Visceral leishmaniasis (VL), izwi ku izina rya kala-azar mu gace k'Ubuhinde, ni indwara iterwa n'udukoko two mu bwoko bwa Leishmania ya protozoan ishobora kwica iyo idavuwe vuba. Isazi yo mu bwoko bwa Phlebotomus argentipes ni yo yonyine yemejwe ko itera VL mu majyepfo y'uburasirazuba bwa Aziya, aho igenzurwa no gutera imiti ikoreshwa mu nzu (IRS), umuti wica udukoko. Gukoresha DDT muri gahunda zo kurwanya VL byatumye habaho ubudahangarwa bw'udukoko two mu bwoko bwa sandwriter, bityo DDT yasimbuwe n'umuti wica udukoko witwa alpha-cypermethrin. Ariko, alpha-cypermethrin ikora kimwe na DDT, bityo ibyago byo kudahangarwa kw'udukoko two mu bwoko bwa sandwriter byiyongera iyo umuntu agize ikibazo cyo guhura n'uyu muti kenshi. Muri ubu bushakashatsi, twasuzumye uburyo imibu yo mu gasozi n'urubyaro rwayo rwa F1 bishobora guhitana abantu benshi dukoresheje uburyo bwa CDC bwo gusuzuma udukoko.
Twakusanyije imibu mu midugudu 10 yo mu karere ka Muzaffarpur muri Bihar, mu Buhinde. Imidugudu umunani yakomeje gukoresha imbaraga nyinshi.cypermethrineKu bijyanye no gutera imiti mu nzu, umudugudu umwe wahagaritse gukoresha cypermethrin ifite imbaraga nyinshi mu gutera imiti mu nzu, naho umudugudu umwe ntiwigeze ukoresha cypermethrin ifite imbaraga nyinshi mu gutera imiti mu nzu. Imibu yakusanyijwe yashyizwe mu byiciro byagenwe mbere y’igihe runaka (3 μg/ml mu minota 40), kandi igipimo cy’impfu n’uko yaguye byagaragaye nyuma y’amasaha 24 nyuma yo guhura n’iyi ndwara.
Igipimo cy’impfu z’imibu yo mu gasozi cyari hagati ya 91.19% na 99.47%, naho iz’abakomoka mu gisekuru cya F1 zari hagati ya 91.70% na 98.89%. Amasaha makumyabiri n’ane nyuma yo kwandura, urupfu rw’imibu yo mu gasozi rwari hagati ya 89.34% na 98.93%, naho iz’abakomoka mu gisekuru cya F1 zari hagati ya 90.16% na 98.33%.
Ibisubizo by'ubu bushakashatsi bigaragaza ko kurwanya P. argentipes bishobora kugaragara, bigaragaza ko hakenewe gukomeza gukurikiranwa no kuba maso kugira ngo hakomeze kugenzurwa igihe cyo kurandura burundu.
Indwara ya Visceral leishmaniasis (VL), izwi ku izina rya kala-azar mu gace k'Ubuhinde, ni indwara iterwa n'udukoko twa Leishmania duto kandi twandurira mu kurumwa n'udukoko tw'ingore twanduye (Diptera: Myrmecophaga). Indwara ya Santimetero ni yo yonyine yemejwe ko itera VL mu majyepfo y'uburasirazuba bwa Aziya. Ubuhinde buri hafi kugera ku ntego yo gukuraho VL. Ariko, kugira ngo umubare w'udukoko nyuma yo kurandura burundu ukomeze kuba muto, ni ngombwa kugabanya umubare w'udukoko kugira ngo hirindwe ko twandura.
Kurwanya imibu muri Aziya y'Amajyepfo y'Uburasirazuba bikorwa binyuze mu gutera imiti yica udukoko mu nzu (IRS) hakoreshejwe imiti yica udukoko ikoze mu nganda. Imyitwarire yo kuruhuka mu ibanga kw'amaguru y'ifeza ituma iba intego ikwiriye yo kurwanya imiti yica udukoko binyuze mu gutera imiti yica udukoko mu nzu [1]. Gutera imiti ya dichlorodiphenyltrichloroethane (DDT) mu nzu muri gahunda y'igihugu yo kurwanya malariya mu Buhinde byagize ingaruka zikomeye mu kugabanya umubare w'imibu no kugabanya cyane umubare w'abandura indwara ya VL [2]. Uku kugenzura VL kutari guteganyijwe byatumye gahunda yo guca VL mu Buhinde ikoresha gutera imiti ikoreshwa mu nzu nk'uburyo bw'ibanze bwo kurwanya amaguru y'ifeza. Mu 2005, guverinoma z'Ubuhinde, Bangladesh, na Nepal zasinye amasezerano y'ubwumvikane hagamijwe gukuraho VL bitarenze 2015 [3]. Ibikorwa byo kurandura, birimo guhuza uburyo bwo kurwanya ibinyabuzima bitera indwara no gusuzuma vuba no kuvura indwara z'abantu, byari bigamije kwinjira mu cyiciro cyo guhuza indwara bitarenze 2015, intego yaje kuvugururwa kugeza 2017 hanyuma 2020. [4] Gahunda nshya ku isi yo kurandura indwara zititaweho zirimo kurandura VL bitarenze 2030. [5]
Mu gihe Ubuhinde bugiye mu cyiciro cya nyuma yo kurandura BCVD, ni ngombwa kugenzura ko ubudahangarwa bukomeye bwa beta-cypermethrin butabaho. Impamvu yo kudahangarwa ni uko DDT na cypermethrin byombi bifite uburyo bumwe bwo gukora, ari byo, byibasira poroteyine ya VGSC [21]. Bityo, ibyago byo kudahangarwa kw'udusimba mu dusimba bishobora kwiyongera bitewe n'umuvuduko uterwa no guhora uhura na cypermethrin ikomeye cyane. Bityo rero, ni ngombwa kugenzura no kumenya ubwoko bw'udusimba dushobora kudahangarwa n'iyi miti yica udukoko. Muri uru rwego, intego y'ubu bushakashatsi kwari ukugenzura uko udusimba two mu gasozi duhagaze hakoreshejwe ibipimo byo gusuzuma no kumara igihe cyo gukwirakwira byagenwe na Chaubey et al. [20] bigaga P. argentipes zo mu midugudu itandukanye yo mu karere ka Muzaffarpur muri Bihar, mu Buhinde, aho dukomeza gukoresha uburyo bwo gutera imiti mu nzu buvurwa na cypermethrin (imidugudu ya IPS ihoraho). Uburyo P. argentipes zo mu gasozi zihagaze mu midugudu yari yarahagaritse gukoresha uburyo bwo gutera imiti mu nzu bwatewe umuti wa cypermethrin (ibyahoze ari imidugudu ya IPS) n'indi itarigeze ikoresha uburyo bwo gutera imiti mu nzu bwatewe umuti wa cypermethrin (imidugudu itari iya IPS) byagereranyijwe hakoreshejwe uburyo bwa CDC bwo gusuzuma indwara.
Imidugudu icumi yatoranijwe kugira ngo ikorerwe ubushakashatsi (Ishusho ya 1; Imbonerahamwe ya 1), muri yo umunani yari ifite amateka yo gutera imiti itera pyrethroids mu nzu (hypermethrin; yitwa imidugudu itera hypethrin ikomeza) kandi yari ifite uburwayi bwa VL (nibura ikibazo kimwe) mu myaka 3 ishize. Mu midugudu ibiri isigaye muri ubwo bushakashatsi, umudugudu umwe utarashyize mu bikorwa gutera imiti itera pyrethrin mu nzu (umudugudu utari utera hypethrin mu nzu) watoranijwe nk'umudugudu ugenzura, naho undi mudugudu wateranye imiti itera pyrethrin mu nzu rimwe na rimwe (umudugudu utera hypethrin mu nzu rimwe na rimwe/uwahoze ari utera hypethrin mu nzu) watoranijwe nk'umudugudu ugenzura. Gutoranya iyi midugudu kwashingiye ku bufatanye n'Ishami ry'Ubuzima n'Itsinda rishinzwe gutera hypethrine mu nzu no kwemeza Gahunda y'Ibikorwa byo gutera hypethrine mu Ngoro mu Karere ka Muzaffarpur.
Ikarita y'ahantu akarere ka Muzaffarpur kagaragaza aho imidugudu iri muri ubwo bushakashatsi iherereye (1–10). Aho ubushakashatsi bubera: 1, Manifulkaha; 2, Ramdas Majhauli; 3, Madhubani; 4, Anandpur Haruni; 5, Pandey; 6, Hirapur; 7, Madhopur Hazari; 8, Hamidpur; 9, Noonfara; 10, Simara. Iyi karita yateguwe hakoreshejwe porogaramu ya QGIS (version 3.30.3) na Open Assessment Shapefile.
Amacupa yo gupima uburozi yateguwe hakurikijwe uburyo bwa Chaubey et al. [20] na Denlinger et al. [22]. Muri make, amacupa y'ibirahure ya mL 500 yateguwe umunsi umwe mbere y'igerageza kandi urukuta rw'imbere rw'amacupa rwari rwasizwe umuti wica udukoko (igipimo cyo gusuzuma cya α-cypermethrin cyari 3 μg / mL) hakoreshejwe umuti wa acetone w'umuti wica udukoko (2.0 mL) hasi, ku nkuta no ku mupfundikizo w'amacupa. Buri cupa ryamanitswe ku mupfundikizo w'icyuma mu gihe cy'iminota 30. Muri iki gihe, kura umupfundikizo buhoro buhoro kugira ngo acetone ishire. Nyuma y'iminota 30 yo kuma, kura umupfundikizo hanyuma uzunguruke icupa kugeza acetone yose ishize. Amacupa yasigaye afunguye kugira ngo yumuke ijoro ryose. Kuri buri kizamini gisubiwemo, icupa rimwe, ryakoreshejwe nk'igenzura, ryasizwe na acetone ya mL 2.0. Amacupa yose yongeye gukoreshwa mu igerageza nyuma yo gusukurwa neza hakurikijwe uburyo bwasobanuwe na Denlinger et al. n'Ishami ry'Umuryango w'Abibumbye ryita ku Buzima [22, 23].
Ku munsi wakurikiyeho wo gutegura imiti yica udukoko, imibu 30-40 yafashwe n’inyamaswa zo mu gasozi (ingore zishonje) yakuwe mu bikari mu ducupa maze ihuhwa buhoro buhoro muri buri gacupa. Hakoreshejwe umubare ungana w’udukoko kuri buri gacupa gapfundikiye imiti yica udukoko, harimo n’agacupa ko kuyirwanya. Subiramo ibi nibura inshuro eshanu kugeza kuri esheshatu muri buri mudugudu. Nyuma y’iminota 40 yo guhura n’umuti wica udukoko, umubare w’udukoko twakubiswe waranditswe. Isazi zose zafashwe hakoreshejwe icyuma gishyushya udukoko, zishyirwa mu bikoresho bya pint bitwikiriwe n’urushundura rwiza, hanyuma zishyirwa mu cyuma gishyushya udukoko mu buryo butandukanye munsi y’ubushuhe n’ubushyuhe bumwe hamwe n’isoko imwe y’ibiribwa (udupira tw’ipamba twashyizwe mu isukari ya 30%) nk’udukoko twavuwe. Impfu zanditswe amasaha 24 nyuma yo guhura n’umuti wica udukoko. Imibu yose yaciwemo ibice kandi irasuzumwa kugira ngo hemezwe ubwoko bw’inyamaswa. Uburyo bumwe bwakozwe ku nsazi z’abana ba F1. Igipimo cyo kugwa no gupfa cyanditswe amasaha 24 nyuma yo guhura n’udukoko. Niba impfu mu macupa yo kurwanya udukoko zari munsi ya 5%, nta gukosora impfu zakozwe mu macupa yo kurwanya udukoko. Iyo impfu mu icupa ryo kugenzura zari ≥ 5% na ≤ 20%, impfu mu macupa yo gusuzuma y’iyo kopi zakosowe hakoreshejwe formula ya Abbott. Iyo impfu mu itsinda ryo kugenzura zarenze 20%, itsinda ryose ryo gusuzuma ryajugunywe [24, 25, 26].
Impfu z’imibu ya P. argentipes yafashwe mu gasozi. Uduce tw’amakosa tugaragaza amakosa asanzwe y’impuzandengo. Aho imirongo ibiri itukura itambitse ihurira n’imbonerahamwe (90% na 98% by’impfu, uko bikurikirana) bigaragaza igihe cy’impfu zishobora kubaho aho ubudahangarwa bushobora kugaragara.[25]
Impfu z’urubyaro rwa F1 rw’udukoko twa P. argentipes twafashwe n’inyamaswa zo mu gasozi. Imirongo y’amakosa yerekana amakosa asanzwe y’impuzandengo. Imirongo ihurirana n’imirongo ibiri itukura itambitse (90% na 98% by’impfu, uko bikurikirana) igaragaza urwego rw’impfu zishobora kubaho ku budahangarwa [25].
Imibu yo mu mudugudu ugenzurwa/utari uwa IRS (Manifulkaha) yagaragaye ko yibasirwa cyane n’imiti yica udukoko. Impfu z’imibu yafashwe mu gasozi (±SE) nyuma y’amasaha 24 imaze kugwa no kwangirika zari 99.47 ± 0.52% na 98.93 ± 0.65%, uko bikurikirana, naho impuzandengo y’impfu z’abana ba F1 yari 98.89 ± 1.11% na 98.33 ± 1.11% uko bikurikirana (Imbonerahamwe ya 2, 3).
Ibisubizo by'ubu bushakashatsi bigaragaza ko isazi zo mu mucanga zifite amaguru y'ifeza zishobora kugira ubudahangarwa kuri pyrethroid (SP) α-cypermethrin mu midugudu aho isazi zo mu mucanga zifite amaguru y'ifeza zakusanyijwe mu midugudu itarimo gahunda ya IRS/igenzura byagaragaye ko zishobora kwibasirwa cyane. Gukurikirana uburyo isazi zo mu mucanga zifatwa n'udukoko two mu gasozi zishobora kwibasirwa ni ingenzi mu kugenzura uburyo imiti yica udukoko ikoreshwa, kuko aya makuru ashobora gufasha mu gucunga uburyo imiti yica udukoko ifatwa n'udukoko. Ingano nini y'ubudahangarwa bwa DDT yakunze kugaragara mu duce twa Bihar bitewe n'igitutu cya kera cyavuye muri IRS ikoresha uyu muti [1].
Twasanze P. argentipes ishobora kwanduza cyane pyrethroids, kandi igerageza ryakozwe mu Buhinde, Bangaladeshi na Nepal ryagaragaje ko IRS ifite ubushobozi bwo kurwanya udukoko mu mitsi iyo ikoreshejwe hamwe na cypermethrin cyangwa deltamethrin [19, 26, 27, 28, 29]. Mu minsi ishize, Roy et al. [18] bavuze ko P. argentipes yagize ubudahangarwa ku ndwara ya pyrethroids muri Nepal. Ubushakashatsi bwacu bwo kwanduza inyamaswa mu murima bwagaragaje ko isazi zo mu mucanga zifite amaguru maremare zakusanyijwe mu midugudu itari iya IRS zari zikunze kwibasirwa cyane, ariko isazi zakusanyijwe mu midugudu ya IRS ihoraho/iyahoze ari iya IRS n’iya IRS ihoraho (impfu zari hagati ya 90% na 97% usibye isazi zo mu mucanga zo muri Anandpur-Haruni zapfuye 89.34% nyuma y’amasaha 24) zishobora kuba zirwanya cypermethrin ikomeye cyane [25]. Impamvu imwe ishoboka yatumye habaho uku kudakora neza kw'iyi miti ni igitutu giterwa no gutera imiti mu nzu (IRS) na gahunda zo gutera imiti mu gace, ari na zo nzira zisanzwe zo gucunga icyorezo cya kala-azar mu turere/imiturire/imidugudu yakunze kugaragara (Uburyo Busanzwe bwo Gukurikirana no Gucunga Icyorezo [30]. Ibisubizo by'ubu bushakashatsi bitanga ibimenyetso bya mbere by'iterambere ry'igitutu cyatoranijwe kuri cypermethrin ifite akamaro kanini. Ikibabaje ni uko amakuru y'amateka y'ububabare kuri aka gace, yabonetse hakoreshejwe isuzuma ry'icupa rya CDC, ntabwo aboneka ngo agereranywe; ubushakashatsi bwose bwakozwe mbere bwakurikiranye uburyo P. argentipes ishobora gutera imiti hifashishijwe impapuro za OMS ziterwa imiti yica udukoko. Ingano y'imiti yica udukoko mu duce twa WHO ni urugero rw'imiti yica udukoko ikoreshwa mu gutera indwara za malariya (Anopheles gambiae), kandi uburyo iyi miti ikoreshwa mu gutera imiti ku dukoko ntabwo busobanutse neza kuko udukoko tw'umucanga tuguruka gake kurusha imibu, kandi tukamara igihe kinini dukorana n'ikintu kiri mu isuzuma ry'ibinyabuzima [23].
Inzoga za pyrethroids za synthetic zakoreshejwe mu turere twa Nepali twibasiwe n’udukoko twa VL, zisimburana na SPs alpha-cypermethrin na lambda-cyhalothrin mu kurwanya inzi zo mu mucanga [31], naho deltamethrin nayo yakoreshejwe muri Bangladesh kuva mu 2012 [32]. Ubudahangarwa bwa phenotypic bwagaragaye mu bwoko bw’inziga zo mu mucanga zifite uburebure bwa silver legged mu turere aho pyrethroids za synthetic zimaze igihe kirekire zikoreshwa [18, 33, 34]. Impinduka idasa na kimwe (L1014F) yagaragaye mu bwoko bw’inziga zo mu mucanga wo mu Buhinde kandi yanajyanye no kurwanya DDT, bigaragaza ko ubudahangarwa bwa pyrethroids buvuka ku rwego rwa molekile, kuko DDT na pyrethroid (alpha-cypermethrin) byombi bibanda kuri gene imwe mu mitsi y’udukoko [17, 34]. Kubwibyo, isuzuma ryimbitse ry’uburyo cypermethrin ishobora kwangirika no kugenzura uburyo inziga zirwanya ni ngombwa mu gihe cyo kurandura no nyuma yo kurandura.
Imbogamizi ishobora guterwa n'ubu bushakashatsi ni uko twakoresheje uburyo bwa CDC bwo gusuzuma indwara kugira ngo dupime ubushobozi bwo kwandura, ariko igereranya ryose ryakoresheje ibyavuye mu bushakashatsi bwabanje hakoreshejwe uburyo bwa WHO bwo gusuzuma indwara. Ibisubizo byavuye muri ubwo bushakashatsi bubiri bishobora kutagereranywa kuko uburyo bwa CDC bwo gusuzuma indwara bupima ko indwara yangiritse mu mpera z'igihe cyo gusuzuma, mu gihe uburyo bwa WHO bwo gusuzuma indwara bupima impfu mu masaha 24 cyangwa 72 nyuma yo guhura n'indwara (iya nyuma ni iy'ibintu bikora buhoro buhoro) [35]. Indi mbogamizi ishobora guterwa n'umubare w'imidugudu ya IRS muri ubu bushakashatsi ugereranije n'umudugudu umwe utari uwa IRS n'undi utari uwa IRS/uwahoze ari uwa IRS. Ntidushobora gutekereza ko urwego rw'ubudahangarwa bw'imibu yagaragaye mu midugudu imwe mu karere kamwe rugaragaza urwego rw'ubudahangarwa mu yindi midugudu n'uturere two muri Bihar. Mu gihe Ubuhinde bwinjiye mu cyiciro cya nyuma cyo gukuraho virusi ya leukemia, ni ngombwa gukumira iterambere rikomeye ry'ubudahangarwa. Gukurikirana byihuse ubudahangarwa bw'imiti mu duce dutandukanye tw'uturere, uduce dutandukanye n'uturere dutandukanye birakenewe. Amakuru yatanzwe muri ubu bushakashatsi ni ay’ibanze kandi agomba kwemezwa ugereranije n’ibipimo by’ibimenyetso byashyizwe ahagaragara n’Ishami ry’Umuryango w’Abibumbye ryita ku Buzima [35] kugira ngo haboneke igitekerezo cyihariye cy’uko P. argentipes ishobora kwanduzwa muri utwo duce mbere yo guhindura gahunda zo kurwanya indwara ziterwa n’udukoko kugira ngo hakomeze kuba hari udukoko duke mu miyoboro y’amazi no gushyigikira kurwanya virusi itera kanseri y’amaraso.
Umubu witwa P. argentipes, utera virusi ya leukosis, ushobora gutangira kugaragaza ibimenyetso bya mbere byo kudakira cypermethrin ifite imbaraga nyinshi. Gukurikirana buri gihe uburyo imiti yica udukoko mu mashyamba ya P. argentipes burwanya ni ngombwa kugira ngo hakomeze kubaho ingaruka z’ibikorwa byo kurwanya udukoko. Guhinduranya imiti yica udukoko hakoreshejwe uburyo butandukanye bwo gukora no/cyangwa gusuzuma no kwandika imiti mishya yica udukoko ni ngombwa kandi birasabwa kugira ngo hacungwe uburyo imiti yica udukoko irwanya udukoko no gushyigikira kurandura virusi ya leukosis mu Buhinde.
Igihe cyo kohereza: Gashyantare-17-2025