Umuti wica udukoko mu nzuGutera imiti (IRS) ni uburyo bw'ingenzi bwo kugabanya ikwirakwira rya Trypanosoma cruzi iterwa n'udukoko, itera indwara ya Chagas mu gice kinini cya Amerika y'Epfo. Ariko, intsinzi ya IRS mu karere ka Grand Chaco, gaherereye muri Boliviya, Arijantine na Paraguay, ntishobora guhwana n'iy'ibindi bihugu byo mu majyepfo ya Cone.
Ubu bushakashatsi bwasuzumye uburyo busanzwe bwo gukoresha imiti ikoreshwa mu kuvura no kurwanya imiti yica udukoko mu gace gasanzwe gakunze kugaragara muri Chaco, muri Boliviya.
Ikintu gikoraalpha-cypermethrine(ai) yafashwe ku mpapuro ziyungurura zishyizwe ku rukuta rw'icyuma gishyushya amazi kandi yapimwe mu buryo bwo gupima imiti ya spray tank yateguwe hakoreshejwe uburyo bwa HPLC bwahinduwe (IQK™). Amakuru yasesenguwe hakoreshejwe uburyo bwa binomial mixed-effects regression mode kugira ngo harebwe isano iri hagati y’ubwinshi bw’imiti yica udukoko bukoreshwa ku mpapuro ziyungurura amazi n’uburebure bw’urukuta rwa spray, uburyo spray ikwirakwira (ubuso bwa spray/igihe cyo gushyushya amazi [m2/min]), hamwe n’igipimo cya spray cyagaragaye/cyari giteganijwe. Itandukaniro riri hagati y’abatanga serivisi z’ubuzima n’abafite amazu bakurikiza ibisabwa na IRS mu ngo zidafite abantu naryo ryapimwe. Igipimo cyo kurangiza alpha-cypermethrin nyuma yo kuvanga mu bigega bya spray byateguwe cyapimwe muri laboratwari.
Impinduka zikomeye zagaragaye mu gipimo cya alpha-cypermethrin AI, aho 10.4% (50/480) by'amafiriti na 8.8% (5/57) by'ingo zageze ku gipimo cyifuzwa cya 50 mg ± 20% AI/m2. Igipimo cyagaragajwe ntikijyanye n'igipimo cyabonetse mu bisubizo bya spray. Nyuma yo kuvanga alpha-cypermethrin ai mu gipimo cyateguwe cy'ikigega cya spray cyahise gishira, byatumye alpha-cypermethrin ai itakaza umurongo ku munota ndetse itakaza 49% nyuma y'iminota 15. 7.5% (6/80) by'ingo gusa ni zo zavuwe ku gipimo cya 19 m2/min (± 10%) cyatanzwe na OMS, mu gihe 77.5% (62/80) by'ingo zavuwe ku gipimo kiri hasi ugereranije n'uko byari byitezwe. Igipimo mpuzandengo cy'ikintu gikora cyagejejwe mu rugo ntabwo cyari gifitanye isano rikomeye n'igipimo cya spray cyagaragaye. Iyubahirizwa ry'amategeko mu ngo ntiryagize ingaruka zikomeye ku gipimo cya spray cyangwa igipimo mpuzandengo cya cypermethrin yagejejwe mu ngo.
Gutanga serivisi za IRS mu buryo butari bwiza bishobora guterwa n’imiterere y’imiti yica udukoko ndetse no kuba hakenewe kuvugurura uburyo bwo gutanga imiti yica udukoko, harimo no guhugura amatsinda ya IRS n’uburezi rusange kugira ngo habeho gushishikariza abantu kubahiriza amategeko. IQK™ ni igikoresho cy’ingenzi gifasha mu kazi kongera ireme rya IRS kandi gifasha amahugurwa y’abatanga serivisi z’ubuvuzi no gufata ibyemezo ku bayobozi mu kugenzura Chagas vector.
Indwara ya Chagas iterwa n'ubwandu bw'udukoko twa Trypanosoma cruzi (kinetoplastid: Trypanosomatidae), dutera indwara zitandukanye mu bantu no mu zindi nyamaswa. Mu bantu, ubwandu bukabije bugaragara mu byumweru cyangwa amezi nyuma yo kwandura kandi burangwa no kugira umuriro, kurwara indwara, no gucika intege kw'umwijima. Bivugwa ko 20-30% by'ubwandu bukomeza kwiyongera bukaba indwara idakira, akenshi indwara z'umutima, zirangwa n'ubusembwa bw'imitsi, indwara z'umutima, imikorere mibi y'imitsi y'ibumoso, ndetse n'indwara z'umutima zifatana, ndetse akenshi n'indwara z'igifu. Izi ndwara zishobora kumara imyaka myinshi kandi ziragoye kuvura [1]. Nta rukingo ruhari.
Umutwaro w’indwara ya Chagas ku isi mu 2017 wageraga ku bantu miliyoni 6.2, bihitana impfu 7900 n’imyaka 232.000 y’ubuzima busanzwe (DALYs) ku bantu b’ingeri zose [2,3,4]. Triatominus cruzi yandurira muri Amerika yo Hagati n’iy’Epfo, no mu bice bimwe na bimwe byo mu majyepfo ya Amerika y’Amajyaruguru, na Triatominus cruzi (Hemiptera: Reduviidae), ingana na 30.000 (77%) by’umubare w’abantu bashya banduye muri Amerika y’Epfo mu 2010 [5]. Izindi nzira zo kwandura mu turere tutarandura indwara nko mu Burayi na Leta Zunze Ubumwe za Amerika harimo kwanduzanya amaraso yanduye n’uko umuntu yayanduye. Urugero, muri Esipanye, hari abantu bagera ku 67.500 banduye mu bimukira bo muri Amerika y’Epfo [6], bigatuma ikiguzi cy’ubuvuzi kigera kuri miliyoni 9.3 z’amadolari ya Amerika ku mwaka [7]. Hagati ya 2004 na 2007, 3.4% by'abagore b'abimukira batwite bo muri Amerika y'Epfo basuzumwe mu bitaro bya Barcelona bari bafite Trypanosoma cruzi [8]. Kubwibyo, imbaraga zo kugenzura ikwirakwira ry'udukoko mu bihugu byanduye ni ingenzi cyane kugira ngo bigabanye umutwaro w'indwara mu bihugu bidafite udukoko twa triatomine [9]. Uburyo bwo kugenzura ubu burimo gutera imiti mu nzu (IRS) kugira ngo bigabanye umubare w'udukoko mu ngo no hafi yazo, gupima ababyeyi kugira ngo hamenyekane kandi hakorwe burundu ubwandu bw'ababyeyi bavukanye, gupima amaraso n'ibice by'umubiri, na gahunda z'uburezi [5,10,11,12].
Muri Cone yo mu Majyepfo ya Amerika y'Epfo, ikintu nyamukuru gitera indwara ni triatomine virus. Ubu bwoko bw'inyamaswa bukunze kuba inyamaswa zikunda indwara kandi zikunda indwara kandi bwororoka cyane mu ngo no mu biraro by'amatungo. Mu nyubako zubatswe nabi, imiyoboro yo ku nkuta no ku gisenge iba irimo udukoko twa triatomine, kandi ubwandu mu ngo buba bukabije cyane [13, 14]. Southern Cone Initiative (INCOSUR) iteza imbere ingamba mpuzamahanga zihuriweho zo kurwanya ubwandu mu ngo muri Tri. Koresha IRS kugira ngo umenye bagiteri zitera indwara n'ibindi bintu byihariye [15, 16]. Ibi byatumye indwara ya Chagas igabanuka cyane ndetse n'Umuryango Mpuzamahanga wita ku Buzima wemeza ko ubwandu bwandujwe n'udukoko bwakuweho mu bihugu bimwe na bimwe (Uruguay, Shili, ibice bya Arijantine na Brezili) [10, 15].
Nubwo INCOSUR yatsinze, vector Trypanosoma cruzi ikomeje mu gace ka Gran Chaco muri Amerika, akarere k’amashyamba yumye mu gihe cy’umwaka gafite uburebure bwa kilometero kare miliyoni 1.3 ku mipaka ya Boliviya, Arijantine na Paraguay [10]. Abaturage bo muri ako karere bari mu matsinda y’abatishoboye cyane kandi baba mu bukene bukabije kandi bafite ubushobozi buke bwo kwivuza [17]. Umubare w’abandura T. cruzi n’abandura virus muri iyi miryango uri mu bakomeye ku isi [5,18,19,20] aho 26-72% by’ingo zuzuyemo trypanosomatides. infestans [13, 21] na 40-56% Tri. Bagiteri zitera indwara zanduza Trypanosoma cruzi [22, 23]. Inyinshi (>93%) z’indwara zose za Chagas ziterwa n’udukoko mu karere ka Cone y’Amajyepfo ziboneka muri Boliviya [5].
IRS ubu ni bwo buryo bwonyine bwemewe cyane bwo kugabanya triacine mu bantu. Infestans ni ingamba zemejwe mu mateka zo kugabanya umutwaro w’indwara nyinshi ziterwa n’udukoko ku bantu [24, 25]. Igice cy’amazu mu mudugudu wa Tri. infestans (igipimo cy’ubwandu) ni ikimenyetso cy’ingenzi gikoreshwa n’inzego z’ubuzima mu gufata ibyemezo ku bijyanye no gushyiraho IRS, kandi icy’ingenzi, ni ukugaragaza ko abana banduye indwara zidakira badafite ibyago byo kongera kwandura [16, 26, 27, 28, 29]. Ingufu za IRS no gukomeza kwandura udukoko mu karere ka Chaco biterwa n’ibintu byinshi: ireme ry’inyubako ritari ryiza [19, 21], ishyirwa mu bikorwa rya IRS ritari ryiza n’uburyo bwo kugenzura ubwandu [30], kutamenya neza ibisabwa na IRS Kutubahiriza amategeko ya IRS ni bike [31], imikorere migufi y’imiti yica udukoko [32, 33] na Tri. infestans bifite ubushobozi bwo kugabanya ubushobozi bwo kurwanya cyangwa/cyangwa kwibasirwa n’imiti yica udukoko [22, 34].
Imiti yica udukoko twa pyrethroid ikoreshwa mu buryo bwa synthetic ikunze gukoreshwa muri IRS bitewe nuko yica udukoko twibasirwa n’udukoko twa triatomine. Iyo turi mu rugero ruto, imiti yica udukoko ya pyrethroid nayo yakoreshejwe nk'ibintu bitera ubwivumbure mu gukuramo udukoko mu myobo yo ku rukuta mu rwego rwo kugenzura [35]. Ubushakashatsi ku igenzura ry’ubuziranenge bw’imiti ya IRS ni buke, ariko ahandi byagaragaye ko hari itandukaniro rinini mu ngano y’imiti ikoreshwa mu kwica udukoko (AIs) igezwa mu ngo, aho ingano ikunze kugabanuka munsi y’urugero rw’imiti ikoreshwa mu buryo bufatika [33,36,37,38]. Impamvu imwe ituma hatabaho ubushakashatsi ku igenzura ry’ubuziranenge ni uko chromatography y’amazi ifite imikorere myiza (HPLC), ihame rya zahabu ryo gupima ingano y’imiti ikoreshwa mu miti, iragoye cyane, irahenze, kandi akenshi ntikwiriye mu bihe bikunze kugaragara mu muryango. Iterambere riherutse gukorwa mu isuzuma rya laboratwari ubu ritanga ubundi buryo kandi buhendutse bwo gusuzuma imitako y’imiti n’imiti ikoreshwa muri IRS [39, 40].
Ubu bushakashatsi bwakozwe kugira ngo bupime impinduka mu bwinshi bw’imiti yica udukoko mu gihe cy’ibikorwa bya IRS byo kurwanya ibirayi mu karere ka Chaco, muri Boliviya. Ubunini bw’imiti yica udukoko bwapimwe mu buryo bwateguwe mu bigega bya spray no mu mpapuro za filter zakusanyijwe mu byumba bya spray. Ibintu bishobora kugira ingaruka ku itangwa ry’imiti yica udukoko mu ngo nabyo byarasuzumwe. Muri urwo rwego, twakoresheje isuzuma rya chemical colorimetric kugira ngo tumenye ingano y’imiti ya pyrethroids muri ibyo bipimo.
Ubushakashatsi bwakorewe i Itanambicua, akarere ka Camili, ishami rya Santa Cruz, muri Boliviya (20°1′5.94″ S; 63°30′41″ W) (Ishusho ya 1). Aka karere ni kamwe mu duce twa Gran Chaco muri Amerika kandi karangwa n'amashyamba yumye mu gihe cy'umwaka afite ubushyuhe buri hagati ya 0–49 °C n'imvura iri hagati ya 500–1000 mm / umwaka [41]. Itanambicua ni imwe mu matsinda 19 ya Guaraní muri uyu mujyi, aho abaturage bagera ku 1.200 batuye mu mazu 220 yubatswe ahanini mu matafari y'izuba (adobe), uruzitiro gakondo na tabique (bizwi muri ako gace nka tabique), ibiti, cyangwa uruvange rw'ibi bikoresho. Izindi nyubako n'inyubako hafi y'inzu zirimo amazu y'inyamaswa, ububiko, ibikoni n'ubwiherero, byubatswe mu bikoresho bisa. Ubukungu bw'akarere bushingiye ku buhinzi butuma umuntu atunga, cyane cyane ibigori n'ubunyobwa, ndetse n'inkoko nto, ingurube, ihene, ibishuhe n'amafi, umusaruro w'imbere mu gihugu ugurishwa mu mujyi wa Kamili (uri hafi kilometero 12). Umujyi wa Kamili unatanga amahirwe menshi y'akazi ku baturage, cyane cyane mu bwubatsi no mu nzego za serivisi zo mu rugo.
Muri ubu bushakashatsi, igipimo cy’ubwandu bwa T. cruzi mu bana ba Itanambiqua (imyaka 2-15) cyari 20% [20]. Ibi bisa n’ubwiyongere bw’ubwandu mu bana bwagaragaye mu gace k’abaturanyi ka Guarani, aho kandi bwagaragaye ko ubwandu bwiyongera uko imyaka igenda ihita, aho abaturage benshi barengeje imyaka 30 banduye [19]. Kwandura kwanduzanya kwanduzanya kwanduzanya kwanduzanya kwanduzanya muri utu duce, aho Tri ari yo itera ubwandu bw’ingenzi. Infestans zinjira mu mazu no mu nyubako ziherereyemo [21, 22].
Urwego rushya rw’ubuzima mu mujyi rwatowe ntirwashoboye gutanga raporo ku bikorwa bya IRS muri Itanambicua mbere y’ubu bushakashatsi, icyakora raporo ziturutse mu baturage begereye aho zigaragaza neza ko ibikorwa bya IRS muri uwo mujyi byagiye bikorwa rimwe na rimwe kuva mu 2000 ndetse no gutera umuti muri rusange wa 20% beta cypermethrin; byakozwe mu 2003, bikurikirwa no gutera umuti mu mazu yangiritse kuva mu 2005 kugeza 2009 [22] no gutera umuti mu buryo busanzwe kuva mu 2009 kugeza 2011 [19].
Muri uyu muryango, IRS yakozwe n'inzobere eshatu z'ubuzima zahuguwe n'abaturage hakoreshejwe 20% bya alpha-cypermethrin suspension concentrate [SC] (Alphamost®, Hockley International Ltd., Manchester, UK). Iyi miti yica udukoko yakozwe ifite 50 mg ai/m2 itangwa hakurikijwe ibisabwa na gahunda yo kurwanya indwara ya Chagas yo mu ishami rishinzwe imiyoborere rya Santa Cruz (Servicio Departmentamental de Salud-SEDES). Imiti yica udukoko yakoreshejwe hakoreshejwe imashini itera umuti ya Guarany® mu mufuka (Guarany Indústria e Comércio Ltda, Itu, São Paulo, Brazil) ifite ubushobozi bwo gukora 8.5 l (kode y'ikigega: 0441.20), ifite umunwa utera umuti n'umuvuduko w'amazi wa 757 ml/min, bigatuma amazi ahinduka 80° ku gitutu gisanzwe cya silindiri ya 280 kPa. Abakozi b'isuku banavangaga amacupa y'umwuka n'amazu atera umuti. Abakozi bari barahuguwe n'ishami ry'ubuzima ryo mu mujyi wo muri ako gace gutegura no gutanga imiti yica udukoko, ndetse no gutera imiti yica udukoko ku nkuta z'imbere n'inyuma z'amazu. Banagiriwe inama yo gusaba abahatuye gusukura ibintu byose mu nzu, harimo n'ibikoresho byo mu nzu (usibye amadirishya yo kuryamamo), nibura amasaha 24 mbere yuko ikigo gishinzwe kugenzura ubwikorezi (IRS) gifata icyemezo cyo kwemerera kwinjira mu nzu imbere kugira ngo batere imiti. Kubahiriza iki gisabwa bipimirwa nkuko byasobanuwe hano hasi. Abaturage nabo baragirwa inama yo gutegereza kugeza igihe inkuta zasizwe irangi zimaze kuma mbere yo kongera kwinjira mu nzu, nk'uko byasabwe [42].
Kugira ngo bapime ingano ya lambda-cypermethrin AI yagejejwe mu ngo, abashakashatsi bashyizeho impapuro ziyungurura (Whatman No. 1; umurambararo wa mm 55) ku nkuta z'amazu 57 yari imbere ya IRS. Inzu zose zakiraga IRS icyo gihe zari zirimo (ingo 25/25 mu Gushyingo 2016 n'ingo 32/32 muri Mutarama-Gashyantare 2017). Izi zirimo amazu 52 ya adobe n'inzu 5 za tabik. Ibice umunani kugeza ku icyenda by'impapuro ziyungurura byashyizwe muri buri nzu, bigabanyijemo uburebure butatu bw'inkuta (0.2, 1.2 na metero 2 uvuye hasi), buri nkuta eshatu zatoranijwe mu buryo bunyuranyije n'isaha, uhereye ku muryango munini. Ibi byatanze kopi eshatu kuri buri nkuta, nk'uko byasabwe kugira ngo harebwe uburyo bwo gutanga imiti yica udukoko [43]. Ako kanya nyuma yo gukoresha umuti wica udukoko, abashakashatsi bakusanyije impapuro ziyungurura maze bazimisha kure y'izuba ryinshi. Iyo zimaze kuma, impapuro ziyungurura zapfundikirwaga kaseti isobanutse kugira ngo zirinde kandi zifate umuti wica udukoko ku buso bwapfundikiwe, hanyuma zipfundikirwa mu gipapuro cya aluminiyumu hanyuma zibikwa kuri dogere selisiyusi 7 kugeza igihe zipimwe. Mu mpapuro 513 zose zakusanyijwe, amazu 480 kuri 57 yari ahari kugira ngo apimwe, ni ukuvuga impapuro 8-9 kuri buri rugo. Ingero z'ibizamini zari zirimo impapuro 437 za filter zo mu mazu 52 ya adobe n'impapuro 43 za filter zo mu mazu 5 ya tabik. Ingero zijyanye n'ubwinshi bw'amazu mu baturage (76.2% [138/181] adobe na 11.6% [21/181] tabika) zanditswe mu bushakashatsi bwakozwe ku nzu n'inzu muri ubu bushakashatsi. Isesengura ry'impapuro za filter hakoreshejwe Insecticide Quantification Kit (IQK™) n'igenzura ryayo hakoreshejwe HPLC byasobanuwe muri Dosiye y'inyongera ya 1. Igipimo cy'imiti yica udukoko ni 50 mg ai/m2, ibyo bikaba byemerera kwihanganira ± 20% (ni ukuvuga 40–60 mg ai/m2).
Igipimo cy’ubukorano bw’ubukorano bwakozwe mu buryo bwa AI cyagenwe mu dusanduku 29 twakozwe n’abaganga. Twafashe ingero z’ibigega 1-4 byateguwe ku munsi, hamwe n’impuzandengo y’ibigega 1.5 (urugero: 1-4) byateguwe ku munsi mu gihe cy’iminsi 18. Urutonde rw’ingero rwakurikije urutonde rw’ingero rwakoreshejwe n’abakozi bo mu rwego rw’ubuzima mu Gushyingo 2016 na Mutarama 2017. Iterambere rya buri munsi kuva muri Mutarama Gashyantare. Nyuma yo kuvanga neza ibikubiye mu bikubiyemo, hatoranijwe mililitiro 2 z’umuti uvuye ku buso bw’ibirimo. Ingero ya mililitiro 2 yavanzwe muri laboratwari mu buryo bwo gukaraba iminota 5 mbere yuko ingero ebyiri za mililitiro 5.2 zikusanywa kandi zipimwa hakoreshejwe IQK™ nk’uko byasobanuwe (reba dosiye y’inyongera ya 1).
Igipimo cy’imiti yica udukoko cyapimwe mu bigega bine byatoranijwe by’umwihariko kugira ngo bigaragaze igipimo cy’imiti ikoreshwa mu ntangiriro (zero) mu gice cyo hejuru, hasi, n’icyagenewe. Nyuma yo kuvanga mu minota 15 ikurikiranye, kura ingero eshatu za 5.2 µL mu buso bwa buri gipimo cya 2 mL vortex mu gihe cy’umunota 1. Igipimo cy’umuti ukoreshwa mu kigega ni 1.2 mg ai/ml ± 20% (ni ukuvuga 0.96–1.44 mg ai/ml), bingana no kugera ku gipimo cy’umuti ukoreshwa mu kuyungurura, nk’uko byasobanuwe haruguru.
Kugira ngo dusobanukirwe isano iri hagati y’ibikorwa byo gutera imiti yica udukoko no gutanga imiti yica udukoko, umushakashatsi (RG) yaherekeje abakozi babiri bo mu rwego rw’ubuzima ba IRS mu gihe cyo kohereza imiti mu ngo 87 (amazu 57 yagaragajwe haruguru na 30 muri 43 yatewe imiti yica udukoko). Werurwe 2016). Inzu cumi n’eshatu muri izi 43 ntizakuwe mu isesengura: ba nyirayo batandatu baranze, naho ingo ndwi zavuwe igice gito gusa. Ubuso bwose bwagombaga guterwa (metero kare) imbere no hanze y’urugo bwapimwe mu buryo burambuye, kandi igihe cyose abakozi b’ubuzima bakoresha batera imiti (iminota) cyanditswe mu ibanga. Aya makuru yinjiye akoreshwa mu kubara igipimo cyo gutera imiti, gisobanurwa nk’ubuso bwatewe imiti ku munota (m2/min). Muri aya makuru, igipimo cyo gutera imiti cyabonetse/cyateganijwe gishobora kandi kubarwa nk'igipimo kigereranijwe, aho igipimo cyo gutera imiti giteganijwe ari 19 m2/min ± 10% ku bipimo by’ibikoresho byo gutera imiti [44]. Ku gipimo cyabonetse/cyateganijwe, intera yo kwihanganira ni 1 ± 10% (0.8–1.2).
Nkuko byavuzwe haruguru, amazu 57 yari afite impapuro ziyungurura ku nkuta zayo. Kugira ngo harebwe niba kuba hari impapuro ziyungurura byagize ingaruka ku mubare w’abakozi basukura, umubare w’izi 57 wagereranyijwe n’umubare w’izi 30 zavuwe muri Werurwe 2016 nta mpapuro ziyungurura zashyizweho. Igipimo cy’imiti yica udukoko cyapimwe gusa mu mazu afite impapuro ziyungurura.
Abaturage bo mu ngo 55 banditse ko bujuje ibisabwa mbere byo gusukura inzu muri IRS, harimo amazu 30 yatewe umuti muri Werurwe 2016 n'amazu 25 yatewe umuti mu Gushyingo 2016. 0–2 (0 = ibintu byose cyangwa byinshi bisigaye mu nzu; 1 = ibintu byinshi byakuwemo; 2 = inzu yakuwemo ubusa burundu). Ingaruka zo kubahiriza amategeko y'abatunze ku gipimo cyo gutera umuti no gukwirakwiza umuti wica udukoko muri moxa zakoreweho ubushakashatsi.
Imbaraga z'ibarurishamibare zarashyizwe mu rwego rwo kumenya itandukaniro rikomeye hagati y'ingano y'ibipimo bya alpha-cypermethrin ikoreshwa ku mpapuro ziyungurura, no kumenya itandukaniro rikomeye hagati y'ingano y'imiti yica udukoko n'umuvuduko wo gutera imiti hagati y'amatsinda y'amazu atandukanye. Imbaraga nkeya z'ibarurishamibare (α = 0.05) zashyizwe mu rwego rwo kumenya umubare muto w'amazu yatoranijwe ku itsinda iryo ari ryo ryose ry'ibyiciro (ni ukuvuga ingano idahinduka y'icyitegererezo) yagenwe ku ikubitiro. Muri make, kugereranya ingano y'imiti yica udukoko mu rugero rumwe mu bintu 17 byatoranijwe (byashyizwe mu byiciro nk'abafite imitungo itubahirije amategeko) byagize imbaraga za 98.5% zo kumenya itandukaniro rya 20% n'ingano y'ikigereranyo cy'icyitegererezo cyitezwe cya 50 mg ai / m2, aho itandukaniro (SD = 10) rirenze urugero hashingiwe ku byagaragaye ahandi [37, 38]. Kugereranya ingano y'imiti yica udukoko mu dusanduku twatoranijwe mu rugo kugira ngo habeho imikorere ingana (n = 21) > 90%.
Kugereranya ingero ebyiri z’ikigereranyo cy’ubucucike bw’imiti yica udukoko mu mazu n = 10 na n = 12 cyangwa igipimo cy’ubucucike bw’imiti muri n = 12 na n = 23 byatanze imbaraga z’ibarurishamibare za 66.2% na 86.2% kugira ngo bivumburwe. Ingano z’ibyitezwe ku gipimo cya 20% ni 50 mg ai/m2 na 19 m2/min, uko bikurikirana. Mu buryo busanzwe, byakekwaga ko hazabaho itandukaniro rinini muri buri tsinda ku gipimo cy’ubucucike bw’imiti (SD = 3.5) n’igipimo cy’ubucucike bw’imiti (SD = 10). Ingufu z’ibarurishamibare zari >90% ku igereranya ringana ry’igipimo cy’ubucucike bw’imiti hagati y’amazu afite impapuro ziyungurura (n = 57) n’amazu adafite impapuro ziyungurura (n = 30). Imibare yose y’ingufu yakozwe hakoreshejwe gahunda ya SAMPSI muri porogaramu ya STATA v15.0 [45]).
Impapuro za filter zakusanyijwe mu nzu zasuzumwe hakoreshejwe uburyo bwo gushyira amakuru muri multivariate negative binomial mixed-effects model (gahunda ya MENBREG muri STATA v.15.0) aho inkuta ziri mu nzu (urwego rutatu) nk'ingaruka zitunguranye. Ingano y'imirasire ya Beta. -cypermethrin io Models zakoreshejwe mu gupima impinduka zijyanye n'uburebure bw'urukuta rwa nebulizer (urwego rutatu), igipimo cyo gufunga (m2/min), itariki yo gutanga dosiye ya IRS, n'imiterere y'umutanga serivisi z'ubuvuzi (urwego rubiri). Modeli rusange y'umurongo (GLM) yakoreshejwe mu gupima isano iri hagati y'ingano mpuzandengo ya alpha-cypermethrin ku mpapuro za filter zagejejwe kuri buri rugo n'ingano iri mu gikoresho gihuye nacyo mu gikoresho cya spray. Gupima ingano y'imiti yica udukoko mu gikoresho cya spray mu gihe runaka byasuzumwe mu buryo nk'ubwo hashyizwemo agaciro k'ibanze (igihe zeru) nk'uko icyitegererezo cyagenwe, hapimwa igihe cy'imikoranire ya tank ID × igihe (iminsi). Ingingo z'amakuru zidasanzwe x zigaragazwa hakoreshejwe itegeko risanzwe rya Tukey boundary, aho x < Q1 - 1.5 × IQR cyangwa x > Q3 + 1.5 × IQR. Nk’uko byagaragajwe, igipimo cyo gutera imiti ku mazu arindwi n’igipimo cy’imiti yica udukoko ku nzu imwe ntibyigeze bigaragazwa mu isesengura ry’imibare.
Ubunyangamugayo bw'ipimwa ry'ibinyabutabire bya ai IQK™ by'ingano ya alpha-cypermethrin byemejwe hagereranyijwe agaciro k'ibipimo 27 by'impapuro ziyungurura zavuye mu bigo bitatu by'inkoko byapimwe na IQK™ na HPLC (ibipimo ngenderwaho bya zahabu), kandi ibyavuye mu bushakashatsi byagaragaje isano ikomeye (r = 0.93; p < 0.001) (Ishusho ya 2).
Isano y'ingano ya alpha-cypermethrin mu mpapuro ziyungurura zakusanyijwe mu mazu y'inkoko yavuye muri IRS, yapimwe na HPLC na IQK™ (n = impapuro 27 ziyungurura zavuye mu mazu atatu y'inkoko)
IQK™ yageragejwe ku mpapuro 480 za filter zakusanyijwe mu macumbi y'inkoko 57. Ku mpapuro za filter, alpha-cypermethrin yari hagati ya 0.19 na 105.0 mg ai/m2 (impuzandengo ya 17.6, IQR: 11.06-29.78). Muri izi, 10.4% gusa (50/480) ni zo zari mu cyiciro cyagenwe cya 40–60 mg ai/m2 (Ishusho ya 3). Ibyinshi mu bipimo (84.0% (403/480)) byari bifite 60 mg ai/m2. Itandukaniro mu mpuzandengo yagereranyijwe kuri buri rugo ku byuma 8-9 bya filter byakusanyijwe kuri buri rugo ryari urwego rw'ingano, hamwe n'impuzandengo ya 19.6 mg ai/m2 (IQR: 11.76-28.32, impuzandengo: 0. 60-67.45). 8.8% gusa (5/57) by'ahantu byabonye ingano y'imiti yica udukoko; 89.5% (51/57) bari munsi y'imipaka y'urwego rw'intego, naho 1.8% (1/57) bari hejuru y'imipaka y'urwego rw'intego (Ishusho ya 4).
Ingano ya alpha-cypermethrin ikwirakwizwa inshuro nyinshi ku byuma byakusanyijwe mu ngo zavuwe na IRS (n = ingo 57). Umurongo uhagaze ugaragaza urugero rw'ingano ya cypermethrin ai (50 mg ± 20% ai / m2).
Igipimo cya beta-cypermethrin av ku mpapuro 8-9 za filter kuri buri rugo, byakusanyijwe mu ngo zatunganyijwe na IRS (n = ingo 57). Umurongo utambitse ugaragaza igipimo cya alpha-cypermethrin ai (50 mg ± 20% ai / m2). Utudomo tw'amakosa tugaragaza imipaka yo hasi n'iyo hejuru y'agaciro k'igipimo kiri hafi.
Igipimo cy’impuzandengo cyatanzwe ku byuma bifata uburebure bw’inkuta 0.2, 1.2 na 2.0 m cyari 17.7 mg ai/m2 (IQR: 10.70–34.26), 17.3 mg a .i./m2 (IQR: 11.43–26.91) na 17.6 mg ai/m2. (IQR: 10.85–31.37) (bigaragara muri dosiye y’inyongera ya 2). Mu kugenzura itariki ya IRS, icyitegererezo cy’ingaruka zivanze nticyagaragaje itandukaniro rinini mu gipimo hagati y’uburebure bw’inkuta (z < 1.83, p > 0.067) cyangwa impinduka zikomeye ku itariki yo gutera (z = 1.84 p = 0.070). Igipimo cy’impuzandengo cyatanzwe ku mazu 5 ya adobe ntabwo cyari gitandukanye n’igipimo cy’impuzandengo cyatanzwe ku mazu 52 ya adobe (z = 0.13; p = 0.89).
Igipimo cya AI mu ducupa 29 twa Guarany® twakozwe ku giti cyazo twatoranijwe mbere yo gukoresha IRS cyahindutseho 12.1, kuva kuri 0.16 mg AI/mL kugeza kuri 1.9 mg AI/mL kuri buri gacupa (Ishusho ya 5). 6.9% (2/29) by'uducupa twa aerosol gusa ni byo byari bifite igipimo cya AI mu gipimo cya 0.96–1.44 mg AI/ml, na 3.5% (1/29) by'uducupa twa aerosol byari bifite igipimo cya AI >1.44 mg AI/ml.
Impuzandengo y'ingano ya alpha-cypermethrin ai yapimwe mu buryo 29 bwo gutera imiti. Umurongo utambitse ugaragaza urugero rw'ingano ya AI isabwa ku macupa ya aerosol (0.96–1.44 mg/ml) kugira ngo hagerwe ku rugero rw'ingano ya AI ya 40–60 mg/m2 mu nzu y'inkoko.
Mu macupa 29 ya aerosol yasuzumwe, 21 yahuye n'amazu 21. Igipimo cy'impuzandengo cya ai yagejejwe mu nzu ntabwo cyajyanye n'ingano iri mu bigega bya spray byakoreshejwe mu kuvura inzu (z = -0.94, p = 0.345), byagaragaye mu isano iri hasi (rSp2 = -0.02) (Ishusho ya .6).).
Isano iri hagati y’ubwinshi bwa beta-cypermethrin AI ku mpapuro 8-9 za filter zakusanyijwe mu mazu yavuwe na IRS n’ubwinshi bwa AI mu miti iterwa na spray mu rugo ikoreshwa mu kuvura buri rugo (n = 21)
Igipimo cya AI mu bisubizo byo hejuru by'imiti ine ya sprayers yakusanyijwe ako kanya nyuma yo kuyinyeganyeza (igihe cya 0) cyarahindutseho 3.3 (0.68–2.22 mg AI/ml) (Ishusho ya 7). Ku gikoresho kimwe agaciro kari mu rwego rw'intego, ku gikoresho kimwe agaciro kari hejuru y'intego, ku bindi bikoresho bibiri agaciro kari munsi y'intego; Igipimo cy'imiti yica udukoko cyagabanutse cyane mu bidendezi byose bine mu gihe cy'iminota 15 yo gukurikiranwa (b = -0.018 kugeza -0.084; z > 5.58; p < 0.001). Ukurikije agaciro k'ibanze k'igikoresho kimwe, igihe cyo gukorana n'ikigega cya Tank ID x Igihe (iminota) ntabwo cyari kinini (z = -1.52; p = 0.127). Mu bidendezi bine, igihombo cy’umuti wica udukoko wa mg ai/ml cyari 3.3% ku munota (95% CL 5.25, 1.71), kigera kuri 49.0% (95% CL 25.69, 78.68) nyuma y’iminota 15 (Ishusho ya 7).
Nyuma yo kuvanga neza imiti iri mu bigega, igipimo cy'imvura ya alpha-cypermethrin ai cyapimwe mu bigega bine bitera imiti mu gihe cy'umunota 1 mu gihe cy'iminota 15. Umurongo ugaragaza neza uko amakuru ahuye neza n'aya makuru ugaragazwa kuri buri kigega. Ibyagaragaye (ingingo) bigaragaza ikigereranyo cy'ibice bitatu by'inyongera.
Ubuso bw'inkuta buri rugo ku buryo bwo kuvura indwara za IRS bwari 128 m2 (IQR: 99.0–210.0, urwego: 49.1–480.0) kandi igihe impuzandengo cyakoreshejwe n'abakozi b'ubuzima cyari iminota 12 (IQR: 8. 2–17.5, urwego: 1.5–36.6). ) buri rugo rwasutsweho (n = 87). Ubuso bw'inkoko bwagaragaye muri izi nkoko bwari hagati ya 3.0 na 72.7 m2/umunota (impuzandengo: 11.1; IQR: 7.90–18.00) (Ishusho ya 8). Ibikoresho byo gusukura byakuwemo kandi igipimo cyo gusukura cyagereranyijwe n'igipimo cyo gusukura cyatanzwe na OMS cya 19 m2/umunota ± 10% (17.1–20.9 m2/umunota). 7.5% gusa (6/80) by'ingo byari muri ubu bwoko; 77.5% (62/80) bari mu cyiciro cyo hasi naho 15.0% (12/80) bari mu cyiciro cyo hejuru. Nta sano yabonetse hagati y’ikigereranyo cy’ubucucike bw’ubukorano bwa AI bugezwa mu ngo n’uburyo bwagaragaye bwo gusukura (z = -1.59, p = 0.111, n = ingo 52).
Igipimo cyo gutera imiti (min/m2) cyagaragaye mu bigo by’inkoko byavuwe na IRS (n = 87). Umurongo w’icyitegererezo ugaragaza igipimo cyo kwihanganira gutera imiti cya 19 m2/min (± 10%) nk’uko bisabwa n’ibikoresho byo gutera imiti.
80% by'amazu 80 yari afite igipimo cyabonetse/cyari giteganijwe cyo gupfundikira imiyoboro y'amazi kiri hanze y'igipimo cya 1 ± 10% cyo kwihanganira, aho 71.3% (57/80) by'amazu byari biri hasi, 11.3% (9/80) byari hejuru, naho amazu 16 yari munsi y'igipimo cyabonetse/cyari giteganijwe. Ingano y'ikwirakwizwa ry'igipimo cyabonetse/cyari giteganijwe igaragara muri dosiye y'inyongera ya 3.
Hari itandukaniro rinini mu gipimo cy’impuzandengo hagati y’abakozi babiri bo mu rwego rw’ubuzima bakoraga IRS buri gihe: 9.7 m2/umunota (IQR: 6.58–14.85, n = 68) ugereranyije na 15.5 m2/umunota (IQR: 13.07–21.17, n = 12). (z = 2.45, p = 0.014, n = 80) (nk’uko bigaragara muri dosiye y’inyongera 4A) n’igipimo cy’igipimo cy’isukari cyabonetse/cyari giteganijwe (z = 2.58, p = 0.010) (nk’uko bigaragara muri dosiye y’inyongera 4B yerekana).
Uretse indwara zidasanzwe, umukozi umwe gusa ni we wasutse imiti mu mazu 54 yashyizwemo impapuro ziyungurura. Igipimo cyo gusukura imiti muri aya mazu cyari 9.23 m2/umunota (IQR: 6.57–13.80) ugereranije na 15.4 m2/umunota (IQR: 10.40–18.67) mu mazu 26 adafite impapuro ziyungurura (z = -2.38, p = 0.017). ).
Ingo zubahiriza itegeko ryo kuva mu mazu yazo kugira ngo zihabwe serivisi za IRS ryaratandukanye: 30.9% (17/55) ntibavuye mu mazu yabo igice naho 27.3% (15/55) ntibavuye mu mazu yabo burundu; basenye amazu yabo.
Urugero rw’imiti yakoreshejwe mu mazu atarimo ubusa (17.5 m2/min, IQR: 11.00–22.50) muri rusange rwari hejuru kurusha mu mazu atarimo ubusa (14.8 m2/min, IQR: 10.29–18 .00) n’amazu yarimo ubusa burundu (11.7 m2). /min, IQR: 7.86–15.36), ariko itandukaniro ntiryari rinini (z > -1.58; p > 0.114, n = 48) (bigaragara muri dosiye y’inyongera 5A). Ibisubizo nk’ibyo byabonetse ubwo hasuzumwaga impinduka zijyanye no kuba hari cyangwa nta rupapuro rwa filter, ariko ntibyagaragaye ko ari covariate ikomeye muri model.
Muri ayo matsinda atatu, igihe ntarengwa cyasabwaga mu gusasa amazu ntabwo cyatandukaniye ku mazu (z < -1.90, p > 0.057), mu gihe ubuso bw'imbere bwatandukanye: amazu adafite ubusa rwose (104 m2 [IQR: 60.0–169, 0 m2) ]) ni ntoya mu mibare ugereranije n'amazu adafite ubusa (224 m2 [IQR: 174.0–284.0 m2]) n'amazu adafite ubusa gato (132 m2 [IQR: 108.0–384.0 m2]) (z > 2 .17; p < 0.031, n = 48). Amazu adafite ubusa rwose ni hafi kimwe cya kabiri cy'amazu adafite ubusa cyangwa adafite ubusa gato.
Ku mubare muto w’ingo (n = 25) hamwe n’amakuru yerekeye ubuziranenge bw’imiti yica udukoko, nta tandukaniro ryagaragaye mu gipimo cy’ubuziranenge bw’imiti ya AI yagejejwe mu ngo hagati y’ibi byiciro by’ubuziranenge (z < 0.93, p > 0.351), nk’uko byagaragajwe muri Dosiye y’inyongera ya 5B. Ibisubizo nk’ibyo byabonetse mu gihe cyo kugenzura niba hari/hari impapuro ziyungurura ndetse no kubona ko hari imiyoboro ipfundikiye (n = 22).
Ubu bushakashatsi busuzuma imikorere n'imikorere ya IRS mu gace gasanzwe ko mu cyaro mu karere ka Gran Chaco muri Boliviya, agace gafite amateka maremare yo kwanduzanya imiyoboro y'amaraso [20]. Igipimo cya alpha-cypermethrin ai itangwa mu gihe cya IRS gisanzwe cyaratandukanye cyane hagati y'amazu, hagati y'amafiriti yo mu nzu, no hagati y'ibigega bya spray byateguwe kugira ngo bigere ku gipimo kimwe cya 50 mg ai / m2. 8.8% by'ingo (10.4% by'amafiriti) ni zo zari zifite igipimo kiri hagati ya 40-60 mg ai / m2, aho inyinshi (89.5% na 84% uko bikurikirana) zifite igipimo kiri munsi y'umupaka muto wemewe.
Kimwe mu bintu bishobora gutuma alpha-cypermethrin igera mu rugo mu buryo butari bwiza ni ukugabanya imiti yica udukoko mu buryo butari bwo ndetse n'ingano idahuye y'imiti ishyirwa mu bigega bya spray [38, 46]. Mu bushakashatsi buriho ubu, ibyo abashakashatsi bagaragaje ku bakozi b'ubuzima bemeje ko bakurikije uburyo bwo gutegura imiti yica udukoko kandi bahuguwe na SEDES gukangura cyane umuti nyuma yo kuwugabanya mu kigega cya spray. Ariko, isesengura ry'ibiri mu kigega ryagaragaje ko ingano ya AI yahindutseho 12, aho 6.9% (2/29) gusa by'imiti ya spray biri mu rwego rwo kugera ku ntego; Kugira ngo hakorwe ubushakashatsi bwimbitse, ibisubizo biri ku buso bw'ikigega cya spray byapimwe mu buryo bwa laboratwari. Ibi bigaragaza igabanuka rya alpha-cypermethrin ai rya 3.3% ku munota nyuma yo kuvanga n'igihombo cya ai cya 49% nyuma y'iminota 15 (95% CL 25.7, 78.7). Igipimo cyo hejuru cy’imitsi iterwa no guhuriza hamwe imiti yica udukoko ikorwa nyuma yo kuvanga ifu itose (WP) ntabwo gikunze kubaho (urugero, DDT [37, 47]), kandi ubu bushakashatsi bukomeza bugaragaza ibi kuri iyo miti ya SA pyrethroid. Imiti ikoreshwa cyane muri IRS kandi, kimwe n’imiti yose yica udukoko, ubushobozi bwayo bwo ku mubiri buterwa n’ibintu byinshi, cyane cyane ingano y’uduce tw’ikintu gikora n’ibindi bikoresho. Imitsi ishobora kandi kugira ingaruka ku bukomere rusange bw’amazi akoreshwa mu gutegura imitsi, ikintu kigoye kugenzura mu murima. Urugero, muri ubu bushakashatsi, amazi agera ku migezi yo mu gace agaragaza impinduka mu bihe by’amazi n’uduce tw’ubutaka duhagaze. Uburyo bwo kugenzura uburyo ibintu bya SA bihagaze neza burimo gukorwa [48]. Ariko, imiti yo munsi y’ubutaka yakoreshejwe neza mu kugabanya ubwandu mu ngo muri bagiteri zitera indwara mu bindi bice bya Amerika y’Epfo [49].
Imiti idahagije yo kwica udukoko yagaragaye no mu zindi gahunda zo kurwanya udukoko. Urugero, muri gahunda yo kurwanya leishmaniasis ya visceral mu Buhinde, 29% gusa by'amatsinda 51 yo gutera imiti ya DDT yateguwe neza kandi ivanze, kandi nta na kimwe cyuzuye ibigega byo gutera imiti nkuko byasabwe [50]. Isuzuma ryakozwe ku midugudu yo muri Bangladesh ryagaragaje icyerekezo nk'iki: 42–43% by'amatsinda y'ishami rya IRS ni yo yateguye imiti yica udukoko n'amabati yuzuza nk'uko byagenwe, mu gihe mu gace kamwe k'umubare wari 7.7% gusa [46].
Impinduka zagaragaye mu bwinshi bw'ubukorano bwa AI bwashyizwe mu ngo nazo si umwihariko. Mu Buhinde, 7.3% gusa (41 kuri 560) by'amazu yavuwe ni yo yabonye urugero rwa DDT, aho itandukaniro riri hagati y'amazu n'andi manini [37]. Muri Nepal, impapuro ziyungurura zafashe impuzandengo ya 1.74 mg ai/m2 (urugero: 0.0–17.5 mg/m2), ni ukuvuga 7% gusa by'urugero rwagenewe (25 mg ai/m2) [38]. Isesengura rya HPLC ku mpapuro ziyungurura ryagaragaje itandukaniro rinini mu bwinshi bw'ubukorano bwa deltamethrin ai ku nkuta z'amazu muri Chaco, muri Paraguay: kuva kuri 12.8–51.2 mg ai/m2 kugeza kuri 4.6–61.0 mg ai/m2 ku bisenge [33]. Muri Tupiza, muri Boliviya, gahunda yo kugenzura Chagas yatangaje ko deltamethrin yageze mu ngo eshanu ku rugero rwa 0.0–59.6 mg/m2, nk'uko HPLC yabipimye [36].
Igihe cyo kohereza ubutumwa: 16 Mata 2024