An samu raguwar nauyin zazzabin cizon sauro na baya-bayan nan a Cote d'Ivoire saboda amfani da gidajen kashe kwari (LIN).Koyaya, wannan ci gaban yana fuskantar barazanar juriya na kwari, sauye-sauyen ɗabi'a a cikin yawan jama'ar Anopheles gambiae, da sauran yaduwar cutar zazzabin cizon sauro, wanda ke buƙatar buƙatar ƙarin kayan aikin.Saboda haka, makasudin wannan binciken shine a kimanta tasirin haɗin gwiwar amfani da LLIN da Bacillus thuringiensis (Bti) da kwatanta shi da LLIN.
An gudanar da binciken daga Maris 2019 zuwa Fabrairu 2020 a kan makamai biyu na binciken (LLIN + Bti hannu da LLIN kawai hannu) a yankin kiwon lafiya na Korhogo a arewacin Cote d'Ivoire.A cikin rukunin LLIN + Bti, ana kula da wuraren tsutsa na Anopheles tare da Bti kowane mako biyu ban da LLIN.An tattara tsutsotsi da kuma manya sauro kuma an gano su ta hanyar morphologically zuwa jinsi da nau'in ta amfani da daidaitattun hanyoyin.Member Ann.An ƙaddara hadadden Gambiya ta amfani da fasahar amsa sarkar polymerase.Kamuwa da Plasmodium An.An kuma tantance cutar zazzabin cizon sauro a Gambiya da mazauna yankin.
Gabaɗaya, Anopheles spp.Ƙarƙashin ƙwayar cuta ya kasance ƙasa a cikin ƙungiyar LLIN + Bti idan aka kwatanta da ƙungiyar LLIN kadai 0.61 [95% CI 0.41-0.81] larvae / dive (l / dive) 3.97 [95% CI 3.56-4 .38] l / dive (RR = 6.50; 95% CI 5.81-7.29 P <0.001).Gabaɗaya gudun cizon An.Abubuwan da suka faru na cizon S. gambiae shine 0.59 [95% CI 0.43-0.75] da mutum / dare a cikin rukunin LLIN + Bti kadai, idan aka kwatanta da 2.97 [95% CI 2.02-3.93] cizon kowane mutum/dare a cikin rukunin LLIN-kawai (P <0.001).Anopheles gambiae sl an fi saninsa da sauro Anopheles.Anopheles gambiae (ss) (95.1%; n = 293), sai kuma Anopheles gambiae (4.9%; n = 15).Ma'anar jinin ɗan adam a cikin binciken shine 80.5% (n = 389).EIR na rukunin LLIN + Bti ya kasance 1.36 masu kamuwa da cizon kowane mutum a kowace shekara (ib/p/y), yayin da EIR na rukunin LLIN kawai ya kasance 47.71 ib/p/y.Yawan zazzabin cizon sauro ya ragu sosai daga 291.8‰ (n = 765) zuwa 111.4‰ (n = 292) a cikin rukunin LLIN + Bti (P <0.001).
Haɗin LLIN da Bti sun rage yawan kamuwa da cutar maleriya.Haɗin LLIN da Bti na iya zama kyakkyawar hanyar haɗin kai don ingantaccen sarrafa An.Gambiya ba ta da zazzabin cizon sauro.
Duk da ci gaban da aka samu wajen shawo kan cutar zazzabin cizon sauro a cikin 'yan shekarun da suka gabata, nauyin zazzabin cizon sauro ya kasance babbar matsala a yankin kudu da hamadar sahara [1].Hukumar Lafiya ta Duniya (WHO) kwanan nan ta ba da rahoton cewa an sami kamuwa da cutar zazzabin cizon sauro miliyan 249 da kuma an kiyasta mutuwar mutane 608,000 masu alaka da zazzabin cizon sauro a duniya a shekarar 2023 [2].Yankin Afirka na WHO ya kai kashi 95% na masu kamuwa da cutar zazzabin cizon sauro a duniya da kashi 96% na mace-macen zazzabin cizon sauro, tare da mata masu juna biyu da yara ‘yan kasa da shekaru 5 da cutar ta fi shafa [2, 3].
Gidan yanar gizo na kwari mai dorewa (LLIN) da sauran feshin cikin gida (IRS) sun taka muhimmiyar rawa wajen rage nauyin zazzabin cizon sauro a Afirka [4].Fadada wadannan kayan aikin maganin zazzabin cizon sauro ya haifar da raguwar kamuwa da cutar da kashi 37% da raguwar mace-mace da kashi 60% tsakanin 2000 da 2015 [5].Koyaya, abubuwan da aka lura tun daga 2015 sun tsaya cik cikin firgita ko ma sun yi sauri, tare da mutuwar zazzabin cizon sauro da ba za a yarda da shi ba, musamman a yankin kudu da hamadar Sahara [3].Yawancin bincike sun gano bullowa da yaduwar juriya a tsakanin manyan cututtukan zazzabin cizon sauro Anopheles zuwa magungunan kashe kwari da ake amfani da su a cikin lafiyar jama'a a matsayin shinge ga tasirin LLIN da IRS na gaba [6,7,8].Bugu da ƙari, canje-canje a cikin halayen cin zarafi a waje da kuma a farkon dare suna da alhakin yaduwar cutar zazzabin cizon sauro kuma suna da damuwa [9, 10].Iyakance na LLIN da IRS a cikin sarrafa abubuwan da ke da alhakin watsa saura babban iyakance ne na ƙoƙarin kawar da zazzabin cizon sauro na yanzu [11].Bugu da ƙari, an bayyana dagewar zazzabin cizon sauro ta yanayin yanayi da ayyukan ɗan adam, waɗanda ke ba da gudummawa ga ƙirƙirar wurin tsutsa [12].
Gudanar da tushen tsutsa (LSM) hanya ce ta tushen kiwo don sarrafa vector wanda ke da nufin rage adadin wuraren kiwo da adadin tsutsar sauro da pupae da ke cikin su [13].An ba da shawarar LSM ta bincike da yawa a matsayin ƙarin dabarun haɗin gwiwa don magance cutar zazzabin cizon sauro [14, 15].A zahiri, tasirin LSM yana ba da fa'ida biyu akan cizon nau'in cutar zazzabin cizon sauro a ciki da waje [4].Bugu da kari, sarrafa vector tare da LSMs na tushen larvicide irin su Bacillus thuringiensis israelensis (Bti) na iya fadada kewayon hanyoyin magance zazzabin cizon sauro.A tarihi, LSM ta taka muhimmiyar rawa wajen samun nasarar shawo kan cutar zazzabin cizon sauro a Amurka, Brazil, Masar, Aljeriya, Libya, Morocco, Tunisia da Zambia [16,17,18].Duk da cewa LSM ta taka muhimmiyar rawa wajen hada-hadar sarrafa kwari a wasu kasashen da suka kawar da zazzabin cizon sauro, amma LSM ba ta shiga cikin manufofin yaki da cutar zazzabin cizon sauro a Afirka ba kuma ana amfani da ita ne kawai a cikin shirye-shiryen magance cutar a wasu kasashen kudu da hamadar Sahara.kasashe [14,15,16,17,18,19].Ɗayan dalili na wannan shi ne yarda da cewa wuraren kiwo suna da yawa da wuya a samu, yana sa LSM tsada sosai don aiwatarwa [4, 5, 6, 7, 8, 9, 10, 11, 13, 14].Sabili da haka, Hukumar Lafiya ta Duniya ta ba da shawarar shekaru da yawa cewa albarkatun da aka tattara don magance cutar zazzabin cizon sauro ya kamata su mayar da hankali kan LLIN da IRS [20, 21].Sai a 2012 ne Hukumar Lafiya ta Duniya ta ba da shawarar haɗa LSM, musamman ayyukan Bti, a matsayin abin da ya dace da LLIN da IRS a wasu wurare a yankin Saharar Afirka [20].Tun bayan da WHO ta ba da wannan shawarar, an gudanar da binciken matukin jirgi da yawa kan yuwuwar, inganci da kuma tsadar magungunan biolarvicides a yankin kudu da hamadar Sahara, wanda ke nuna tasirin LSM wajen rage yawan sauro na Anopheles da ingancin watsa cutar malaria dangane da [22, 23].., 24].
Cote d'Ivoire na cikin kasashe 15 da suka fi fama da cutar zazzabin cizon sauro a duniya [25].Yawan zazzabin cizon sauro a Cote d'Ivoire yana wakiltar kashi 3.0 cikin 100 na nauyin zazzabin cizon sauro a duniya, tare da kiyasin kamuwa da cutar da adadin wadanda suka kama daga 300 zuwa sama da 500 a cikin 1000 mazaunan [25].Duk da tsawon lokacin rani daga Nuwamba zuwa Mayu, zazzabin cizon sauro na yaduwa a duk shekara a yankin savanna na arewacin kasar [26].Yaduwar zazzabin cizon sauro a wannan yanki yana da alaƙa da kasancewar ɗimbin lambobi masu ɗauke da asymptomatic na Plasmodium falciparum [27].A wannan yanki, cutar zazzabin cizon sauro da aka fi sani shine Anopheles gambiae (SL).Tsaro na gida.Anopheles gambiae sauro sun ƙunshi Anopheles gambiae (SS), wanda ke da matukar juriya ga maganin kwari don haka yana haifar da haɗarin kamuwa da cutar zazzabin cizon sauro [26].Amfani da LLIN na iya samun iyakanceccen tasiri akan rage yaduwar cutar zazzabin cizon sauro saboda juriya na maganin kwari na gida don haka ya kasance wani yanki mai mahimmanci.Nazarin gwaji ta amfani da Bti ko LLIN ya nuna tasiri wajen rage yawan sauro a arewacin Cote d'Ivoire.Koyaya, babu wani binciken da ya gabata wanda ya tantance tasirin maimaita aikace-aikacen Bti tare da LLIN akan watsa cutar zazzabin cizon sauro da kamuwa da cutar zazzabin cizon sauro a wannan yanki.Don haka, wannan binciken ya yi niyya ne don auna tasirin haɗaɗɗun amfani da LLIN da Bti kan watsa cutar zazzabin cizon sauro ta hanyar kwatanta ƙungiyar LLIN + Bti da ƙungiyar LLIN kaɗai a ƙauyuka huɗu a yankin arewacin Cote d'Ivoire.An yi hasashe cewa aiwatar da LSM na tushen Bti a saman na LLIN zai ƙara ƙima ta hanyar rage yawan sauro na zazzabin cizon sauro idan aka kwatanta da na LLIN kadai.Wannan hadaddiyar hanya, da ta shafi sauro Anopheles wadanda ba su balaga ba dauke da Bti da kuma manya Anopheles sauro dauke da LLIN, na iya zama muhimmi wajen rage yaduwar cutar zazzabin cizon sauro a yankunan da ke fama da cutar zazzabin cizon sauro, kamar kauyuka a arewacin Cote d'Ivoire.Saboda haka, sakamakon wannan binciken na iya taimakawa wajen yanke shawarar haɗa LSM a cikin shirye-shiryen magance cutar zazzabin cizon sauro na ƙasa (NMCPs) a cikin ƙasashe na kudu da hamadar Sahara.
An gudanar da binciken na yanzu a kauyuka hudu na sashen Napieldougou (wanda aka fi sani da Napier) a yankin tsaftar Korhogo a arewacin Cote d'Ivoire (Fig. 1).Ƙauyen da ake nazari: Kakologo (9° 14′ 2″ N, 5° 35′ 22″ E), Kolekakha (9° 17′ 24″ N, 5° 31′ 00″ E.), Lofinekha (9° 17′ 31) ″).) 5° 36′ 24″ N) da Nambatiurkaha (9° 18′ 36″ N, 5° 31′ 22″ E).Yawan mutanen Napierledougu a cikin 2021 an kiyasta su zama mazauna 31,000, kuma lardin ya ƙunshi ƙauyuka 53 masu cibiyoyin kiwon lafiya guda biyu [28].A lardin Napyeledougou, inda zazzabin cizon sauro ke kan gaba wajen kai ziyara asibiti, asibiti da mace-mace, LLIN ne kawai ake amfani da shi wajen sarrafa maganin Anopheles [29].Duk ƙauyuka huɗu na ƙungiyoyin binciken duka cibiyar lafiya ɗaya ce, waɗanda aka duba bayanan asibiti game da cutar zazzabin cizon sauro a cikin wannan binciken.
Taswirar Cote d'Ivoire da ke nuna yankin binciken.(Tsarin taswira da software: bayanan GADM da ArcMap 10.6.1. LLIN net na kwari mai dorewa, Bti Bacillus thuringiensis israelensis
Yaduwar zazzabin cizon sauro a tsakanin Cibiyar Kiwon Lafiya ta Napier da aka yi niyya ya kai kashi 82.0 cikin 100 (2038 lokuta) (bayanan pre-Bti).A cikin dukkanin ƙauyuka huɗu, gidaje suna amfani da PermaNet® 2.0 LLIN kawai, wanda NMCP na Ivory Coast ya rarraba a cikin 2017, tare da> 80% ɗaukar hoto [25, 26, 27, 28, 30].Kauyukan na yankin Korhogo ne, wanda ke zama wurin sa ido ga hukumar soji ta kasar Ivory Coast kuma ana iya kaiwa ga duk shekara.Kowace ƙauyuka huɗu tana da gidaje aƙalla 100 kuma kusan mutane ɗaya ne, kuma bisa ga rajistar kiwon lafiya (takardar aiki na Ma'aikatar Lafiya ta Ivory Coast), ana ba da rahoton kamuwa da cutar zazzabin cizon sauro da yawa kowace shekara.Plasmodium falciparum (P. falciparum) ne ke haifar da zazzabin cizon sauro kuma Plasmodium yana ɗaukarsa ga mutane.Gambiae kuma ana yada shi ta hanyar Anopheles da Anopheles nili sauro a yankin [28].Hadaddiyar gida An.Gambiyae ya ƙunshi galibin sauro Anopheles.gambiae ss yana da babban mitar maye gurbi na kdr (kewayon mitar: 90.70-100%) da matsakaicin mitar ace-1 alleles (kewan mitar: 55.56-95%) [29].
Matsakaicin ruwan sama na shekara-shekara da yanayin zafi daga 1200 zuwa 1400 mm da 21 zuwa 35 ° C bi da bi, kuma an kiyasta zafi (RH) a 58%.Wannan yanki na binciken yana da yanayi irin na Sudan tare da lokacin rani na watanni 6 (Nuwamba zuwa Afrilu) da lokacin damina na watanni 6 (Mayu zuwa Oktoba).Yankin yana fuskantar wasu illolin sauyin yanayi, kamar asarar ciyayi da kuma tsawon lokacin rani, wanda ke nuna bushewar jikunan ruwa ( guraren ƙasa, filayen shinkafa, tafkuna, kududdufai) waɗanda za su iya zama wurin zama ga tsutsar sauro na Anopheles. .Sauro[26].
An gudanar da binciken ne a cikin rukunin LLIN + Bti, wanda ƙauyukan Kakologo da Nambatiurkaha ke wakilta, kuma a cikin rukunin LLIN kawai, waɗanda ƙauyukan Kolekaha da Lofinekaha ke wakilta.A lokacin wannan binciken, mutane a duk waɗannan ƙauyuka suna amfani da PermaNet® 2.0 LLIN kawai.
An kimanta tasirin LLIN (PermaNet 2.0) a hade tare da Bti akan sauro Anopheles da watsa malaria a cikin gwajin gwajin da bazuwar (RCT) tare da makamai biyu na binciken: ƙungiyar LLIN + Bti (kungiyar jiyya) da ƙungiyar LLIN kadai (ƙungiyar kulawa). ).Kakologo da Nambatiourkaha ne ke wakiltan hannayen riga na LLIN + Bti, yayin da Kolékaha da Lofinékaha aka tsara su azaman kafadu na LLIN kawai.A cikin duka ƙauyuka huɗu, mazauna gida suna amfani da LLIN PermaNet® 2.0 da aka karɓa daga Ivory Coast NMCP a cikin 2017. An ɗauka cewa yanayin yin amfani da PermaNet® 2.0 iri ɗaya ne a ƙauyuka daban-daban saboda sun karɓi hanyar sadarwa ta hanya ɗaya..A cikin rukunin LLIN + Bti, ana kula da wuraren tsutsa na Anopheles tare da Bti kowane mako biyu baya ga LLIN da jama'a ke amfani da su.Mazaunan tsutsotsi a cikin ƙauyuka da kuma nisan kilomita 2 daga tsakiyar kowane ƙauye an yi musu magani bisa ga shawarwarin Hukumar Lafiya ta Duniya da NMCP na Cote d'Ivoire [31].Sabanin haka, ƙungiyar LLIN-kawai ba ta sami maganin larvicidal Bti a lokacin binciken ba.
An yi amfani da nau'in nau'in ƙoshin ruwa na Bti (Vectobac WG, 37.4% wt; lambar kuri'a 88-916-PG; 3000 Units Toxicity Units IU/mg; Valent BioScience Corp, Amurka) a kashi na 0.5 mg/L..Yi amfani da mai fesa jakar baya ta 16L da bindigar feshin fiberglass tare da hannu da bututun ƙarfe mai daidaitacce tare da yawan kwararar 52 ml a sakan daya (3.1 L/min).Don shirya wani nebulizer dauke da 10 L na ruwa, adadin Bti diluted a dakatar ne 0.5 mg/L × 10 L = 5 MG.Alal misali, ga wani yanki tare da zane-zane na ruwa na 10 L, ta yin amfani da 10 L sprayer don magance yawan ruwa, adadin Bti da ake buƙatar diluted shine 0.5 mg / L × 20 L = 10 MG.An auna 10 MG Bti a cikin filin ta amfani da sikelin lantarki.Yin amfani da spatula, shirya slurry ta hanyar haɗa wannan adadin na Bti a cikin guga mai digiri 10 L.An zaɓi wannan kashi bayan gwajin filin na tasiri na Bti a kan instars daban-daban na Anopheles spp.da Culex spp.a cikin yanayi na yanayi a wani yanki daban-daban, amma kama da yankin bincike na zamani [32].An ƙididdige ƙimar aikace-aikacen dakatarwar larvicide da tsawon lokacin aikace-aikacen kowane wurin kiwo bisa ƙididdige adadin ruwa a wurin kiwo [33].Aiwatar da Bti ta yin amfani da injin feshin hannu.Nebulizers an daidaita su kuma an gwada su a lokacin motsa jiki na mutum da kuma a wurare daban-daban don tabbatar da daidaitattun adadin Bti.
Don nemo lokaci mafi kyau don kula da wuraren kiwon tsutsa, ƙungiyar ta gano feshin taga.Tagar feshin shine lokacin da ake amfani da samfur don cimma ingantaccen tasiri: a cikin wannan binciken, taga feshin ya kasance daga sa'o'i 12 zuwa makonni 2, dangane da dagewar Bti.A bayyane yake, ɗaukar Bti ta larvae a wurin kiwo yana buƙatar lokaci daga 7:00 zuwa 18:00.Ta wannan hanyar, za a iya guje wa lokutan ruwan sama mai yawa lokacin da ruwan sama ke nufin dakatar da feshi da sake farawa gobe idan yanayi ya yi hadin gwiwa.Kwanakin fesa da ainihin ranaku da lokuta sun dogara da yanayin yanayin da aka lura.Don daidaita masu feshin jakar baya don ƙimar aikace-aikacen Bti da ake so, kowane mai fasaha an horar da shi don duba gani da saita bututun feshin da kula da matsa lamba.Ana kammala gyare-gyare ta hanyar tabbatar da cewa ana amfani da daidaitattun adadin jiyya na Bti daidai da kowane yanki.Kula da mazaunin tsutsa kowane mako biyu.Ana gudanar da ayyukan larvicidal tare da goyon bayan ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararrun ƙwararru huɗu.Gogaggun masu kulawa ne ke kulawa da ayyukan larvicidal da mahalarta.An fara maganin larvicidal a cikin Maris 2019 a lokacin rani.A gaskiya ma, wani bincike da aka yi a baya ya nuna cewa lokacin rani shine lokacin da ya fi dacewa don shiga tsakani na tsutsotsi saboda kwanciyar hankali na wuraren kiwo da raguwar yawansu [27].Ana sa ran sarrafa tsutsa a lokacin rani zai hana sha'awar sauro a lokacin damina.Kimanin kilogiram biyu (02) na Bti da ke kashe dalar Amurka 99.29 ya ba ƙungiyar binciken da ke karɓar jiyya ta mamaye duk yankuna.A cikin rukunin LLIN+Bti, maganin larvicidal ya ɗauki tsawon shekara guda, daga Maris 2019 zuwa Fabrairu 2020. Jimillar lokuta 22 na maganin larvicidal sun faru a cikin rukunin LLIN + Bti.
Abubuwan da za su iya haifar da lahani (kamar itching, dizziness ko hanci) an lura da su ta hanyar binciken daidaikun mutane na Bti biolarvicide nebulizers da mazauna gida da ke shiga cikin rukunin LIN + Bti.
An gudanar da binciken gida a tsakanin gidaje 400 (magidanta 200 a kowace rukunin nazarin) don ƙididdige adadin yawan amfani da cutar ta LLIN a tsakanin jama'a.Lokacin binciken gidaje, ana amfani da hanyar ƙididdigewa.An raba yawan amfani da LLIN zuwa ƙungiyoyin shekaru uku: shekaru 15.An kammala tambayoyin kuma an bayyana shi a cikin yaren Senoufo na gida ga shugaban gidan ko wani babba mai shekaru 18.
An ƙididdige mafi ƙarancin girman gidan da aka bincika ta amfani da dabarar da Vaughan da Morrow suka bayyana [34].
n shine girman samfurin, e shine gefen kuskure, t shine yanayin aminci da aka samo daga matakin amincewa, kuma p shine rabon iyayen jama'a tare da sifa da aka bayar.Kowane kashi na juzu'in yana da daidaiton ƙima, don haka (t) = 1.96;Matsakaicin girman iyali a cikin wannan yanayin a cikin binciken shine gidaje 384.
Kafin gwajin na yanzu, an gano nau'ikan wurin zama daban-daban na tsutsa Anopheles a cikin rukunin LLIN+Bti da LLIN, an kwatanta su, an kwatanta su, georeferenced da lakabi.Yi amfani da ma'aunin tef don auna girman mazaunin gida.Sannan ana tantance yawan tsutsar sauro a kowane wata na tsawon watanni 12 a wuraren kiwo guda 30 a kowane kauye, domin jimillar wuraren kiwo 60 a kowace rukunin bincike.Akwai samfuran tsutsa guda 12 a kowane yanki na binciken, daidai da jiyya 22 Bti.Manufar zabar waɗannan wuraren kiwo guda 30 a kowane ƙauye shine don kama isassun wuraren tattara tsutsa a ƙauyuka da wuraren karatu don rage son zuciya.An tattara tsutsa ta hanyar tsomawa tare da cokali 60 ml [35].Saboda kasancewar wasu gidajen gandun daji suna da ƙanƙanta da ƙanƙanta, ya zama dole a yi amfani da ɗan ƙaramin guga banda bokitin WHO (350 ml).An yi jimillar nutsewar 5, 10 ko 20 daga wuraren da aka yi shela tare da kewayen 10 m, bi da bi.Gano ilimin halittar jiki na tsutsa da aka tattara (misali Anopheles, Culex da Aedes) an gudanar da su kai tsaye a cikin filin [36].An raba tsutsa da aka tattara zuwa nau'i biyu dangane da matakin ci gaba: farkon tsutsa na farko (mataki na 1 da 2) da kuma larvae na ƙarshe (mataki na 3 da 4) [37].An ƙidaya larvae ta jinsin halitta kuma a kowane mataki na ci gaba.Bayan an ƙidaya, za a sake dawo da tsutsar sauro zuwa wuraren da suke kiwo kuma a sake cika su zuwa asalinsu da ruwa mai tushe wanda aka ƙara da ruwan sama.
An yi la'akari da wurin kiwo tabbatacce idan aƙalla tsutsa ɗaya ko pupa na kowane nau'in sauro ya kasance.An ƙididdige yawan ƙwayar tsutsa ta hanyar rarraba adadin larvae na nau'in nau'in nau'in nau'in nau'in nutsewa.
Kowane binciken ya dauki kwanaki biyu a jere, kuma duk wata biyu, ana tattara manya sauro daga gidaje 10 da aka zaba daga kowane kauye.A cikin binciken, kowace ƙungiyar bincike ta gudanar da binciken samfurori na gidaje 20 a cikin kwanaki uku a jere.An kama sauro ta amfani da daidaitattun tarkunan taga (WT) da tarkon feshin pyrethrum (PSC) [38, 39].Da farko, duk gidajen kowane ƙauye an ƙidaya su.Sannan an zabo gidaje hudu a kowane kauye ba da gangan ba a matsayin wuraren tattara manyan sauro.A cikin kowane gida da aka zaɓa, ana tattara sauro daga babban ɗakin kwana.Dakunan dakunan da aka zaɓa suna da kofofi da tagogi kuma an shagaltar da su a daren da ya gabata.A rufe dakunan kwana kafin a fara aiki da kuma lokacin da ake tara sauro don hana sauro tashi daga dakin.An shigar da WT a kowane taga na kowane ɗakin kwana a matsayin wurin gwajin sauro.Washegari, sauro da suka shiga wurin aiki daga dakunan kwana an tattara su tsakanin 06:00 zuwa 08:00 na safe.Tattara sauro daga wurin aikinku ta amfani da bakin baki kuma adana su a cikin kofin takarda da za a iya zubarwa da ɗanyen yanki.Gidan sauro.An kama sauro da ke hutawa a cikin ɗakin kwana ɗaya kai tsaye bayan tarin WT ta amfani da PSC na tushen pyrethroid.Bayan yada farar zanen gado a kan bene mai dakuna, rufe kofofin da tagogi da fesa maganin kwari (kayan aiki masu aiki: 0.25% transfluthrin + 0.20% permethrin).Kimanin mintuna 10 zuwa 15 bayan an fesa, sai a cire shimfidar gadon da ke cikin dakin da aka yi wa magani, a yi amfani da tweezers wajen dauko duk wani sauro da ya sauka a kan farar zanen gado, sannan a ajiye su a cikin kwanon Petri mai cike da ulun auduga mai ruwa.An kuma rubuta adadin mutanen da suka kwana a cikin dakunan da aka zaba.Ana saurin tura sauro da aka tattara zuwa dakin gwaje-gwaje na kan layi don ci gaba da sarrafawa.
A cikin dakin gwaje-gwaje, duk sauro da aka tattara an gano su ta hanyar halitta da nau'in halitta [36].Anna ta ovaries.gambiae SL ta amfani da na'urar rarrabuwar kawuna tare da digon ruwa da aka ɗora akan faifan gilashi [35].An ƙididdige matsayin daidaito don raba mata masu yawa daga mata masu ɓarna dangane da ilimin halittar ovarian da tracheal, da kuma ƙayyade ƙimar haihuwa da shekarun ilimin lissafi [35].
Ana ƙayyade ma'anar dangi ta hanyar gwada tushen abincin da aka tattara sabon jini.Gambiyae ta hanyar enzyme-linked immunosorbent assay (ELISA) ta amfani da jini daga mutane, dabbobi (shanu, tumaki, awaki) da kuma kaji masu masaukin baki [40].An ƙididdige cutar cututtukan mahaifa (EIR) ta amfani da An.Ƙididdiga na matan SL a Gambiya [41] Bugu da ƙari, An.An ƙaddara kamuwa da cutar da Plasmodium gambiae ta hanyar nazarin kai da ƙirjin mata masu yawa ta amfani da hanyar circumsporozoite antigen ELISA (CSP ELISA) [40].A ƙarshe, akwai membobin Ann.Gambiae an gano ta ta hanyar nazarin kafafunta, fuka-fukanta da cikinta ta hanyar amfani da fasahar polymerase chain reaction (PCR) [34].
An samo bayanan asibiti game da zazzabin cizon sauro daga wurin rajistar tuntuba na asibiti na Cibiyar Kiwon Lafiya ta Napyeledugou, wacce ta shafi duk ƙauyuka huɗu da ke cikin wannan binciken (watau Kakologo, Kolekaha, Lofinekaha da Nambatiurkaha).Binciken yin rajista ya mayar da hankali kan bayanan daga Maris 2018 zuwa Fabrairu 2019 da kuma daga Maris 2019 zuwa Fabrairu 2020. Bayanan asibiti daga Maris 2018 zuwa Fabrairu 2019 yana wakiltar tushen tushe ko bayanan shiga tsakani na pre-Bti, yayin da bayanan asibiti daga Maris 2019 zuwa Fabrairu 2020 ke wakiltar pre-Bti bayanan shiga tsakani.Bayanai bayan shiga tsakani Bti.An tattara bayanan asibiti, shekaru da ƙauyen kowane majiyyaci a cikin rukunin binciken LLIN+Bti da LLIN a cikin rajistar kiwon lafiya.Ga kowane majiyyaci, an rubuta bayanai kamar asalin ƙauye, shekaru, ganewar asali, da ilimin cututtuka.A cikin al'amuran da aka sake dubawa a cikin wannan binciken, an tabbatar da zazzabin cizon sauro ta hanyar gwajin gwaji mai sauri (RDT) da / ko malaria microscopy bayan gudanar da maganin haɗin gwiwa na tushen artemisinin (ACT) ta hanyar mai ba da lafiya.An raba cutar zazzabin cizon sauro zuwa rukuni na shekaru uku (watau shekaru 15).An kiyasta yawan kamuwa da cutar zazzabin cizon sauro a kowace shekara a cikin mazaunan 1000 ta hanyar raba yawan zazzabin cizon sauro ga mazaunan 1000 ga mazauna kauyuka.
Bayanan da aka tattara a cikin wannan binciken an shigar da su sau biyu a cikin bayanan Microsoft Excel sannan aka shigo da su cikin buɗaɗɗen software R [42] sigar 3.6.3 don nazarin ƙididdiga.Ana amfani da kunshin ggplot2 don zana filaye.An yi amfani da samfuran layi na gaba ɗaya ta amfani da koma bayan Poisson don kwatanta yawan tsutsa da ma'anar adadin cizon sauro kowane mutum kowane dare tsakanin ƙungiyoyin bincike.An yi amfani da ma'aunin dacewa (RR) don kwatanta ma'anar ma'aunin tsutsa da yawan cizon sauro na Culex da Anopheles.An sanya Gambia SL tsakanin ƙungiyoyin binciken biyu ta amfani da rukunin LLIN + Bti a matsayin tushen tushe.An bayyana ma'auni masu tasiri azaman ƙimar rashin daidaituwa da tazarar amincewa 95% (95% CI).An yi amfani da ma'auni (RR) na gwajin Poisson don kwatanta ma'auni da yawan adadin zazzabin cizon sauro kafin da kuma bayan sa baki na Bti a cikin kowane rukunin binciken.Matsayin mahimmancin da aka yi amfani da shi shine 5%.
Kwamitin da'a na bincike na kasa na Ma'aikatar Lafiya da Lafiyar Jama'a na Cote d'Ivoire (N/Ref: 001//MSHP/CNESVS-kp) ya amince da ka'idar binciken, da kuma gundumar kiwon lafiya na yanki da kuma gudanarwa. da Korhogo.Kafin tattara larvae na sauro da manya, an sami sa hannun sanarwar izini daga mahalarta binciken gida, masu su, da/ko mazauna.Bayanai na iyali da na asibiti ba a san su ba ne kuma na sirri kuma suna samuwa ga waɗanda aka zaɓa kawai.
An ziyarci jimlar wuraren zama 1198.Daga cikin waɗannan shafukan gida da aka bincika a cikin binciken, 52.5% (n = 629) na cikin rukunin LLIN + Bti da 47.5% (n = 569) zuwa rukunin LLIN kawai (RR = 1.10 [95% CI 0 .98-1.24). , P = 0.088).Gabaɗaya, an rarraba wuraren zama na tsutsa na gida zuwa nau'ikan 12, daga cikinsu akwai mafi girman kaso na wuraren tsutsa sune filayen shinkafa (24.5%, n=294), tare da magudanar ruwa (21.0%, n=252) da tukwane (8.3).%. Buga kofato (4.8%, n = 58), fadama (4.0%, n = 48), tulun ruwa (5.2%, n = 62), tafkunan (1.9%, n = 23) da rijiyoyi (0.9%, n = 11) .) .
Gabaɗaya, an tattara jimlar 47,274 sauro sauro daga yankin binciken, tare da adadin 14.4% (n = 6,796) a cikin rukunin LLIN + Bti idan aka kwatanta da 85.6% (n = 40,478) a cikin rukunin LLIN kadai (RR = 5.96) [95% CI 5.80-6.11], P ≤ 0.001).Wadannan tsutsa sun ƙunshi nau'ikan sauro guda uku, mafi yawan nau'in su ne Anopheles.(48.7%, n = 23,041), sannan Culex spp.(35.0%, n = 16,562) da Aedes spp.(4.9%, n = 2340).Pupae ya ƙunshi 11.3% na ƙudaje marasa balaga (n = 5344).
Gabaɗaya matsakaicin yawan Anopheles spp.tsutsa.A cikin wannan binciken, adadin larvae a kowace scoop shine 0.61 [95% CI 0.41-0.81] L / dip a cikin rukunin LLIN + Bti da 3.97 [95% CI 3.56-4.38] L / nutse a cikin rukunin LLIN kawai (na zaɓi).fayil 1: Hoto S1).Matsakaicin yawa na Anopheles spp.Ƙungiyar LLIN kadai ta kasance sau 6.5 sama da ƙungiyar LLIN + Bti (HR = 6.49; 95% CI 5.80-7.27; P <0.001).Ba a gano sauro Anopheles yayin jiyya ba.An tattara larvae a cikin rukunin LLIN + Bti wanda ya fara a watan Janairu, daidai da jiyya na Bti na ashirin.A cikin rukunin LLIN + Bti, an sami raguwa sosai a farkon matakan tsutsa da kuma ƙarshen matakin.
Kafin fara jiyya na Bti (Maris), ma'anar yawan ma'anar sauro na farko Anopheles an kiyasta su zama 1.28 [95% CI 0.22-2.35] L / nutse a cikin LLIN + Bti rukuni da 1.37 [95% CI 0.36-2.36] l/ nutse a cikin rukunin LLIN + Bti.l/dip./ tsoma hannun LLIN kawai (Fig. 2A).Bayan aikace-aikacen jiyya na Bti, ma'anar yawancin sauro Anopheles a cikin rukunin LLIN + Bti gabaɗaya a hankali ya ragu daga 0.90 [95% CI 0.19-1.61] zuwa 0.10 [95% CI - 0.03-0.18] l / dip.Tun farkon farkon Anopheles ƙananan tsutsa sun ragu a cikin rukunin LLIN + Bti.A cikin rukunin LLIN-kawai, sauye-sauye a cikin yawan Anopheles spp.An lura da larvae na farko tare da ma'anar ma'ana daga 0.23 [95% CI 0.07-0.54] L / dive zuwa 2.37 [95% CI 1.77-2.98] L / dive.Gabaɗaya, ma'anar yawan larvae na Anopheles na farko a cikin rukunin LLIN-kawai ya kasance mafi girma a ƙididdigewa a 1.90 [95% CI 1.70-2.10] L / dive, yayin da ma'anar yawan larvae na Anopheles na farko a cikin rukunin LLIN shine 0.38 [95% CI 0.28]. -0.47]) l/dip.+ Ƙungiyar Bti (RR = 5.04; 95% CI 4.36-5.85; P <0.001).
Canje-canje a cikin matsakaicin yawa na Anopheles larvae.Farko (A) da kuma ƙarshen instar (B) gidajen sauro a cikin rukunin bincike daga Maris 2019 zuwa Fabrairu 2020 a yankin Napier, arewacin Cote d'Ivoire.LLIN: net ɗin kwari mai dorewa Bti: Bacillus thuringiensis, Isra'ila TRT: jiyya;
Matsakaicin yawa na Anopheles spp.tsutsa.marigayi tsufa a cikin rukunin LLIN + Bti.Yawan Jiyya na Bti na farko shine 2.98 [95% CI 0.26-5.60] L / dip, yayin da yawa a cikin rukunin LLIN-kadai shine 1.46 [95% CI 0.26-2.65] l / rana Bayan aikace-aikacen Bti, yawancin ƙarshen- instar Anopheles larvae a cikin rukunin LLIN + Bti sun ragu daga 0.22 [95% CI 0.04-0.40] zuwa 0.03 [95% CI 0.00-0.06] L / dip (Fig. 2B).A cikin rukunin LLIN-kawai, yawancin larvae na marigayi Anopheles ya karu daga 0.35 [95% CI - 0.15-0.76] zuwa 2.77 [95% CI 1.13-4.40] l / nutse tare da wasu bambance-bambance a cikin ƙwayar tsutsa dangane da kwanan watan samfur.Matsakaicin ma'auni na larvae-instar Anopheles a cikin rukunin LLIN-kawai shine 2.07 [95% CI 1.84-2.29] L / nutse, sau tara sama da 0.23 [95% CI 0.11-0.36] l/ nutsewa cikin LLIN.+ Ƙungiyar Bti (RR = 8.80; 95% CI 7.40-10.57; P <0.001).
Matsakaicin yawa na Culex spp.Darajar sun kasance 0.33 [95% CI 0.21-0.45] L / dip a cikin rukunin LLIN + Bti da 2.67 [95% CI 2.23-3.10] L / tsoma a cikin rukunin LLIN kawai (ƙarin fayil 2: Hoto S2).Matsakaicin yawa na Culex spp.Ƙungiyar LLIN kadai ta kasance mafi girma fiye da ƙungiyar LLIN + Bti (HR = 8.00; 95% CI 6.90-9.34; P <0.001).
Matsakaicin yawa na jinsin Culex Culex spp.Kafin magani, Bti l / dip shine 1.26 [95% CI 0.10-2.42] l / dip a cikin rukunin LLIN + Bti da 1.28 [95% CI 0.37-2.36] a cikin rukunin LLIN kawai (Fig. 3A).Bayan aikace-aikacen jiyya na Bti, ƙananan ƙwayoyin Culex na farko sun ragu daga 0.07 [95% CI - 0.001-0.] zuwa 0.25 [95% CI 0.006-0.51] L / dip.Ba a tattara larvae na Culex daga wuraren tsutsa da aka yi da Bti a farkon Disamba.An rage yawan larvae na farko na Culex zuwa 0.21 [95% CI 0.14-0.28] L / dip a cikin rukunin LLIN + Bti, amma ya kasance mafi girma a cikin rukunin LLIN kawai a 1.30 [95% CI 1.10- 1.50] l / nutsewa.sauke/d.Girman tsutsa na farko na Culex a cikin rukunin LLIN kadai ya ninka sau 6 fiye da na LLIN + Bti (RR = 6.17; 95% CI 5.11-7.52; P <0.001).
Canje-canje a cikin matsakaicin yawa na Culex spp.tsutsa.Gwajin rayuwar farko (A) da farkon rayuwa (B) a cikin rukunin bincike daga Maris 2019 zuwa Fabrairu 2020 a yankin Napier, arewacin Cote d'Ivoire.LLIN na kwari mai dorewa, Bti Bacillus thuringiensis Isra'ila, maganin Trt
Kafin jiyya na Bti, ma'anar maƙasudin ƙarshen instar Culex larvae a cikin ƙungiyar LLIN + Bti da ƙungiyar LLIN shine 0.97 [95% CI 0.09-1.85] da 1.60 [95% CI - 0.16-3.37] l / nutsewa daidai (Fig. 3B) ku.Ma'anar yawa na nau'in Culex na ƙarshe bayan ƙaddamar da jiyya na Bti.Yawan LLIN + Bti ya ragu a hankali kuma ya yi ƙasa da na cikin rukunin LLIN kawai, wanda ya kasance mai girma sosai.Matsakaicin ma'auni na ƙarshen instar Culex larvae shine 0.12 [95% CI 0.07-0.15] L / nutse a cikin rukunin LLIN + Bti da 1.36 [95% CI 1.11-1.61] L / nutse a cikin rukuni kawai LLIN.Matsakaicin ma'auni na larvae-instar Culex ya kasance mafi girma a cikin rukunin LLIN-kawai fiye da rukunin LLIN + Bti (RR = 11.19; 95% CI 8.83-14.43; P <0.001).
Kafin jiyya na Bti, ma'anar ma'anar pupae ta mace-bug shine 0.59 [95% CI 0.24-0.94] a cikin rukunin LLIN + Bti da 0.38 [95% CI 0.13-0.63] a cikin LLIN kawai (Fig. 4).Gabaɗaya yawan pupal shine 0.10 [95% CI 0.06-0.14] a cikin ƙungiyar LLIN + Bti da 0.84 [95% CI 0.75-0.92] a cikin ƙungiyar LLIN kaɗai.Maganin Bti ya rage yawan ma'anar pupal a cikin ƙungiyar LLIN + Bti idan aka kwatanta da ƙungiyar LLIN kadai (OR = 8.30; 95% CI 6.37-11.02; P <0.001).A cikin rukunin LLIN + Bti, ba a tattara pupae bayan Nuwamba.
Canje-canje a cikin matsakaicin yawa na pupae.An gudanar da binciken daga Maris 2019 zuwa Fabrairu 2020 a yankin Napier da ke arewacin Cote d'Ivoire.LLIN na kwari mai dorewa, Bti Bacillus thuringiensis Isra'ila, maganin Trt
An tattara jimlar manya sauro 3456 daga wurin binciken.Sauro na cikin nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan nau'ikan 17 (Anopheles, Culex, Aedes, Eretmapodites) (Table 1).A cikin cututtukan zazzabin cizon sauro An.gambiae sl ita ce mafi yawan nau'in nau'in nau'in nau'in nau'in nau'in nau'i na 74.9% (n = 2587), sai kuma An.gambiya sl.funestus (2.5%, n = 86) da kuma null (0.7%, n = 24).Arzikin Anna.gambiae sl a cikin rukunin LLIN + Bti (10.9%, n = 375) ya yi ƙasa da na rukunin LLIN kaɗai (64%, n = 2212).Babu zaman lafiya.An tara mutane da LLIN kawai.Duk da haka, An.Gambiya and An.funestus sun kasance a duka rukunin LLIN + Bti da ƙungiyar LLIN kaɗai.
A cikin binciken da aka fara kafin aikace-aikacen Bti a wurin kiwo (watanni 3), yawan adadin sauro na dare a kowane mutum (b / p / n) a cikin rukunin LLIN + Bti an kiyasta su zama 0.83 [95% CI 0.50-1.17]. , yayin da a cikin rukunin LLIN + Bti ya kasance 0.72 a cikin rukunin LLIN kawai [95% CI 0.41-1.02] (Fig. 5).A cikin rukunin LLIN + Bti, Culex sauro lalacewa ya ragu kuma ya kasance ƙasa kaɗan duk da kololuwar 1.95 [95% CI 1.35-2.54] bpp a cikin Satumba bayan aikace-aikacen 12th Bti.Koyaya, a cikin rukunin LLIN-kawai, matsakaicin cizon sauro ya karu a hankali kafin ya tashi a cikin Satumba a 11.33 [95% CI 7.15-15.50] bp/n.Yawan cizon sauro ya ragu sosai a cikin rukunin LLIN + Bti idan aka kwatanta da ƙungiyar LLIN kadai a kowane lokaci yayin binciken (HR = 3.66; 95% CI 3.01-4.49; P <0.001).
Yawan cizon sauro a yankin na Napier a arewacin Cote d'Ivoire daga Maris 2019 zuwa Fabrairu 2020 LLIN Dogon maganin kwari, Bti Bacillus thuringiensis Isra'ila, Trt magani, cizon b/p/dare/dan adam/ dare
Anopheles gambiae shine cutar zazzabin cizon sauro da aka fi sani da shi a yankin da aka yi nazari.Gudun cizon An.A asali, matan Gambia suna da darajar b / p / n na 0.64 [95% CI 0.27-1.00] a cikin rukunin LLIN + Bti da 0.74 [95% CI 0.30-1.17] a cikin rukuni kawai LLIN (Fig. 6) .A lokacin lokacin shigar da Bti, an lura da aikin cizon da ya fi girma a watan Satumba, wanda ya dace da hanya na goma sha biyu na maganin Bti, tare da kololuwar 1.46 [95% CI 0.87-2.05] b / p / n a cikin rukunin LLIN + Bti da kuma kololuwar 9.65 [95% CI 0.87–2.05] w/n 5.23–14.07] rukunin LLIN kawai.Gabaɗaya gudun cizon An.Yawan kamuwa da cuta a Gambiya ya ragu sosai a cikin rukunin LLIN + Bti (0.59 [95% CI 0.43-0.75] b/p/n) fiye da ƙungiyar LLIN kaɗai (2.97 [95% CI 2, 02-3.93] b /p/ba).(RR = 3.66; 95% CI 3.01-4.49; P <0.001).
Gudun cizon Anna.Gambiae sl, sashin bincike a yankin Napier, arewacin Cote d'Ivoire, daga Maris 2019 zuwa Fabrairu 2020 LLIN mai maganin kwari mai dorewa, gidan gado na Bti Bacillus thuringiensis Israel, Trt magani, cizon b/p/dare/ mutum/dare
Jimlar 646 amps.Gambiya ta wargaje.Gabaɗaya, adadin tsaro na gida.Adadin daidaito a Gambiya ya kasance> 70% a duk tsawon lokacin binciken, ban da Yuli, lokacin da kawai aka yi amfani da rukunin LLIN (Ƙarin fayil 3: Hoto S3).Koyaya, matsakaicin ƙimar haihuwa a yankin binciken shine 74.5% (n = 481).A cikin rukunin LLIN+Bti, adadin daidaito ya kasance a matsayi mai girma, sama da 80%, ban da Satumba, lokacin da adadin daidaito ya faɗi zuwa 77.5%.Koyaya, an lura da bambance-bambancen ma'ana na yawan haihuwa a cikin rukunin LLIN kawai, tare da kiyasin mafi ƙasƙanci na yawan haihuwa shine 64.5%.
Da 389 Ann.Wani binciken da aka yi na sassan jini guda ɗaya daga Gambiya ya gano cewa 80.5% (n = 313) sun fito ne daga asalin ɗan adam, 6.2% (n = 24) na mata sun cinye jini mai gauraye (na mutum da na gida) da 5.1% (n = 20) sun cinye jini. .ciyar daga dabbobi (shanu, tumaki da awaki) da 8.2% (n = 32) na samfuran da aka bincika ba su da kyau ga abincin jini.A cikin rukunin LLIN + Bti, adadin matan da ke karɓar jinin ɗan adam shine 25.7% (n = 100) idan aka kwatanta da 54.8% (n = 213) a cikin rukunin LLIN kawai (Ƙarin fayil 5: Table S5).
Jimlar 308 amps.An gwada P. gambiae don gano mambobi na hadaddun nau'in da P. falciparum kamuwa da cuta (Ƙarin fayil 4: Table S4).Biyu "nau'i-nau'i masu alaƙa" sun kasance tare a cikin yankin binciken, wato An.gambiae ss (95.1%, n = 293) da kuma An.coluzzii (4.9%, n = 15).Anopheles gambiae ss sun kasance ƙasa da ƙasa sosai a cikin rukunin LLIN + Bti fiye da rukunin LLIN kaɗai (66.2%, n = 204) (RR = 2.29 [95% CI 1.78-2.97], P <0.001).An samo irin wannan nau'in sauro na Anopheles a cikin rukunin LLIN + Bti (3.6%, n = 11) da kuma ƙungiyar LLIN kawai (1.3%, n = 4) (RR = 2.75 [95% CI 0.81-11 .84], P = .118).Yawan kamuwa da cutar Plasmodium falciparum tsakanin An.SL a Gambiya ya kasance 11.4% (n = 35).Plasmodium falciparum kamuwa da cuta.Yawan kamuwa da cuta a Gambiya ya ragu sosai a cikin rukunin LLIN + Bti (2.9%, n = 9) fiye da rukunin LLIN kadai (8.4%, n = 26) (RR = 2.89 [95% CI 1. 31-7.01). , P = 0.006).).Idan aka kwatanta da sauro Anopheles, Anopheles gambiae sauro yana da mafi girman adadin kamuwa da cutar Plasmodium a 94.3% (n=32).coluzzii kawai 5.7% (n = 5) (RR = 6.4 [95% CI 2.47-21.04], P <0.001).
An yi binciken jimillar mutane 2,435 daga gidaje 400.Matsakaicin yawa shine mutane 6.1 a kowane gida.Adadin mallakar LLIN tsakanin gidaje shine 85% (n = 340), idan aka kwatanta da 15% (n = 60) na gidaje marasa LLIN (RR = 5.67 [95% CI 4.29-7.59], P <0.001) (Ƙarin fayil 5). : tebur S5)..Amfani da LLIN shine 40.7% (n = 990) a cikin rukunin LLIN + Bti idan aka kwatanta da 36.2% (n = 882) a cikin rukunin LLIN kadai (RR = 1.12 [95% CI 1.02-1.23], P = 0.013).Matsakaicin yawan amfani da yanar gizo gabaɗaya a yankin binciken shine 38.4% (n = 1842).Adadin yara 'yan kasa da shekaru biyar masu amfani da Intanet sun kasance iri ɗaya a cikin ƙungiyoyin binciken biyu, tare da ƙimar amfani da yanar gizo na 41.2% (n = 195) a cikin rukunin LLIN + Bti da 43.2% (n = 186) a cikin rukuni kawai LLIN.(HR = 1.05 [95% CI 0.85-1.29], P = 0.682).Daga cikin yara masu shekaru 5 zuwa 15, babu bambanci a cikin ƙimar amfani tsakanin 36.3% (n = 250) a cikin rukunin LLIN + Bti da 36.9% (n = 250) a cikin rukunin LLIN kawai (RR = 1. 02. 95% CI 1.02-1.23], P = 0.894).Duk da haka, waɗanda suka wuce shekaru 15 sun yi amfani da gidajen gado 42.7% (n = 554) sau da yawa a cikin rukunin LLIN + Bti fiye da 33.4% (n = 439) a cikin rukunin LLIN kawai (RR = 1.26 [95% CI 1.11-1.43) , P <0.001).
An yi rikodin shari'o'in asibiti 2,484 a Cibiyar Kiwon Lafiya ta Napier tsakanin Maris 2018 da Fabrairu 2020. Yawan zazzabin cizon sauro na asibiti a cikin yawan jama'a shine 82.0% na duk cututtukan cututtukan asibiti (n = 2038).Adadin cutar zazzabin cizon sauro na gida na shekara-shekara a cikin wannan yanki na binciken shine 479.8‰ da 297.5‰ kafin da bayan jiyya na Bti (Table 2).
Lokacin aikawa: Jul-01-2024