Kugera kuriumuti wica udukoko-inshundura zo kuryama hamwe no gushyira mu bikorwa urwego rw’imisoro byagize uruhare mu kugabanya cyane ubwiyongere bwa malariya ubwabo mu bagore bafite imyaka y’imyororokere muri Gana. Ubu bushakashatsi bushimangira ko hakenewe igisubizo cyuzuye cyo kurwanya malariya kugira ngo kigire uruhare mu kurandura malariya muri Gana.
Ubushakashatsi bwakozwe muri Gana Malariya (GMIS). GMIS ni ubushakashatsi buhagarariye igihugu bwakozwe n’urwego rushinzwe ibarurishamibare muri Gana kuva mu Kwakira kugeza Ukuboza 2016. Muri ubu bushakashatsi, ni bwo abagore bonyine bafite imyaka 15-49 ari bo bitabiriye ubwo bushakashatsi. Abagore bafite amakuru kuri variable zose bashyizwe mubisesengura.
Mu bushakashatsi bwakozwe mu mwaka wa 2016, MIS yo muri Gana yakoresheje uburyo bwo gutoranya ibyiciro byinshi mu turere 10 twose tw’igihugu. Igihugu kigabanyijemo ibyiciro 20 (uturere 10 n'ubwoko bwo guturamo - imijyi / icyaro). Ihuriro risobanurwa nk'ahantu ho kubarura (CE) rigizwe n'imiryango igera kuri 300-500. Mu cyiciro cya mbere cyicyitegererezo, cluster yatoranijwe kuri buri cyiciro hamwe nibishoboka bijyanye nubunini. Hatoranijwe amatsinda 200. Mu cyiciro cya kabiri cy'icyitegererezo, umubare uteganijwe w'ingo 30 watoranijwe ku bushake muri buri tsinda ryatoranijwe ridasimbuwe. Igihe cyose bishoboka, twabajije abagore bafite hagati yimyaka 15-49 muri buri rugo [8]. Ubushakashatsi bwambere bwabajije abagore 5.150. Icyakora, kubera kudasubiza ku mpinduka zimwe na zimwe, abagore 4861 ni bo bashyizwe muri ubu bushakashatsi, bangana na 94.4% by'abagore bari mu cyitegererezo. Amakuru akubiyemo amakuru ku miturire, ingo, ibiranga abagore, kwirinda malariya, n'ubumenyi bwa malariya. Amakuru yakusanyijwe hifashishijwe sisitemu yabajijwe na mudasobwa (CAPI) kuri tableti no kubaza impapuro. Abashinzwe amakuru bakoresha sisitemu yo kubarura no gukora ubushakashatsi (CSPro) kugirango bahindure kandi bayobore amakuru.
Ibyavuye mu bushakashatsi bwakozwe ni ubwikorezi bwa malariya mu bagore bafite imyaka iri hagati ya 15-49, bisobanurwa ko ari abagore bavuze ko nibura igice kimwe cya malariya mu mezi 12 abanziriza ubushakashatsi. Ni ukuvuga ko ubwabo malariya yiganje mu bagore bafite hagati y’imyaka 15-49 yakoreshejwe nka porokisi ya malariya nyayo ya RDT cyangwa positivitike ya microscopi mu bagore kuko ibyo bizamini ntibyabonetse mu bagore mu gihe cy’ubushakashatsi.
Ibikorwa byagize uruhare mu kubona ingo zivura udukoko twica udukoko (ITN) no gukoresha urugo rwa IRS mu mezi 12 abanziriza ubushakashatsi. Imiryango yakiriye ibikorwa byombi yabonaga ko yinjiye. Ingo zifite inshundura zivura imiti yica udukoko zasobanuwe nkabagore baba mu ngo zifite byibuze inshundura imwe y’ubuvuzi bw’udukoko, mu gihe ingo zifite IRS zasobanuwe nk’abagore baba mu ngo zavuwe n’udukoko mu mezi 12 mbere y’ubushakashatsi. y'abagore.
Ubushakashatsi bwasuzumye ibyiciro bibiri bigari bihindagurika, aribyo biranga umuryango nibiranga umuntu. Harimo ibiranga urugo; karere, ubwoko bwo guturamo (icyaro-imijyi), igitsina cyumutware wurugo, ingano yurugo, gukoresha amashanyarazi murugo, ubwoko bwa lisansi yo guteka (ikomeye cyangwa idakomeye), ibikoresho byo hasi, ibikoresho bikuta, ibikoresho byo hejuru, isoko y'amazi yo kunywa . Ibyiciro biranga urugo byasubiwemo hakurikijwe ibipimo ngenderwaho bya raporo ya DHS muri raporo ya GMIS ya 2016 na 2014 muri Gana y’ubushakashatsi ku buzima bw’abaturage (GDHS) [8, 9]. Ibiranga umuntu ku giti cye byasuzumwe harimo imyaka umugore afite muri iki gihe, urwego rwo hejuru rw’amashuri, uko atwite igihe yabajijwe, ubwishingizi bw’ubuzima, idini, amakuru ajyanye no kwandura malariya mu mezi 6 mbere y’ibazwa, ndetse n’ubumenyi bw’umugore ku bijyanye na malariya. ibibazo. . Ibibazo bitanu byubumenyi byakoreshejwe mu gusuzuma ubumenyi bw’umugore, harimo ubumenyi bw’umugore ku mpamvu zitera malariya, ibimenyetso bya malariya, uburyo bwo kwirinda malariya, kuvura malariya, no kumenya ko malariya ikubiye muri gahunda y’ubwishingizi bw’ubuzima muri Gana (NHIS). Abagore batsinze 0-22 bafatwaga nkubumenyi buke, abagore batsinze 3 cyangwa 4 bafatwaga nkubumenyi buciriritse, naho abagore batsinze 5 bafatwaga nkubumenyi bwuzuye kuri malariya. Impinduka ku giti cye zajyanye no kubona inshundura zivura udukoko, IRS, cyangwa malariya yiganje mu bitabo.
Ibiranga imiterere yabategarugori byakusanyirijwe hamwe hakoreshejwe inshuro nijanisha kubijyanye nimpinduka zitandukanye, mugihe impinduka zihoraho zavunaguye hakoreshejwe uburyo no gutandukana bisanzwe. Ibi biranga byakusanyirijwe hamwe nuburyo bwo gutabara kugirango harebwe ubusumbane n’imiterere yabaturage byerekana kubogama. Ikarita ya kontour yakoreshejwe mu gusobanura ubwiyongere bwa malariya mu bagore no gukwirakwiza ibikorwa byombi ukurikije aho uherereye. Ibarurishamibare rya Scott Rao chi-kare, ryerekana imiterere yubushakashatsi (urugero, gutondekanya, guhuza, hamwe nuburemere bwikigereranyo), ryakoreshejwe mugusuzuma isano iri hagati y’ubwandu bwa malariya ndetse no kugera kubintu byombi ndetse n'ibiranga imiterere. Ubwiyongere bwa malariya bwabazwe nk’umubare w’abagore bahuye nibura n’igice kimwe cya malariya mu mezi 12 mbere y’ubushakashatsi bugabanijwe n’umubare w’abagore bujuje ibisabwa bapimwe.
Moderi yahinduwe ifite uburemere bwa Poisson yakoreshejwe mu kugereranya ingaruka zo kugera kuri gahunda yo kurwanya malariya ku bagore biyitirira ubwandu bwa malariya16, nyuma yo guhindura uburyo butandukanye bwo gupima imiti (IPTW) hamwe n’ubushakashatsi bwakozwe hakoreshejwe urugero rwa “svy-linearization” muri Stata IC. (Stata Corporation, Sitasiyo ya Koleji, Texas, Amerika). Impinduka zishobora kuba zifite uburemere bwo kuvura (IPTW) zo gutabara “i” n’umugore “j” byagereranijwe nka:
Impinduka ziremereye zanyuma zikoreshwa muri moderi yo gusubira inyuma ya Poisson noneho ihindurwa kuburyo bukurikira:
Muri bo, \ (fw_ {ij} \) ni uburemere bwanyuma bwimpinduka zumuntu kugiti cye no gutabara i, \ (sw_ {ij} \) nuburemere bwikitegererezo bwa j kugiti cye no gutabara i muri GMIS 2016.
Itegeko rya nyuma yo kugereranya “margins, dydx (intervention_i)” muri Stata noneho ryakoreshejwe mu kugereranya itandukaniro (ingaruka) yo gutabara “i” ku bantu ubwabo bavuga ko malariya yiganje mu bagore nyuma yo guhuza imiterere iremereye ya Poisson yo kugenzura. byose byagaragaye bihindagurika.
Uburyo butatu bwo gusubira inyuma nabwo bwakoreshejwe nk'isesengura ryibyiyumvo: gusubira inyuma kwa binary, gusubira inyuma, hamwe no kwerekana umurongo ugereranya ingaruka za buri gikorwa cyo kurwanya malariya ku bantu ubwabo bavuga ko malariya yiganje mu bagore bo muri Gana. 95% intera yicyizere yagereranijwe kubintu byose byagereranijwe, ibipimo byiganjemo, hamwe nigereranya ryingaruka. Isesengura ryibarurishamibare ryose muri ubu bushakashatsi ryafatwaga nkenerwa kurwego rwa alfa ya 0.050. Stata IC verisiyo ya 16 (StataCorp, Texas, USA) yakoreshejwe mu gusesengura imibare.
Mu buryo bune bwo gusubira inyuma, ubwabo ubwabo bavuga ko malariya yanduye ntabwo yari hasi cyane mu bagore bahabwa ITN na IRS ugereranije n’abagore bahabwa ITN bonyine. Byongeye kandi, muburyo bwa nyuma, abantu bakoresha ITN na IRS ntibagaragaje igabanuka rikabije rya malariya ugereranije nabantu bakoresha IRS bonyine.
Ingaruka zo kugera kubikorwa byo kurwanya malariya ku bagore bavuga ko malariya yiganje ku biranga urugo
Ingaruka zo kugera kuri gahunda yo kurwanya malariya ku bantu ubwabo bavuga ko malariya yiganje mu bagore, bitewe n'ibiranga abagore。
Ihuriro ry’ingamba zo gukumira malariya zifasha kugabanya cyane ubwiganze bwa malariya mu bagore bafite imyaka y’imyororokere muri Gana. Ubwiyongere bwa malariya bwagabanutseho 27% mu bagore bakoresha inshundura zivura udukoko hamwe na IRS. Ubu bushakashatsi bujyanye n’ibyavuye mu igeragezwa ryateganijwe ryerekanye ko umubare muto w’indwara ya malariya DT ugereranyije n’abakoresha IRS ugereranije n’abatari IRS mu gace kanduye malariya ariko amahame yo hejuru ya ITN muri Mozambike [19]. Mu majyaruguru ya Tanzaniya, inshundura zivura udukoko hamwe na IRS byahujwe kugira ngo bigabanye cyane ubucucike bwa Anopheles ndetse n’ikigereranyo cyo gukingira udukoko [20]. Ingamba zifatika zo kurwanya inzitizi nazo zishyigikirwa n’ubushakashatsi bw’abaturage mu ntara ya Nyanza mu burengerazuba bwa Kenya, bwagaragaje ko gutera mu ngo hamwe n’inzitiramubu zivura udukoko twangiza udukoko twica udukoko. Ihuriro rishobora gutanga ubundi buryo bwo kwirinda malariya. imiyoboro ifatwa ukwayo [21].
Ubu bushakashatsi bwagereranije ko 34% by'abagore barwaye malariya mu mezi 12 abanziriza ubushakashatsi, aho 95% byagereranijwe hagati ya 32-36%. Abagore baba mu ngo zifite inshundura zivura udukoko twica udukoko (33%) bari hasi cyane ku buryo bwiyitirira ubwandu bwa malariya kurusha abagore baba mu ngo badafite inshundura zanduye zica udukoko (39%). Mu buryo nk'ubwo, abagore baba mu ngo zatewe batewe ubwabo bavuga ko banduye malariya bangana na 32%, ugereranije na 35% mu ngo zidatewe. Ubwiherero ntabwo bwigeze bunozwa kandi isuku ni mibi. Benshi muribo hanze kandi amazi yanduye arirundanya muri yo. Iyi mibiri y'amazi idahagaze, yanduye itanga ahantu heza ho kororera imibu ya Anopheles, nyamukuru ya malariya muri Gana. Kubera iyo mpamvu, ubwiherero n’isuku ntibyigeze bihinduka, ibyo bikaba byaratumye ubwiyongere bwa malariya mu baturage. Hagomba gushyirwamo ingufu hagamijwe kunoza ubwiherero n’imiterere y’isuku mu ngo no mu baturage.
Ubu bushakashatsi bufite aho bugarukira. Ubwa mbere, ubushakashatsi bwakoresheje amakuru yubushakashatsi bwambukiranya ibice, bituma bigora gupima impamvu. Kugira ngo iyi mbogamizi igerweho, uburyo bw’ibarurishamibare bwakoreshejwe mu kugereranya ingaruka zo kuvura zagereranijwe. Isesengura rihindura inshingano zo kuvura kandi rikoresha impinduka zikomeye mu kugereranya ingaruka zishobora guterwa ku bagore ingo zabo zagize uruhare (niba nta gutabara) no ku bagore ingo zabo zitabonye ubufasha.
Icya kabiri, kubona inshundura zivura imiti yica udukoko ntabwo bivuze byanze bikunze gukoresha inshundura zatewe nudukoko twica udukoko, bityo rero ugomba kwitonda mugihe usobanura ibyavuye mumyanzuro nu myanzuro yubu bushakashatsi. Icya gatatu, ibyavuye muri ubu bushakashatsi kuri malariya yivugiye ubwabyo mu bagore ni porokireri yo kwandura malariya mu bagore mu mezi 12 ashize bityo ikaba ishobora kubogama ku bumenyi bw'abagore ku bijyanye na malariya, cyane cyane indwara zitamenyekanye.
Hanyuma, ubushakashatsi ntibwigeze bugaragaza ibibazo byinshi bya malariya ku bitabiriye amahugurwa mu gihe cy’umwaka umwe, cyangwa igihe nyacyo cyo kurwanya malariya no gutabara. Urebye aho ubushakashatsi bugarukira, ibigeragezo byinshi byateganijwe bizagerwaho bizaba ubushakashatsi bwingenzi.
Ingo zakiriye ITN na IRS zifite ubwiyongere bwa malariya ugereranije n’ingo zitigeze zitabarwa. Iyi nyigo ishyigikiye ko hajyaho ingamba zo kurwanya malariya kugira uruhare mu kurandura malariya muri Gana.
Igihe cyo kohereza: Ukwakira-15-2024