Visceral leishmaniasis (VL), izwi ku izina rya kala-azar ku mugabane w’Ubuhinde, ni indwara ya parasitike iterwa na protozoan Leishmania yanditseho ibendera ishobora guhitana abantu iyo itavuwe vuba. Umusenyi witwa Phlebotomus argentipes niwo muti wonyine wemejwe na VL mu majyepfo y’amajyepfo ya Aziya, aho ugenzurwa no gutera ibiti byo mu nzu (IRS), umuti wica udukoko. Gukoresha DDT muri gahunda yo kugenzura VL byatumye habaho iterambere ry’imyigaragambyo mu mucanga, DDT rero yasimbuwe na alpha-cypermethrin yica udukoko. Nyamara, alpha-cypermethrin ikora kimwe na DDT, bityo ibyago byo guhangana nudusimba twiyongera mugihe uhangayitse uterwa no guhura kenshi niyi miti yica udukoko. Muri ubu bushakashatsi, twasuzumye kwandura imibu yo mu gasozi n'urubyaro rwabo F1 dukoresheje icupa rya CDC bioassay.
Twakusanyije imibu yo mu midugudu 10 yo mu karere ka Muzaffarpur muri Bihar, mu Buhinde. Imidugudu umunani yakomeje gukoresha imbaraga nyinshicypermethrinyo gutera mu nzu, umudugudu umwe wahagaritse gukoresha cypermethrine ifite imbaraga nyinshi mu gutera mu ngo, kandi umudugudu umwe ntiwigeze ukoresha cypermethrine ifite imbaraga nyinshi mu gutera mu ngo. Imibu yakusanyirijwe hamwe yagaragaye mbere yo kwisuzumisha mugihe cyagenwe (3 μg / ml muminota 40), kandi igipimo cyo gukomeretsa nimpfu byanditswe 24h nyuma yo kugaragara.
Umubare w’ubwicanyi bw’imibu wo mu gasozi wari hagati ya 91.19% na 99.47%, naho abo mu gisekuru cyabo F1 bari hagati ya 91.70% na 98.89%. Nyuma yamasaha 24 nyuma yo kwerekanwa, impfu z’imibu zo mu gasozi zari hagati ya 89.34% na 98.93%, naho iz'ibisekuruza bya F1 ziva kuri 90.16% zigera kuri 98.33%.
Ibyavuye muri ubu bushakashatsi byerekana ko kurwanya bishobora gutera imbere muri P. argentipes, byerekana ko hakenewe gukomeza gukurikiranwa no kuba maso kugira ngo bikomeze kugenzurwa bimaze kurandurwa.
Visceral leishmaniasis (VL), izwi ku izina rya kala-azar ku mugabane w’Ubuhinde, ni indwara ya parasitike yatewe na protozoan Leishmania yanduye kandi yandurira mu kurumwa n’isazi z’umusenyi zanduye (Diptera: Myrmecophaga). Isazi z'umucanga nizo zemeza gusa VL mu majyepfo y'uburasirazuba bwa Aziya. Ubuhinde buri hafi kugera ku ntego yo gukuraho VL. Icyakora, kugira ngo umubare muto w’abantu banduye nyuma yo kurandurwa, ni ngombwa kugabanya umubare w’abaturage kugira ngo wirinde kwandura.
Kurwanya imibu mu majyepfo y’iburasirazuba bwa Aziya bikorwa binyuze mu gutera ibiti bisigaye mu ngo (IRS) hakoreshejwe udukoko twica udukoko. Imyitwarire yo kuruhuka rwihishwa ya silverlegs ituma iba intego nziza yo kurwanya udukoko twica udukoko dusize mu nzu [1]. Gutera ibisigazwa byo mu nzu bya dichlorodiphenyltrichloroethane (DDT) muri gahunda y’igihugu ishinzwe kurwanya malariya mu Buhinde byagize ingaruka zikomeye mu kurwanya imibu no kugabanya cyane virusi ya VL [2]. Uku kugenzura kutateganijwe kuri VL kwatumye Gahunda yo Kurandura VL yo mu Buhinde gufata imiti yo gutera mu nzu nkuburyo bwibanze bwo kugenzura silverlegs. Mu 2005, guverinoma y'Ubuhinde, Bangladesh, na Nepal zashyize umukono ku masezerano y'ubwumvikane hagamijwe gukuraho VL bitarenze 2015 [3]. Ibikorwa byo kurandura burundu, birimo guhuza igenzura no gusuzuma byihuse no kuvura indwara z’abantu, byari bigamije kwinjira mu cyiciro cyo guhuriza hamwe bitarenze 2015, intego yaje kuvugururwa kugeza muri 2017 hanyuma 2020. [4] Igishushanyo mbonera gishya ku isi cyo gukuraho indwara zo mu turere dushyuha zititaweho harimo no gukuraho VL mu 2030. [5]
Mugihe Ubuhinde bwinjiye mu cyiciro cya nyuma yo kurandura BCVD, ni ngombwa ko harebwa niba kurwanya-beta-cypermethrine bidatera imbere. Impamvu yo guhangana ni uko DDT na cypermethrine byombi bifite uburyo bumwe bwo gukora, aribwo byibasira poroteyine ya VGSC [21]. Rero, ibyago byo gukura mukurwanya umusenyi birashobora kwiyongera kubera guhangayika guterwa no guhura na cypermethrine ikomeye. Ni ngombwa rero gukurikirana no kumenya abantu bashobora kuba bafite umusenyi urwanya iyi miti yica udukoko. Ni muri urwo rwego, intego y’ubu bushakashatsi yari iyo kugenzura imiterere y’umusenyi wo mu gasozi ukoresheje dosiye yo gusuzuma no kumara igihe cyagenwe na Chaubey n'abandi. [20] yize P. argentipes yo mu midugudu itandukanye yo mu karere ka Muzaffarpur muri Bihar, mu Buhinde, yakoreshaga uburyo bwo gutera imiti yo mu ngo ivurwa na cypermethrine (imidugudu ikomeza IPS). Imiterere yimiterere ya P. argentipes yo mumidugudu yari yarahagaritse gukoresha sisitemu yo gutera imiti yo mu ngo (yahoze ari imidugudu ya IPS) ndetse itigeze ikoresha sisitemu yo gutera imiti yo mu ngo (imidugudu itari IPS) yagereranijwe ikoresheje icupa rya CDC bioassay.
Imidugudu icumi yatoranijwe kugira ngo ikore ubushakashatsi (Ishusho 1; Imbonerahamwe 1), muri yo umunani yari ifite amateka yo gukomeza gutera mu nzu ya pyrethroide ya syntetique (hypermethrin; yagenwe nk'imidugudu ikomeza hypermethrine) kandi ifite ibibazo bya VL (byibuze ikibazo kimwe) mu myaka 3 ishize. Mu midugudu ibiri isigaye mu bushakashatsi, umudugudu umwe utashyize mu bikorwa gutera imiti yo mu ngo ya beta-cypermethrin (umudugudu utera mu nzu) watoranijwe nk'umudugudu ugenzura ndetse n'undi mudugudu wari ufite imiti yo gutera mu nzu rimwe na rimwe beta-cypermethrin (umudugudu utera imbere mu mudugudu / umudugudu wahoze utera mu nzu) watoranijwe nk'umudugudu ugenzura. Guhitamo iyi midugudu byari bishingiye ku bufatanye n’ishami ry’ubuzima hamwe n’itsinda rishinzwe gusasa mu nzu no kwemeza gahunda y’ibikorwa byo gutera imbere mu nzu mu Karere ka Muzaffarpur.
Ikarita ya geografiya yakarere ka Muzaffarpur yerekana aho imidugudu yashyizwe mubushakashatsi (1-10). Ahantu ho kwigira: 1, Manifulkaha; 2, Ramdas Majhauli; 3, Madhubani; 4, Anandpur Haruni; 5, Pandey; 6, Hirapur; 7, Madhopur Hazari; 8, Hamidpur; 9, Noonfara; 10, Simara. Ikarita yateguwe hifashishijwe porogaramu ya QGIS (verisiyo 3.30.3) na Shakisha Ifungura.
Amacupa yubushakashatsi bwerekanwe yateguwe akurikije uburyo bwa Chaubey nabandi. [20] na Denlinger n'abandi. [22]. Muri make, amacupa yikirahure 500 mL yateguwe umunsi umwe mbere yubushakashatsi kandi urukuta rwimbere rwamacupa rwashizwemo umuti wica udukoko twerekana (igipimo cyo gusuzuma α-cypermethrin cyari 3 μg / mL) ukoresheje umuti wa acetone wica udukoko (2.0 mL) munsi, kurukuta no mumutwe wamacupa. Buri gacupa ryumishijwe kumashini yimashini muminota 30. Muri iki gihe, fungura buhoro buhoro umupira kugirango acetone ishire. Nyuma yiminota 30 yumye, kura capa hanyuma uzenguruke icupa kugeza acetone yose izimye. Amacupa yahise asigara afunguye kugirango yumuke ijoro ryose. Kuri buri kizamini cyo kwigana, icupa rimwe, ryakoreshejwe nkigenzura, ryashizwemo na mL 2.0 ya acetone. Amacupa yose yongeye gukoreshwa mubushakashatsi nyuma yo gukora isuku ikurikije inzira yasobanuwe na Denlinger nabandi. n'Umuryango w'Abibumbye ryita ku Buzima [22, 23].
Bukeye bwaho nyuma yo gutegura udukoko twica udukoko, imibu yafashwe n’ishyamba 30-40 (igitsina gore cyicwa ninzara) yakuwe mu kato mu gasegereti hanyuma ihita yiturirwa muri buri kibindi. Hafi yisazi imwe isazi yakoreshejwe kuri buri gacupa katewe nudukoko, harimo no kugenzura. Subiramo ibi byibuze inshuro eshanu kugeza kuri esheshatu muri buri mudugudu. Nyuma yiminota 40 yo guhura nudukoko twica udukoko, umubare w isazi zaguye hasi wanditswe. Isazi zose zafashwe zifata ibyuma bifata imashini, zishyirwa mubikarito ya pint yipfundikishijwe inshundura nziza, hanyuma bigashyirwa muri incubator itandukanye mu gihe cy’ubushyuhe n’ubushyuhe hamwe n’isoko rimwe ry’ibiribwa (imipira y’ipamba yinjijwe mu bisukari 30%) hamwe na koloni itavuwe. Urupfu rwanditswe nyuma yamasaha 24 nyuma yo guhura nudukoko. Inzitiramubu zose zaraciwe zirasuzumwa kugira ngo hemezwe ubwoko. Uburyo bumwe bwakorewe hamwe nisazi ya F1. Ibipimo byo gukomanga no gupfa byanditswe 24h nyuma yo kugaragara. Niba impfu mumacupa yubugenzuzi yari <5%, nta gukosora impfu byakozwe mubigana. Niba impfu ziri mu icupa ryigenzura zari ≥ 5% na ≤ 20%, impfu ziri mumacupa yipimisha zokwigana zarakosowe hakoreshejwe formula ya Abbott. Niba impfu mu itsinda rishinzwe kugenzura zarenze 20%, itsinda ry’ibizamini byose ryatawe [24, 25, 26].
Hagati yimfu zinzitiramubu P. argentipes. Utubari twibeshya twerekana amakosa asanzwe yuburyo. Ihuriro ry’imirongo ibiri itukura itambitse hamwe nishusho (90% na 98% bipfa), byerekana idirishya ryimpfu zishobora guhangana nazo.
Gupfa impfu za F1 urubyaro rwafashwe na P. argentipes. Utubari twibeshya twerekana amakosa asanzwe yuburyo. Imirongo ihujwe n'imirongo ibiri itukura itambitse (90% na 98% bapfa), byerekana impfu zishobora guhangana nazo [25].
Umubu uri mu mudugudu ugenzura / utari IRS (Manifulkaha) wasangaga wumva udukoko twica udukoko. Impfu zingana (± SE) z’imibu yafashwe n’ishyamba 24 h nyuma yo gukomanga no guhura ni 99.47 ± 0.52% na 98.93 ± 0,65%, naho impfu z’abana ba F1 ni 98.89 ± 1.11% na 98.33 ± 1.11%, (Imbonerahamwe 2, 3).
Ibyavuye muri ubu bushakashatsi byerekana ko isazi z’umusenyi zifite amaguru zishobora guteza imbaraga zo kurwanya pyrethroide (SP) α-cypermethrine mu midugudu aho pyrethroide (SP) α-cypermethrine yakoreshwaga bisanzwe. Ibinyuranye, isazi zumucanga zumucanga zegeranijwe ziva mumidugudu zitarebwa na gahunda ya IRS / kugenzura wasangaga zishobora kwibasirwa cyane. Kugenzura ibyoroshye by’isazi zo mu gasozi by’abaturage ni ngombwa mu kugenzura imikorere y’imiti yica udukoko ikoreshwa, kuko aya makuru ashobora gufasha mu kurwanya imiti yica udukoko. Umubare munini wo kurwanya DDT wagaragaye buri gihe mu isazi zumucanga ziva mu turere tw’icyorezo cya Bihar kubera igitutu cy’amateka cyatoranijwe na IRS ukoresheje iyi miti yica udukoko [1].
Twasanze P. argentipes yunvikana cyane na pyrethroide, kandi ibigeragezo byakorewe mubuhinde, Bangaladeshi na Nepal byerekanaga ko Ikigo cy'imisoro n'amahoro cyagize entomologiya nyinshi mugihe cyakoreshejwe hamwe na cypermethrine cyangwa deltamethrine [19, 26, 27, 28, 29]. Vuba aha, Roy n'abandi. [18] yatangaje ko P. argentipes yateje imbere kurwanya pyrethroide muri Nepal. Ubushakashatsi bwakorewe mu murima bwerekanye ko isazi zumucanga zegeranijwe zivuye mu midugudu itari IRS zagaragaye cyane, ariko isazi zegeranijwe zivuye hagati / zahoze ari IRS hamwe n’imidugudu ikomeza ya IRS (impfu ziva kuri 90% kugeza kuri 97% usibye isazi zumucanga ziva muri Anandpur-Haruni zapfuye 89.34% kuri 24h zanduye) zishobora guhangana na cypermethrine [25]. Imwe mu mpamvu zishoboka zitera iterambere ry’iyi myigaragambyo ni igitutu cyatewe no gutera imiti yo mu ngo (IRS) hamwe na gahunda yo gutera imiti yo mu karere, ikaba ari inzira zisanzwe zo guhangana n’icyorezo cya kala-azar mu turere tw’icyorezo / imidugudu / imidugudu (Standard Operating Procedure for Investigation Production Investigation and Management [30]. Ibyavuye muri ubu bushakashatsi bitanga ibimenyetso byerekana iterambere ry’umuvuduko ukabije wa CDC. icupa bioassay, ntiriboneka kubigereranya ubushakashatsi bwose bwibanze bwagiye bukurikirana P. argentipes kwandura hakoreshejwe impapuro zanduza udukoko twica udukoko twangiza udukoko twangiza udukoko twangiza udukoko twangiza udukoko twa malariya (Anopheles gambiae), kandi ikoreshwa ryumusenyi ni bike cyane. substrate muri bioassay [23].
Pyrethroide ya sintetike yakoreshejwe mu bice by’icyorezo cya VL muri Nepal kuva mu 1992, isimburana na SPs alpha-cypermethrin na lambda-cyhalothrin mu kugenzura umucanga [31], kandi deltamethrin nayo yakoreshejwe muri Bangladesh kuva mu 2012 [32]. Kurwanya indwara ya fenotipiki byagaragaye mu baturage bo mu gasozi k’umusenyi w’ifeza mu turere aho pyrethroide ikoreshwa mu gihe kirekire [18, 33, 34]. Ihinduka ridahuje (L1014F) ryagaragaye mu baturage bo mu gasozi k’umusenyi w’Ubuhinde kandi ryagize uruhare mu kurwanya DDT, byerekana ko kurwanya pyrethroide biva ku rwego rwa molekile, kubera ko DDT na pyrethroide (alpha-cypermethrin) byibasira gene imwe muri sisitemu y’imitsi y’udukoko [17, 34]. Kubwibyo, gusuzuma buri gihe kwandura cypermethrine no kugenzura kurwanya imibu ni ngombwa mugihe cyo kurandura no nyuma yo kurandurwa.
Impamvu ishobora kugarukira kuri ubu bushakashatsi nuko twakoresheje CDC vial bioassay kugirango tupime indwara, ariko kugereranya kwose byakoresheje ibisubizo bivuye mubushakashatsi bwabanje dukoresheje OMS bioassay kit. Ibisubizo bivuye muri bioassay byombi ntibishobora kugereranywa muburyo butaziguye kuko CDC vial bioassay ipima gukomanga nyuma yigihe cyo kwisuzumisha, mugihe kitwa OMS kit bioassay gipima impfu mumasaha 24 cyangwa 72 nyuma yo kwerekanwa (icya nyuma kijyanye no gukora buhoro buhoro) [35]. Indi mbogamizi ishobora guterwa ni umubare wimidugudu ya IRS muri ubu bushakashatsi ugereranije n’umwe utari IRS hamwe n’umudugudu utari IRS / wahoze ari umudugudu wa IRS. Ntidushobora gutekereza ko urwego rw’indwara ziterwa n’umubu zigaragara mu midugudu imwe yo mu karere kamwe rugereranya urwego rwanduye mu yindi midugudu no mu turere twa Bihar. Mugihe Ubuhinde bwinjiye mu cyiciro cya nyuma yo kurandura virusi ya leukemia, ni ngombwa gukumira iterambere rikomeye ry’imyigaragambyo. Birakenewe ko hakurikiranwa vuba ingamba zo guhangana n’umusenyi uturuka mu turere dutandukanye, uturere n’uturere. Amakuru yatanzwe muri ubu bushakashatsi ni ayambere kandi agomba kugenzurwa ugereranije n’ubushakashatsi bwamenyekanye bwashyizwe ahagaragara n’umuryango w’ubuzima ku isi [35] kugira ngo hamenyekane neza imiterere y’imiterere ya P. argentipes muri utwo turere mbere yo guhindura gahunda yo kugenzura inzitizi kugira ngo abaturage bo mu mucanga muke kandi bashyigikire burundu virusi ya leukemia.
Umubu P. argentipes, vector ya virusi ya leukose, urashobora gutangira kwerekana ibimenyetso byambere byo kurwanya cypermethrine ikora neza. Gukurikirana buri gihe kurwanya udukoko twica udukoko mu baturage bo mu gasozi ka P. argentipes ni ngombwa kugira ngo ingaruka z’ibyorezo ziterwa no kurwanya virusi. Guhinduranya udukoko twica udukoko hamwe nuburyo butandukanye bwibikorwa na / cyangwa gusuzuma no kwandikisha udukoko twica udukoko birakenewe kandi birasabwa kurwanya imiti yica udukoko no gushyigikira kurandura virusi ya leukose mu Buhinde.
Igihe cyo kohereza: Gashyantare-17-2025