama kubantu. Biroroshye cyane gukoresha ibiranga urugo kugirango dusuzume uko ubukungu bwifashe, nubwo izi ngamba zishobora kuba zihariye mugihe n’imiterere y’imiterere yatunganijwemo kandi ntibishobora kwerekana ukuri kugezweho kubintu byihariye bifite umuco, bigatuma kugereranya ubushakashatsi bigorana. Mubyukuri, hashobora kubaho impinduka zikomeye muburyo bwo gutunga urugo rwibice bitagomba byanze bikunze kugabanya ubukene bwibintu.
Bamwe mu bahinzi ntibibuka amazina y’ibicuruzwa byica udukoko, bityo umubare w’imiti yica udukoko abahinzi bakoresha irashobora kudahabwa agaciro cyangwa kurenza urugero. Ubushakashatsi bwacu ntabwo bwasuzumye imyumvire y'abahinzi mu gutera imiti yica udukoko cyangwa imyumvire yabo ku ngaruka z’ibikorwa byabo ku buzima bwabo no ku bidukikije. Ubushakashatsi kandi ntabwo bwarimo abadandaza. Izi ngingo zombi zishobora gushakishwa mubyigisho bizaza.
Igihe cyo kohereza: Kanama-13-2024