Inzitiramubu zimaze igihe kirekire zivura inzitiramubu (ILNs) zikoreshwa nkinzitizi yumubiri kugirango wirinde malariya. Muri Afurika yo munsi y'Ubutayu bwa Sahara, kimwe mu bikorwa by'ingenzi bigabanya kugabanya malariya ni ikoreshwa rya ILN. Ariko, amakuru ajyanye no gukoresha ILN muri Etiyopiya ni make. Kubwibyo, ubu bushakashatsi bugamije gusuzuma ikoreshwa rya ILN n’ibintu bifitanye isano n’ingo zo mu Ntara y’Iburengerazuba bwa Arsi, muri Leta ya Oromia, muri Etiyopiya y’Amajyepfo mu 2023. Amakuru yakusanyirijwe mu ngo akoresheje ibibazo byabajijwe ibibazo. Amakuru yagenzuwe, yandikwa kandi yinjira muri Epiinfo verisiyo ya 7 hanyuma asukurwa kandi arasesengurwa akoresheje verisiyo ya SPSS 25. Isesengura ryerekana ryakoreshejwe mugutanga imirongo, ibipimo n'ibishushanyo. Isesengura ryibiri rya logistique ryabazwe kandi impinduka zifite agaciro ka p munsi ya 0.25 zatoranijwe kugirango zinjizwe muri moderi zitandukanye. Icyitegererezo cyanyuma cyasobanuwe hifashishijwe ibipimo byahinduwe (95% intera yicyizere, p agaciro kari munsi ya 0.05) kugirango yerekane ishyirahamwe ryibarurishamibare hagati y'ibisubizo n'ibihinduka byigenga. Ingo zigera kuri 2389 (86.2%) zifite inshundura ndende zica udukoko zishobora gukoreshwa mugusinzira. Nyamara, muri rusange gukoresha inshundura ndende zica udukoko twari 69.9% (95% CI 68.1–71.8). Gukoresha inshundura zica udukoko twangiza igihe kinini byajyanye no kuba umutware wurugo wumugore (AOR 1.69; 95% CI 1.33–4.15), umubare wibyumba bitandukanye murugo (AOR 1.80; 95% CI 1.23-22.29), igihe cyo gusimbuza inshinge zigihe kirekire (AOR 2.81; 95% CI 2.18–5.35), hamwe nubumenyi bwabajijwe (AOR 3.68); Muri rusange gukoresha inshundura zica udukoko mu miryango yo muri Etiyopiya byari bike ugereranije n’igihugu (≥ 85). Ubushakashatsi bwerekanye ko ibintu nk'umukuru w'urugo rw'umugore, umubare w'ibyumba bitandukanye mu nzu, igihe cyo gusimbuza inshundura zica udukoko twangiza kandi urwego rw'ubumenyi bw'ababajijwe ni abahanuzi bakoresha LLIN n'abagize urugo. Kubwibyo, kugirango hongerwe imikoreshereze ya LLIN, Ibiro by’ubuzima by’akarere ka Alsi y’iburengerazuba n’abafatanyabikorwa bagomba gutanga amakuru afatika ku baturage no gushimangira ikoreshwa rya LLIN ku rwego rw’urugo.
Malariya ni ikibazo gikomeye cy’ubuzima rusange ku isi n’indwara yandura itera indwara n’impfu zikomeye. Iyi ndwara iterwa na parasite ya protozoan yo mu bwoko bwa Plasmodium, yandura binyuze mu kurumwa n'imibu ya Anopheles y'abagore1,2. Abantu bagera kuri miliyari 3.3 bafite ibyago byo kurwara malariya, bakaba bafite ibyago byinshi muri Afurika yo munsi y'Ubutayu bwa Sahara (SSA) 3. Raporo y’umuryango w’abibumbye ryita ku buzima (OMS) 2023 yerekana ko kimwe cya kabiri cy’abatuye isi bafite ibyago byo kurwara malariya, mu bihugu 29 bikaba bivugwa ko abantu bagera kuri miliyoni 233 banduye malariya, muri bo hakaba hapfa abantu bagera ku 580.000, aho abana bari munsi y’imyaka itanu n’abagore batwite aribo bibasiwe cyane3,4.
Ubushakashatsi bwakozwe mbere muri Etiyopiya bwerekanye ko ibintu bigira ingaruka ku mikoreshereze y’inzitiramubu igihe kirekire birimo ubumenyi bw’uburyo bwo kwandura malariya, amakuru yatanzwe n’abakozi bashinzwe ubuzima (HEWs), ubukangurambaga bw’itangazamakuru, uburezi mu bigo nderabuzima, imyifatire ndetse no kutamererwa neza mu mubiri igihe uryamye munsi y’inzitiramubu, kutagira amananiza y’imibu, ibikoresho bidahagije kugira ngo umanike inzitiramubu, ibikoresho bidahagije kugira ngo umanike inzitiramubu. ibyago bya malariya, no kutamenya ibyiza byinzitiramubu. 17,20,21 Ubushakashatsi bwerekanye kandi ko ibindi biranga, urugero ingano y’urugo, imyaka, amateka y’imvune, ingano, imiterere, ibara, n’umubare w’aho baryama, bifitanye isano no gukoresha inzitiramubu igihe kirekire. 5,17,18,22 Nyamara, ubushakashatsi bumwe bwerekanye ko nta sano rihambaye riri hagati yubutunzi bwurugo nigihe cyo gukoresha imibu3,23.
Inzitiramubu zimaze igihe kinini, nini bihagije ku buryo zashyirwa mu bitotsi, byagaragaye ko zikoreshwa cyane, kandi ubushakashatsi bwinshi bwakozwe mu bihugu byanduye malariya bwemeje agaciro kabo mu kugabanya imikoranire y’abantu na virusi ya malariya n’izindi ndwara ziterwa na virusi 7,19,23. Mu bice byanduye malariya, gukwirakwiza inzitiramubu zimaze igihe kirekire byagaragaye ko bigabanya indwara ya malariya, indwara zikomeye, n’impfu ziterwa na malariya. Inzitiramubu zivura udukoko byagaragaye ko zigabanya malariya 48-50%. Niba ikoreshwa cyane, inshundura zishobora gukumira 7% byimpfu zabatarengeje imyaka itanu kwisi yose kandi zifitanye isano no kugabanuka cyane kwibyago byo kubyara ibiro bike no gutakaza uruhinja25.
Ntibisobanutse kurwego abantu bazi gukoresha inshundura zica udukoko twangiza kandi nuburyo babigura. Ibitekerezo n'ibihuha bijyanye no kutamanika inshundura na gato, kubimanika nabi kandi mu mwanya mubi, no kudashyira imbere abana n'abagore batwite bikwiye iperereza ryitondewe. Indi mbogamizi ni imyumvire y'abaturage ku ruhare rw'inzitiramubu zimara igihe kirekire mu gukumira malariya. 23 Indwara ya Malariya ni myinshi mu bice byo mu Ntara y’Iburengerazuba bwa Arsi, kandi amakuru ku mikoreshereze y’urugo n’abaturage mu gukoresha inshundura zica udukoko twangiza igihe kirekire. Kubwibyo rero, intego y’ubu bushakashatsi yari iyo gusuzuma ubwinshi bw’imiti yica udukoko twangiza igihe kirekire hamwe n’ibintu bifitanye isano n’ingo zo mu Ntara ya Arsi y’Iburengerazuba, mu karere ka Oromia, mu majyepfo y’iburengerazuba bwa Etiyopiya.
Ubushakashatsi bushingiye ku baturage bwakozwe kuva ku ya 1 kugeza ku ya 30 Gicurasi 2023 mu Ntara ya Arsi. Intara ya West Arsi iherereye mu karere ka Oromia gaherereye mu majyepfo ya Etiyopiya, km 250 uvuye Addis Abeba. Abaturage bo muri ako karere ni 2.926.749, bagizwe n'abagabo 1.344.107 n'abagore 1.492.642. Mu Ntara ya West Arsi, abantu bagera kuri 963.102 bo mu turere dutandatu n'umujyi umwe batuye ibyago byinshi bya malariya; ariko, uturere icyenda nta malariya. Intara y’iburengerazuba bwa Arsi ifite imidugudu 352, muri yo 136 ikaba yibasiwe na malariya. Muri poste yubuzima 356, 143 ni poste ishinzwe kurwanya malariya kandi hari ibigo nderabuzima 85, 32 muri byo biherereye mu turere twibasiwe na malariya. Ibitaro bitatu kuri bitanu bivura abarwayi ba malariya. Aka gace gafite imigezi n’ahantu ho kuhira bikwiriye korora imibu. Mu 2021, muri ako karere hatanzwe udukoko twica udukoko 312.224 mu rwego rwo gutabara byihutirwa, naho icyiciro cya kabiri cy’udukoko twangiza imyaka 150,949 cyatanzwe mu 2022-26.
Umubare w'abaturage bafatwaga nk'ingo zose zo mu karere ka Alsi y'Uburengerazuba ndetse n'ababa muri ako karere mu gihe cyo kwiga.
Umubare w’ubushakashatsi watoranijwe ku buryo butemewe mu ngo zose zujuje ibisabwa mu karere ka Alsi y’iburengerazuba, ndetse n’abatuye mu turere dufite ibyago byinshi bya malariya mu gihe cyo kwiga.
Ingo zose ziherereye mu midugudu yatoranijwe yo mu Ntara ya Alsi y’iburengerazuba kandi ziba mu gace k’inyigisho amezi arenga atandatu zashyizwe mu bushakashatsi.
Ingo zitabonye LLINs mugihe cyo kugabura hamwe nabadashoboye gusubiza kubera kutumva no kutavuga ntibakuwe mubushakashatsi.
Ingano yicyitegererezo kumpamvu ya kabiri yibintu bifitanye isano no gukoresha LLIN yabazwe hashingiwe kumibare yabaturage ikoresheje Epi info verisiyo ya 7 software computing software. Dufashe 95% CI, 80% imbaraga nigisubizo cya 61.1% mumatsinda atateganijwe, iki gitekerezo cyavuye mubushakashatsi bwakorewe mubuhinde rwagati13 bukoresheje abayobozi bimiryango batize nkibintu bihinduka, hamwe na OR ya 1.25. Ukoresheje ibitekerezo byavuzwe haruguru no kugereranya impinduka numubare munini, impinduka "umutware wurugo utarize" yatekerejweho kugirango hamenyekane ingano yanyuma, kuko yatangaga urugero runini rwabantu 2808.
Ingano yicyitegererezo yatanzwe ugereranije numubare wimiryango muri buri mudugudu kandi ingo 2808 zatoranijwe mumidugudu yabigenewe hakoreshejwe uburyo bworoshye bwo gutoranya. Umubare w'ingo muri buri mudugudu wabonetse muri sisitemu yubuzima bwumudugudu (CHIS). Umuryango wambere watoranijwe na tombora. Niba urugo rwabitabiriye kwiga rwarafunzwe mugihe cyo gukusanya amakuru, hakozwe ibibazo byinshi bibiri byakurikiranwe kandi byafashwe nkibisubizo.
Ibihinduka byigenga byari ibiranga sociodemografiya (imyaka, imiterere yumubano, idini, uburezi, akazi, ingano yumuryango, aho atuye, amoko n’amafaranga yinjiza buri kwezi), urwego rwubumenyi hamwe nimpinduka zijyanye no gukoresha igihe kirekire inshundura zica udukoko.
Ingo zabajijwe ibibazo cumi na bitatu ku bumenyi bujyanye no gukoresha udukoko twangiza. Igisubizo cyukuri cyahawe amanota 1, naho igisubizo kitari cyo cyahawe amanota 0. Nyuma yo kuvuga amanota ya buri wese mu bitabiriye amahugurwa, harabaruwe amanota mpuzandengo, kandi abitabiriye bafite amanota ari hejuru y’ikigereranyo bafatwaga nk '“ubumenyi bwiza” naho abitabiriye bafite amanota ari munsi y’ikigereranyo bafatwaga nk’ubumenyi “bubi” ku bijyanye no gukoresha udukoko twangiza igihe kirekire.
Amakuru yakusanyijwe hifashishijwe ibibazo byubatswe byatanzwe imbonankubone nuwabajije kandi byahinduwe mubitabo bitandukanye2,3,7,19. Ubushakashatsi bwarimo imibereho-demokarasi, ibiranga ibidukikije nubumenyi bwabitabiriye gukoresha ISIS. Ikusanyamakuru ryakusanyirijwe mu bantu 28 bo muri hoteri ya malariya, hanze y’ikusanyamakuru ryabo kandi rikagenzurwa buri munsi n’inzobere 7 za malariya zo mu bigo nderabuzima.
Ikibazo cyateguwe mucyongereza gihindurwa mu rurimi rwaho (Afan Oromo) hanyuma cyongera guhindurwa mu Cyongereza kugira ngo kigenzure niba gihamye. Ikibazo cyabajijwe mbere kuri 5% yicyitegererezo (135) hanze yikigo nderabuzima. Nyuma yo kwipimisha mbere, ikibazo cyarahinduwe kugirango bisobanurwe kandi byoroshe amagambo. Isuku ryamakuru, ryuzuye, ingano hamwe nigenzura ryakozwe buri gihe kugirango hamenyekane ireme ryamakuru mbere yo kwinjiza amakuru. Nyuma yo kugenzura hamwe nu mucungezi, amakuru yose atuzuye kandi adahuye yakuwe mumibare. Abakusanya amakuru n'abagenzuzi bahawe amahugurwa y'umunsi umwe uburyo n'amakuru yo gukusanya. Umushakashatsi yakurikiranye abakusanya amakuru n'abashinzwe kugenzura niba amakuru ari meza mu gihe cyo gukusanya amakuru.
Ibyatanzwe byagenzuwe kugirango bibe byuzuye kandi bihamye, hanyuma byandikwa hanyuma byinjira muri Epi-info verisiyo ya 7, hanyuma bisukurwa kandi bisesengurwa hifashishijwe verisiyo ya 25. Imibare isobanura nka frequence, ibipimo, n'ibishushanyo byakoreshejwe kugirango berekane ibisubizo. Bivariate binary logistic regression isesengura ryabazwe, kandi covariates ifite p agaciro kari munsi ya 0.25 muburyo bwa bivariate yatoranijwe kugirango ishyirwe muburyo butandukanye. Icyitegererezo cyanyuma cyasobanuwe hifashishijwe ibipimo byagereranijwe, 95% intera yicyizere, na p agaciro <0.05 kugirango hamenyekane isano iri hagati y'ibisubizo nibihinduka byigenga. Multicollinearity yageragejwe hakoreshejwe ikosa risanzwe (SE), ritari munsi ya 2 muri ubu bushakashatsi. Ikizamini cya Hosmer na Lemeshow cyiza-cyiza cyakoreshejwe mugupima icyitegererezo gikwiye, naho p agaciro kizamini cya Hosmer na Lemeshow muri ubu bushakashatsi cyari 0.746.
Mbere yo gukora ubushakashatsi, icyemezo cy’imyitwarire cyabonetse muri komite ishinzwe imyitwarire y’ubuzima mu Burengerazuba bwa Elsea County hakurikijwe Itangazo rya Helsinki. Nyuma yo gusobanura intego y’ubushakashatsi, amabaruwa y’uruhushya yabonetse ku biro by’ubuzima by’intara n’umujyi byatoranijwe. Abitabiriye ubushakashatsi bamenyeshejwe intego y’ubushakashatsi, ibanga, n’ibanga. Icyemezo kibimenyeshejwe cyabonetse kubitabiriye ubushakashatsi mbere yuburyo bwo gukusanya amakuru. Amazina yababajijwe ntabwo yanditse, ariko buri wese mubajijwe yahawe kode yo kubika ibanga.
Mu babajijwe, benshi (2738, 98.8%) bari bumvise ikoreshwa ry’udukoko twangiza. Ku bijyanye n'inkomoko y'amakuru ajyanye no gukoresha imiti yica udukoko tumara igihe kinini, benshi mu babajijwe 2202 (71.1%) bayakiriye n'abashinzwe ubuzima. Hafi yababajijwe 2735 (99,9%) bari bazi ko udukoko twica udukoko tumaze igihe kirekire dushobora gusanwa. Abitabiriye hafi ya bose 2614 (95.5%) bari bazi imiti yica udukoko igihe kirekire kuko ishobora kwirinda malariya. Umubare munini w'ingo 2529 (91.5%) wari ufite ubumenyi bwiza kubyerekeye udukoko twangiza. Ikigereranyo cyo hagati yubumenyi bwurugo kubyerekeye ikoreshwa ry’udukoko twangiza igihe kirekire ni 7.77 hamwe no gutandukana bisanzwe ± 0.91 (Imbonerahamwe 2).
Mu isesengura rya bivariate yibintu bifitanye isano no gukoresha inzitiramubu igihe kirekire, impinduka nkuburinganire bwababajijwe, aho atuye, ingano yumuryango, uko amashuri ameze, uko abashakanye babayeho, umubare w’ibyumba bitandukanye mu nzu, ubumenyi bw’inzitiramubu zimara igihe kirekire, aho waguze inzitiramubu zimaze igihe kinini zikoreshwa n’inzitiramubu zikoreshwa n’inzitiramubu. Nyuma yo guhindura ibintu bitera urujijo, impinduka zose zifite p-agaciro <0.25 mu isesengura rya bivariate zashyizwe mubisesengura ryibintu byinshi.
Icyari kigamijwe muri ubu bushakashatsi kwari ugusuzuma ikoreshwa ry’urushundura rurerure rwica udukoko hamwe n’ibintu bifitanye isano n’ingo mu Ntara ya Arsi y’Iburengerazuba, Etiyopiya. Ubushakashatsi bwerekanye ko ibintu bifitanye isano no gukoresha inshundura zica udukoko twica udukoko twinshi harimo igitsina gore cy’ababajijwe, umubare w’ibyumba bitandukanye mu nzu, igihe kinini gisabwa kugira ngo usimbure inshundura zica udukoko twangiza, ndetse n’ubumenyi bw’ababajijwe, ibyo bikaba byari bifitanye isano cyane no gukoresha inshundura zica udukoko twangiza.
Uku kunyuranya gushobora guterwa nubunini bwubunini bwikitegererezo, umubare w’abaturage biga, imiterere y’akarere, hamwe nubukungu. Kugeza ubu, muri Etiyopiya, Minisiteri y’Ubuzima irimo gushyira mu bikorwa ingamba nyinshi zo kugabanya umutwaro wa malariya mu kwinjiza ingamba zo gukumira malariya muri gahunda z’ubuvuzi bw’ibanze, zishobora gufasha kugabanya indwara ziterwa na malariya n’impfu.
Ibyavuye muri ubu bushakashatsi byagaragaje ko abatware b’ingo b’abagore bakunze gukoresha imiti yica udukoko igihe kirekire ugereranije n’abagabo. Ubu bushakashatsi bujyanye n’ubushakashatsi bwakorewe mu Ntara ya Ilugalan5, mu karere ka Raya Alamata33 no mu mujyi wa Arbaminchi34, muri Etiyopiya, bwerekanye ko abagore bakunze gukoresha abagabo bica udukoko twangiza. Ibi birashobora kandi kuba ibisubizo byumuco gakondo muri societe ya Etiyopiya iha agaciro abagore kuruta abagabo, kandi iyo abagore babaye abatware bimiryango, abagabo baba bafite igitutu gito cyo guhitamo gukoresha imiti yica udukoko ubwabo. Byongeye kandi, ubushakashatsi bwakorewe mu cyaro, aho ingeso z’umuco n’imigenzo y’abaturage zishobora kurushaho kubaha abagore batwite kandi bikabashyira imbere mu gukoresha udukoko twica udukoko tumara igihe kirekire kugira ngo twanduze malariya.
Ikindi cyagaragaye muri ubwo bushakashatsi cyerekanye ko umubare w’ibyumba bitandukanye mu ngo z’abitabiriye amahugurwa byari bifitanye isano n’ikoreshwa ry’inzitiramubu ziramba. Ubu bushakashatsi bwemejwe n’ubushakashatsi bwakorewe mu ntara ya Belessa7, Garan5, Adama21 na Bahir Dar20. Ibi birashobora guterwa nuko ingo zifite ibyumba bike bitandukanye munzu zikunda gukoresha inzitiramubu ziramba, mugihe ingo zifite ibyumba byinshi bitandukanye murugo ndetse nabagize umuryango benshi bakunze gukoresha inzitiramubu ndende, ibyo bikaba byaviramo ikibazo cyo kubura inzitiramubu mubyumba byose bitandukanye.
Igihe cyo gusimbuza inshundura ndende zica udukoko twahujwe cyane no gukoresha urugo inshundura zica udukoko. Abantu basimbuye inshundura ndende zica udukoko kugeza mu myaka itatu ishize wasangaga bakoresha inshundura ndende zica udukoko kurusha izasimbuwe mu myaka itarenze itatu ishize. Ubu bushakashatsi burahuye nubushakashatsi bwakorewe mu mujyi wa Arbaminchi, Etiyopiya34 no mu majyaruguru y'uburengerazuba bwa Etiyopiya20. Ibi birashobora kuba kubera ko ingo zifite amahirwe yo kugura inzitiramubu nshya kugirango zisimbuze izishaje usanga zishobora gukoresha inshundura zica udukoko twica udukoko mu bagize urugo, bashobora kumva banyuzwe kandi bafite ubushake bwo gukoresha inzitiramubu nshya mu rwego rwo kwirinda malariya.
Ubundi bushakashatsi bwakozwe muri ubu bushakashatsi bwerekanye ko ingo zifite ubumenyi buhagije ku bijyanye n’udukoko twica udukoko twikubye inshuro enye gukoresha imiti yica udukoko igihe kirekire ugereranije n’ingo zifite ubumenyi buke. Ubu bushakashatsi kandi buhuye n’ubushakashatsi bwakorewe muri Hawassa no mu majyepfo y’iburengerazuba bwa Etiyopiya 18,22. Ibi birashobora gusobanurwa n’uko ubumenyi bw’urugo n’ubukangurambaga ku buryo bwo kwirinda kwanduza, ibintu bishobora guteza ingaruka, ubukana n’ingamba zo gukumira indwara ku giti cye, amahirwe yo gufata ingamba zo gukumira ariyongera. Byongeye kandi, ubumenyi bwiza hamwe no kumva neza uburyo bwo kwirinda malariya butera inkunga yo gukoresha udukoko twangiza igihe kirekire. Kubwibyo rero, ingamba zo guhindura imyitwarire zigamije gushishikariza kubahiriza gahunda zo gukumira malariya mu bagize urugo bashira imbere imibereho-umuco n’umuco rusange.
Ubu bushakashatsi bwakoresheje igishushanyo mbonera kandi isano itera ntabwo igaragara. Ibuka kubogama bishobora kuba byarabaye. Kwitegereza inshundura zo kuryama byemeza ko gutanga raporo y'ibindi byavuye mu bushakashatsi (urugero, gukoresha inshundura zo kuryama mu ijoro ryakeye, inshuro zo gukaraba uburiri, hamwe n'amafaranga yinjiza) bishingiye kuri raporo yonyine, ikaba ishobora kubogama.
Muri rusange gukoresha inshundura zimaze igihe kirekire zivura udukoko twangiza udukoko mu ngo zari nke ugereranije n’igihugu cya Etiyopiya (≥ 85). Ubushakashatsi bwerekanye ko inshuro nyinshi zo gukoresha inshundura zimaze igihe kirekire zivura udukoko twatewe n’uko umutware w’urugo yari umugore, ibyumba byinshi byigenga byari mu nzu, igihe byatwaye kugira ngo asimbure urushundura rumaze igihe kirekire ruvura udukoko, ndetse n’uburyo ababajijwe bari bafite ubumenyi. Kubera iyo mpamvu, Ikigo cy’ubuzima cy’Intara ya Arsi n’abafatanyabikorwa bireba bagomba gukora kugira ngo bongere ikoreshwa ry’urushundura rumaze igihe kirekire ruvurwa n’udukoko twangiza udukoko twangiza udukoko twangiza udukoko twangiza udukoko twangiza udukoko twangiza udukoko twangiza udukoko twangiza udukoko twangiza udukoko twangiza udukoko. Shimangira amahugurwa y’abakorerabushake, inzego z’abaturage, n’abayobozi b’amadini ku gukoresha neza inshundura zimaze igihe kirekire zivura udukoko twica udukoko.
Amakuru yose yabonetse kandi / cyangwa yasesenguwe mugihe cyo kwiga araboneka kubanditsi babisabye babisabye.
Igihe cyo kohereza: Werurwe-07-2025