Raguwar da aka samu kwanan nan a cikin nauyin cutar maleriya a Côte d'Ivoire ya fi yawa ne sakamakon amfani da gidajen sauro masu ɗorewa (LIN). Duk da haka, wannan ci gaba yana fuskantar barazana daga juriyar maganin kwari, canje-canjen halaye a yawan mutanen Anopheles gambiae, da kuma yaduwar cutar maleriya da ta rage, wanda hakan ya haifar da buƙatar ƙarin kayan aiki. Saboda haka, manufar wannan binciken ita ce a tantance ingancin amfani da LLIN da Bacillus thuringiensis (Bti) tare da kwatanta shi da LLIN.
An gudanar da binciken ne daga Maris 2019 zuwa Fabrairu 2020 a kan makamai biyu na bincike (hannun LLIN + Bti da hannun LLIN kawai) a yankin kiwon lafiya na Korhogo a arewacin Côte d'Ivoire. A cikin ƙungiyar LLIN + Bti, ana yi wa mazaunin tsutsotsi na Anopheles magani da Bti duk bayan makonni biyu ban da LLIN. An tattara tsutsotsi da sauro manya kuma an gano su ta hanyar siffofi daban-daban ta amfani da hanyoyin da aka saba. Memba Ann. An gano hadaddun Gambian ta amfani da fasahar polymerase chain reaction. Kamuwa da cuta tare da Plasmodium An. An kuma tantance yawan kamuwa da cutar zazzabin cizon sauro a Gambia da kuma al'ummar yankin.
Gabaɗaya, yawan tsutsotsi na Anopheles ya yi ƙasa a cikin ƙungiyar LLIN + Bti idan aka kwatanta da ƙungiyar LLIN kaɗai 0.61 [95% CI 0.41–0.81] tsutsotsi/nutsewa (l/nutsewa) 3.97 [95% CI 3.56–4 .38] l/nutsewa (RR = 6.50; 95% CI 5.81–7.29 P < 0.001). Jimillar saurin cizon An. Yawan cizon S. gambiae shine 0.59 [95% CI 0.43–0.75] ga kowane mutum/dare a cikin ƙungiyar LLIN + Bti kaɗai, idan aka kwatanta da cizon 2.97 [95% CI 2.02–3.93] ga kowane mutum/dare a cikin ƙungiyar LLIN kawai (P < 0.001). An fi gano Anopheles gambiae a matsayin sauro na Anopheles. Anopheles gambiae (ss) (95.1%; n = 293), sai kuma Anopheles gambiae (4.9%; n = 15). Ma'aunin jinin ɗan adam a yankin binciken shine 80.5% (n = 389). EIR na ƙungiyar LLIN + Bti shine cizon kamuwa 1.36 ga kowane mutum a kowace shekara (ib/p/y), yayin da EIR na ƙungiyar LLIN kawai shine 47.71 ib/p/y. Yawan kamuwa da cutar zazzabin cizon sauro ya ragu sosai daga 291.8‰ (n = 765) zuwa 111.4‰ (n = 292) a cikin ƙungiyar LLIN + Bti (P < 0.001).
Haɗin LLIN da Bti ya rage yawan kamuwa da cutar maleriya sosai. Haɗin LLIN da Bti na iya zama wata hanya mai kyau ta haɗaka don shawo kan cutar A. Gambia ba ta da maleriya.
Duk da ci gaba a fannin shawo kan cutar maleriya a cikin 'yan shekarun da suka gabata, nauyin cutar maleriya ya kasance babbar matsala a yankin kudu da hamadar sahara [1]. Hukumar Lafiya ta Duniya (WHO) ta ba da rahoton kwanan nan cewa akwai masu cutar maleriya miliyan 249 da kuma kimanin mace-mace 608,000 da suka shafi maleriya a duk duniya a shekarar 2023 [2]. Yankin Afirka na WHO ya kai kashi 95% na masu cutar maleriya a duniya da kuma kashi 96% na mace-macen maleriya, inda mata masu juna biyu da yara 'yan ƙasa da shekara 5 suka fi kamuwa da cutar [2, 3].
Gidajen kashe kwari masu ɗorewa (LLIN) da feshi na cikin gida (IRS) sun taka muhimmiyar rawa wajen rage nauyin cutar malaria a Afirka [4]. Faɗaɗa waɗannan kayan aikin sarrafa ƙwayoyin cuta na malaria ya haifar da raguwar kamuwa da cutar malaria da kashi 37% da raguwar mace-mace da kashi 60% tsakanin 2000 da 2015 [5]. Duk da haka, yanayin da aka lura tun 2015 ya tsaya cak ko ma ya yi sauri, inda mutuwar maleriya ta kasance mai yawa ba za a yarda da ita ba, musamman a yankin kudu da hamadar Saharar Afirka [3]. Nazari da dama sun gano fitowar da yaduwar juriya tsakanin manyan ƙwayoyin cuta na malaria Anopheles ga magungunan kwari da ake amfani da su a lafiyar jama'a a matsayin shinge ga tasirin LLIN da IRS a nan gaba [6,7,8]. Bugu da ƙari, canje-canje a cikin halayen cizon ƙwayoyin cuta a waje da kuma da daddare suna da alhakin yaɗuwar cutar malaria kuma abin damuwa ne da ke ƙaruwa [9, 10]. Iyakokin LLIN da IRS wajen sarrafa ƙwayoyin cuta da ke da alhakin yaɗuwar cutar malaria babban ƙuntatawa ne ga ƙoƙarin kawar da cutar malaria na yanzu [11]. Bugu da ƙari, ana bayyana dagewar cutar zazzabin cizon sauro ta hanyar yanayin yanayi da ayyukan ɗan adam, waɗanda ke ba da gudummawa ga ƙirƙirar wurin zama na tsutsotsi [12].
Gudanar da tushen tsutsotsi (LSM) wata hanya ce ta kiwo wadda ta dogara da wurin kiwo don rage yawan wuraren kiwo da kuma adadin tsutsotsin sauro da 'yan karnuka da ke cikinsu [13]. An ba da shawarar LSM ta hanyar bincike da dama a matsayin ƙarin dabarar haɗaka don kula da ƙwayoyin zazzabin cizon sauro [14, 15]. A gaskiya ma, ingancin LSM yana ba da fa'ida biyu akan cizon nau'in ƙwayoyin zazzabin cizon sauro a cikin gida da waje [4]. Bugu da ƙari, sarrafa ƙwayoyin cuta tare da LSMs masu tushen larvicide kamar Bacillus thuringiensis israelensis (Bti) na iya faɗaɗa kewayon zaɓuɓɓukan sarrafa zazzabin cizon sauro. A tarihi, LSM ta taka muhimmiyar rawa wajen nasarar shawo kan 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 kula da kwari a wasu ƙasashe da suka kawar da zazzabin cizon sauro, LSM ba a haɗa ta sosai cikin manufofi da ayyukan sarrafa zazzabin cizon sauro a Afirka ba kuma ana amfani da ita ne kawai a cikin shirye-shiryen sarrafa zazzabin cizon sauro a wasu ƙasashen kudu da hamadar sahara. ƙasashe [14,15,16,17,18,19]. Ɗaya daga cikin dalilan da ke haifar da wannan shi ne yadda aka yi imani da cewa wuraren kiwo suna da yawa kuma suna da wahalar samu, wanda hakan ya sa LSM ta yi tsada sosai don aiwatarwa [4, 5, 6, 7, 8, 9, 10, 11, 13, 14]. Saboda haka, Hukumar Lafiya ta Duniya ta ba da shawarar tsawon shekaru da dama cewa albarkatun da aka tattara don kula da ƙwayoyin cutar malaria ya kamata su mai da hankali kan LLIN da IRS [20, 21]. Sai a shekarar 2012 ne Hukumar Lafiya ta Duniya ta ba da shawarar haɗa LSM, musamman hanyoyin Bti, a matsayin ƙarin taimako ga LLIN da IRS a wasu wurare a yankin kudu da hamadar Sahara na Afirka [20]. Tun lokacin da WHO ta ba da wannan shawarar, an gudanar da bincike da dama kan yuwuwar, inganci da farashin biolarvicides a yankin kudu da hamadar Sahara na Afirka, wanda ke nuna ingancin LSM wajen rage yawan sauro na Anopheles da ingancin yaɗa cutar malaria dangane da [22, 23]. . , 24].
Côte d'Ivoire tana cikin ƙasashe 15 da suka fi fama da cutar maleriya a duniya [25]. Yaɗuwar cutar maleriya a Côte d'Ivoire tana wakiltar kashi 3.0% na nauyin maleriya a duniya, tare da kiyasin faruwar cutar da adadin waɗanda suka kamu da cutar ya kama daga 300 zuwa sama da 500 ga kowane mutum 1000 [25]. Duk da tsawon lokacin rani daga Nuwamba zuwa Mayu, maleriya tana yaɗuwa a duk shekara a yankin arewacin ƙasar [26]. Yaɗuwar cutar maleriya a wannan yanki yana da alaƙa da kasancewar adadi mai yawa na masu ɗauke da cutar Plasmodium falciparum marasa alamun cutar [27]. A wannan yanki, cutar maleriya mafi yawan gaske ita ce Anopheles gambiae (SL). Tsaron gida. Sauro na Anopheles gambiae galibi sun ƙunshi Anopheles gambiae (SS), wanda ke da matuƙar juriya ga magungunan kwari don haka yana haifar da babban haɗarin yaɗuwar cutar maleriya [26]. Amfani da LLIN na iya samun ɗan tasiri kan rage yaɗuwar cutar maleriya saboda juriyar maganin kwari na ƙwayoyin cuta na gida don haka ya kasance babban abin damuwa. Nazarin gwaji da aka yi amfani da Bti ko LLIN ya nuna tasiri wajen rage yawan ƙwayoyin sauro a arewacin Côte d'Ivoire. Duk da haka, babu wani bincike da aka yi a baya da ya tantance tasirin yawan amfani da Bti tare da LLIN akan yaduwar cutar malaria da kuma yawan kamuwa da cutar malaria a wannan yanki. Saboda haka, wannan binciken yana da nufin kimanta tasirin amfani da LLIN da Bti tare da haɗin gwiwa kan yaduwar cutar malaria ta hanyar kwatanta ƙungiyar LLIN + Bti tare da ƙungiyar LLIN kaɗai a ƙauyuka huɗu a yankin arewacin Côte d'Ivoire. An yi hasashen cewa aiwatar da LSM mai tushen Bti a saman LLIN zai ƙara daraja ta hanyar ƙara rage yawan sauro na malaria idan aka kwatanta da LLIN kaɗai. Wannan hanyar haɗin gwiwa, wacce ke kai hari ga sauro na Anopheles marasa girma waɗanda ke ɗauke da Bti da kuma sauro na Anopheles manya waɗanda ke ɗauke da LLIN, na iya zama mahimmanci don rage yaduwar cutar malaria a yankunan da ke da yawan masu kamuwa da cutar malaria, kamar ƙauyuka a arewacin Côte d'Ivoire. Saboda haka, sakamakon wannan binciken na iya taimakawa wajen yanke shawara ko za a haɗa LSM a cikin shirye-shiryen kula da ƙwayoyin cutar malaria na ƙasa (NMCPs) a cikin ƙasashen da ke kudu da hamadar Sahara.
An gudanar da wannan binciken a ƙauyuka huɗu na sashen Napieldugou (wanda aka fi sani da Napier) a yankin tsaftar muhalli na Korhogo a arewacin Côte d'Ivoire (Hoto na 1). Ƙauyukan da ake nazari a kansu: Kakologo (9° 14′ 2″ N, 5° 35′ 22″ E), Kolekakha (9° 17′ 24″ N, 5° 31′ 00″ E.), Lofinekaha (9° 17′ 31″). ) 5° 36′ 24″ N) da Nambatiurkaha (9° 18′ 36″ N, 5° 31′ 22″ E). An kiyasta yawan mutanen Napierledougou a shekarar 2021, kuma lardin ya ƙunshi ƙauyuka 53 tare da cibiyoyin lafiya guda biyu [28]. A lardin Napyeledougou, inda zazzabin cizon sauro shine babban abin da ke haifar da ziyarar likita, asibiti da kuma mace-mace, LLIN ne kawai ake amfani da shi don sarrafa cututtukan Anopheles [29]. Duk ƙauyuka huɗu a cikin ƙungiyoyin binciken biyu suna ƙarƙashin cibiyar lafiya ɗaya, waɗanda aka sake duba bayanan asibiti na shari'o'in cutar malaria a cikin wannan binciken.
Taswirar Côte d'Ivoire da ke nuna yankin binciken. (Tushen taswira da manhajar kwamfuta: bayanai na GADM da ArcMap 10.6.1. Gidan maganin kwari mai ɗorewa na LLIN, Bti Bacillus thuringiensis israelensis
Yaɗuwar cutar maleriya a tsakanin mutanen da Cibiyar Lafiya ta Napier ta yi niyya ya kai kashi 82.0% (masu cutar 2038) (bayanan kafin Bti). A cikin dukkan ƙauyuka huɗu, gidaje suna amfani da PermaNet® 2.0 LLIN kawai, wanda NMCP ta Ivory Coast ta rarraba a shekarar 2017, tare da ɗaukar nauyin da ya wuce 80% [25, 26, 27, 28, 30]. Ƙauyukan suna cikin yankin Korhogo, wanda ke zama wurin da Majalisar Soja ta Ƙasa ta Ivory Coast ke kula da shi kuma ana iya samunsa duk shekara. Kowace ƙauyuka huɗu suna da aƙalla gidaje 100 da kusan mutane iri ɗaya, kuma a cewar rajistar lafiya (takardar aiki ta Ma'aikatar Lafiya ta Ivory Coast), ana ba da rahoton shari'o'i da dama na maleriya kowace shekara. Plasmodium falciparum (P. falciparum) galibi ke haifar da maleriya kuma Plasmodium yana yaɗawa ga mutane. gambiae kuma sauro ne na Anopheles da Anopheles nili a yankin [28]. An. gambiae na gida ya ƙunshi sauro ne na Anopheles. gambiae ss yana da yawan sauye-sauyen kdr (mita: 90.70–100%) da matsakaicin mita na ace-1 aceles (mita: 55.56–95%) [29].
Matsakaicin ruwan sama da zafin jiki na shekara-shekara yana tsakanin 1200 zuwa 1400 mm da 21 zuwa 35 °C bi da bi, kuma an kiyasta cewa ɗanɗanon da ke tsakanin su (RH) ya kai 58%. Wannan yanki na binciken yana da yanayi irin na Sudan tare da lokacin bushewa na watanni 6 (Nuwamba zuwa Afrilu) da kuma lokacin damina na watanni 6 (Mayu zuwa Oktoba). Yankin yana fuskantar wasu daga cikin tasirin sauyin yanayi, kamar asarar ciyayi da kuma lokacin bushewa mai tsawo, wanda ke da alaƙa da bushewar wuraren ruwa (ƙasa, filayen shinkafa, tafkuna, kududdufai) waɗanda za su iya zama wurin zama ga tsutsotsin sauro na Anopheles. Sauro[26].
An gudanar da binciken ne a cikin ƙungiyar LLIN + Bti, wadda ƙauyukan Kakologo da Nambatiurkaha suka wakilta, da kuma a cikin ƙungiyar LLIN kawai, waɗanda ƙauyukan Kolekaha da Lofinekaha suka wakilta. A lokacin wannan binciken, mutane a duk waɗannan ƙauyukan suna amfani da LLIN PermaNet® 2.0 kawai.
An kimanta ingancin LLIN (PermaNet 2.0) tare da Bti akan sauro na Anopheles da kuma yaduwar cutar maleriya a cikin wani gwaji mai sarrafawa bazuwar (RCT) tare da makamai biyu na bincike: ƙungiyar LLIN + Bti (ƙungiyar magani) da ƙungiyar LLIN kaɗai (ƙungiyar kulawa). Kakologo da Nambatiourkaha ne suka wakilci hannayen LLIN + Bti, yayin da aka tsara Kolékaha da Lofinékaha a matsayin kafadu na LLIN kawai. A cikin dukkan ƙauyuka huɗu, mazauna yankin suna amfani da LLIN PermaNet® 2.0 da aka karɓa daga Ivory Coast NMCP a 2017. Ana tsammanin cewa yanayin amfani da PermaNet® 2.0 iri ɗaya ne a ƙauyuka daban-daban saboda sun sami hanyar sadarwa ta hanya ɗaya. . A cikin ƙungiyar LLIN + Bti, ana kula da mazaunin tsutsotsi na Anopheles da Bti duk bayan makonni biyu ban da LLIN da jama'a suka riga suka yi amfani da shi. An yi wa mazaunan tsutsotsi a cikin ƙauyuka da kuma cikin radius na kilomita 2 daga tsakiyar kowace ƙauye magani bisa ga shawarwarin Hukumar Lafiya ta Duniya da NMCP na Côte d'Ivoire [31]. Sabanin haka, ƙungiyar LLIN kawai ba ta sami maganin Bti na tsutsotsi a lokacin binciken ba.
An yi amfani da nau'in Bti mai narkewa a ruwa (Vectobac WG, 37.4% wt; lambar yanki 88–916-PG; 3000 International Toxicity Units IU/mg; Valent BioScience Corp, Amurka) a cikin adadin 0.5 mg/L. Yi amfani da na'urar fesawa ta baya mai lita 16 da bindigar fesawa ta fiberglass mai manne da bututun fesawa mai daidaitawa tare da saurin kwarara na 52 ml a kowace daƙiƙa (3.1 L/min). Don shirya nebulizer mai ɗauke da L 10 na ruwa, adadin Bti da aka narkar a cikin dakatarwa shine 0.5 mg/L × 10 L = 5 mg. Misali, ga yankin da ke da kwararar ruwa mai tsari na L 10, ta amfani da na'urar fesawa ta L 10 don magance yawan ruwa, adadin Bti da ake buƙatar narkarwa shine 0.5 mg/L × 20 L = 10 mg. An auna 10 mg Bti a filin ta amfani da sikelin lantarki. Ta amfani da spatula, shirya slurry ta hanyar haɗa wannan adadin Bti a cikin bokiti mai girman lita 10. An zaɓi wannan adadin bayan gwaje-gwajen filin na tasirin Bti akan nau'ikan Anopheles spp. da Culex spp. a cikin yanayi na halitta a wani yanki daban, amma yayi kama da yankin bincike na zamani [32]. An ƙididdige yawan amfani da dakatarwar larvicide da tsawon lokacin amfani da shi ga kowane wurin kiwo bisa ga ƙimar adadin ruwa a wurin kiwo [33]. A shafa Bti ta amfani da feshin hannu mai daidaitawa. Ana daidaita kuma ana gwada Nebulizers yayin motsa jiki daban-daban da kuma a wurare daban-daban don tabbatar da cewa an isar da adadin Bti daidai.
Domin nemo mafi kyawun lokacin da za a yi maganin wuraren kiwon tsutsotsi, ƙungiyar ta gano feshin tagar. Tagar feshin ita ce lokacin da ake amfani da samfurin don cimma ingantaccen tasiri: a cikin wannan binciken, tagar feshin ta kasance daga awanni 12 zuwa makonni 2, ya danganta da juriyar Bti. A bayyane yake, shan Bti ta hanyar tsutsotsi a wurin kiwon yana buƙatar lokaci daga 7:00 zuwa 18:00. Ta wannan hanyar, ana iya guje wa lokutan ruwan sama mai ƙarfi lokacin da ruwan sama ke nufin dakatar da feshi da sake farawa washegari idan yanayi ya yi aiki tare. Kwanakin feshin da ainihin kwanakin da lokutan sun dogara ne akan yanayin yanayi da aka lura. Don daidaita feshin jakunkunan baya don ƙimar amfani da Bti, kowane ma'aikaci yana da horo don duba da kuma saita bututun feshin da ake so da kuma kula da matsin lamba. Ana kammala daidaitawa ta hanyar tabbatar da cewa ana amfani da madaidaicin adadin maganin Bti daidai gwargwado a kowane yanki. Kula da mazaunin tsutsotsi a kowane mako biyu. Ana gudanar da ayyukan kashe tsutsotsi tare da tallafin ƙwararru huɗu masu ƙwarewa da horo. Masu kula da tsutsotsi da mahalarta suna kula da ayyukan kashe tsutsotsi. Maganin kashe tsutsotsi ya fara ne a watan Maris na 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 maganin kashe ƙwari saboda kwanciyar hankalin wuraren kiwo da raguwar yawansu [27]. Ana sa ran sarrafa tsutsotsi a lokacin rani zai hana jawo sauro a lokacin damina. Kilogiram biyu (02) na Bti wanda farashinsa ya kai dala $99.29 ya ba ƙungiyar binciken da ke karɓar magani damar rufe dukkan yankuna. A cikin ƙungiyar LLIN+Bti, maganin kashe ƙwari ya ɗauki shekara guda, daga Maris 2019 zuwa Fabrairu 2020. Jimillar shari'o'i 22 na maganin kashe ƙwari sun faru a cikin ƙungiyar LLIN+Bti.
An lura da illolin da ka iya tasowa (kamar ƙaiƙayi, jiri ko kuma hanci mai gudu) ta hanyar binciken da aka yi wa nebulizers na Bti biolarvicide da mazauna gidaje da ke cikin ƙungiyar LIN + Bti.
An gudanar da wani bincike na gida a tsakanin gidaje 400 (gidaje 200 a kowace rukunin bincike) don kimanta kaso na yawan amfani da LLIN a tsakanin al'umma. Lokacin da ake binciken gidaje, ana amfani da hanyar tambayoyi masu yawa. An raba yawan amfani da LLIN zuwa ƙungiyoyi uku: shekaru 15. An kammala tambayoyin kuma an yi bayani a cikin harshen Senoufo na gida ga shugaban gidan ko wani babba sama da shekaru 18.
An ƙididdige mafi ƙarancin girman gidan da aka yi bincike a kansa ta amfani da dabarar da Vaughan da Morrow suka bayyana [34].
n shine girman samfurin, e shine gefen kuskure, t shine abin da ya shafi aminci wanda aka samo daga matakin amincewa, kuma p shine rabon iyayen jama'a tare da sifar da aka bayar. Kowane sashi na ɓangaren yana da ƙima mai daidaito, don haka (t) = 1.96; Mafi ƙarancin girman gida a wannan yanayin a cikin binciken shine gidaje 384.
Kafin gwajin da ake yi yanzu, an gano nau'ikan matsugunan tsutsotsi na Anopheles a cikin ƙungiyoyin LLIN+Bti da LLIN, an yi musu samfuri, an bayyana su, an yi musu kwatancen ƙasa kuma an yi musu lakabi. Yi amfani da ma'aunin tef don auna girman mazaunin gida. Daga nan aka tantance yawan tsutsotsi na sauro kowane wata na tsawon watanni 12 a wurare 30 da aka zaɓa bazuwar kowace ƙauye, don jimlar wuraren kiwo 60 ga kowace ƙungiyar bincike. Akwai samfuran tsutsotsi 12 a kowane yanki na nazari, wanda ya yi daidai da maganin Bti 22. Manufar zaɓar waɗannan wuraren kiwo 30 a kowace ƙauye ita ce a kama isassun wuraren tattara tsutsotsi a cikin ƙauyuka da sassan karatu don rage son zuciya. An tattara tsutsotsi ta hanyar tsoma cokali 60 ml [35]. Saboda gaskiyar cewa wasu wuraren kiwo ƙanana ne kuma ba su da zurfi, ya zama dole a yi amfani da ƙaramin bokiti banda bokitin WHO na yau da kullun (350 ml). An yi nutsewa 5, 10 ko 20 daga wuraren kiwo tare da kewayen mita 10, bi da bi. An gudanar da tantance yanayin tsutsotsin da aka tattara (misali Anopheles, Culex da Aedes) kai tsaye a cikin filin [36]. An raba tsutsotsin da aka tattara zuwa rukuni biyu bisa ga matakin ci gaba: tsutsotsin da suka fara shiga (matakai na 1 da 2) da tsutsotsin da suka fara shiga a ƙarshen lokaci (matakai na 3 da 4) [37]. An ƙirga tsutsotsin ta hanyar jinsi da kuma a kowane matakin ci gaba. Bayan ƙirgawa, ana sake mayar da tsutsotsin sauro zuwa wuraren kiwo kuma a cika su da ruwan da aka ƙara musu ruwan sama zuwa girmansu na asali.
Ana ɗaukar wurin da ake kiwo a matsayin wurin da ake da tabbacin samun kwari idan akwai aƙalla tsutsa ɗaya ko ɗan ƙwaro na kowace nau'in sauro. Ana tantance yawan tsutsa ta hanyar raba adadin tsutsotsi na wannan nau'in da adadin nutsewa.
Kowace binciken ta ɗauki tsawon kwana biyu a jere, kuma duk bayan watanni biyu, ana tattara sauro manya daga gidaje 10 da aka zaɓa ba bisa ƙa'ida ba daga kowace ƙauye. A cikin binciken, kowace ƙungiyar bincike ta gudanar da bincike na gidaje 20 a cikin kwanaki uku a jere. An kama sauro ta amfani da tarkunan taga na yau da kullun (WT) da tarkunan feshi na pyrethrum (PSC) [38, 39]. Da farko, an yi wa dukkan gidaje a kowace ƙauye lambobi. Daga nan aka zaɓi gidaje huɗu a kowace ƙauye ba bisa ƙa'ida ba a matsayin wuraren tattara sauro manya. A cikin kowace gida da aka zaɓa ba bisa ƙa'ida ba, an tattara sauro daga babban ɗakin kwana. Dakunan kwanan da aka zaɓa suna da ƙofofi da tagogi kuma an zauna a cikinsu a daren da ya gabata. Dakunan kwanan da aka zaɓa suna da ƙofofi da tagogi kuma an zauna a cikinsu a daren da ya gabata. Dakunan kwanan da aka zaɓa suna rufe kafin fara aiki da kuma lokacin tattara sauro don hana sauro fitowa daga ɗakin. An sanya WT a kowace taga ta kowace ɗakin kwana a matsayin wurin ɗaukar samfurin sauro. Washegari, an tattara sauro waɗanda suka shiga wurin aiki daga ɗakunan kwanan tsakanin 06:00 zuwa 08:00 na safe. Tattara sauro daga wurin aikinku ta amfani da abin magana kuma a adana su a cikin kofin takarda da aka zubar da aka rufe da ɗanyen yanki. Gidan sauro. An kama sauro da ke kwance a ɗakin kwana ɗaya nan da nan bayan an tattara maganin WT ta amfani da PSC mai tushen pyrethroid. Bayan an shimfiɗa fararen zanen gado a ƙasan ɗakin kwana, a rufe ƙofofi da tagogi a fesa maganin kwari (sinadaran aiki: 0.25% transfluthrin + 0.20% permethrin). Kimanin mintuna 10 zuwa 15 bayan fesawa, a cire murfin gado daga ɗakin kwana da aka yi wa magani, a yi amfani da tweezers don ɗaukar duk wani sauro da ya faɗi akan fararen zanen, sannan a adana su a cikin kwano na Petri da aka cika da ulu na auduga da aka jika da ruwa. An kuma rubuta adadin mutanen da suka kwana a ɗakunan kwana da aka zaɓa. Ana aika sauro da aka tattara cikin sauri zuwa dakin gwaje-gwaje don ƙarin sarrafawa.
A dakin gwaje-gwaje, duk sauro da aka tattara an gano su ta hanyar siffofi da nau'ikan halittu [36]. Kwaikwayon Anna. gambiae SL ta amfani da na'urar hangen nesa ta binocular dissecting microscope tare da digo na ruwan da aka tace a kan gilashin zamewa [35]. An tantance matsayin daidaito don raba mata masu juna biyu daga mata masu juna biyu bisa ga yanayin kwaikwaiyo da tracheal, da kuma tantance yawan haihuwa da shekarun jiki [35].
Ana tantance ma'aunin dangi ta hanyar gwada tushen abincin jini da aka tattara sabo. gambiae ta hanyar gwajin enzyme-linked immunosorbent assay (ELISA) ta amfani da jini daga mutane, dabbobi (shanu, tumaki, awaki) da kuma masu masaukin kaji [40]. An ƙididdige kamuwa da cutar entomological infestation (EIR) ta amfani da An. Kimantawar matan SL a Gambia [41] Bugu da ƙari, An. An tantance kamuwa da cutar 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 da aka gano ta hanyar nazarin ƙafafunta, fikafikanta da cikinta ta amfani da dabarun polymerase chain reaction (PCR) [34].
An samo bayanan asibiti kan zazzabin cizon sauro daga rajistar shawarwari ta asibiti ta Cibiyar Lafiya ta Napyeledugou, wacce ta shafi dukkan ƙauyuka huɗu da aka haɗa a cikin wannan binciken (misali Kakologo, Kolekaha, Lofinekaha da Nambatiurkaha). Binciken 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 suna wakiltar bayanan farko ko na kafin shiga Bti, yayin da bayanan asibiti daga Maris 2019 zuwa Fabrairu 2020 suna wakiltar bayanan kafin shiga Bti. Bayanai bayan shiga Bti. An tattara bayanan asibiti, shekaru da ƙauyen kowane majiyyaci a cikin ƙungiyoyin binciken LLIN+Bti da LLIN a cikin rajistar lafiya. Ga kowane majiyyaci, an rubuta bayanai kamar asalin ƙauye, shekaru, ganewar asali, da cututtukan cututtuka. A cikin shari'o'in da aka sake duba a cikin wannan binciken, an tabbatar da zazzabin cizon sauro ta hanyar gwajin ganewar asali (RDT) da/ko na'urar duba cutar malaria bayan an yi amfani da maganin haɗin gwiwa na artemisinin (ACT) ta hanyar mai ba da sabis na kiwon lafiya. An raba masu fama da cutar zazzabin cizon sauro zuwa ƙungiyoyi uku na shekaru (watau shekaru 15). An kiyasta yawan kamuwa da cutar zazzabin cizon sauro a kowace shekara ga kowane mutum 1000 ta hanyar raba yawan kamuwa da cutar zazzabin cizon sauro ga kowane mutum 1000 bisa ga yawan mutanen ƙauyen.
An shigar da bayanan da aka tattara a cikin wannan binciken sau biyu a cikin rumbun adana bayanai na Microsoft Excel sannan aka shigo da su cikin manhajar bude tushen R [42] sigar 3.6.3 don nazarin kididdiga. Ana amfani da fakitin ggplot2 don zana zane-zane. An yi amfani da samfuran layi na gabaɗaya ta amfani da Poisson regression don kwatanta yawan tsutsa da matsakaicin adadin cizon sauro ga mutum ɗaya a kowace dare tsakanin ƙungiyoyin bincike. An yi amfani da ma'aunin rabon dacewa (RR) don kwatanta matsakaicin yawan tsutsa da ƙimar cizon sauro na Culex da Anopheles. An sanya Gambia SL tsakanin ƙungiyoyin binciken guda biyu ta amfani da ƙungiyar LLIN + Bti a matsayin tushen. An bayyana girman tasirin a matsayin rabon rashin daidaito da tazara na amincewa 95% (95% CI). An yi amfani da rabon (RR) na gwajin Poisson don kwatanta rabo da yawan kamuwa da cutar malaria kafin da bayan shiga tsakani na Bti a cikin kowace ƙungiyar bincike. Matsayin mahimmancin da aka yi amfani da shi shine 5%.
Kwamitin Da'a na Bincike na Ƙasa na Ma'aikatar Lafiya da Lafiyar Jama'a ta Côte d'Ivoire ya amince da yarjejeniyar binciken (N/Ref: 001//MSHP/CNESVS-kp), da kuma gundumar lafiya ta yankin da kuma gwamnatin Korhogo. Kafin a tattara tsutsotsi da manya, an sami amincewar da aka sanya hannu daga mahalarta binciken gida, masu su, da/ko mazauna. Bayanan iyali da na asibiti ba a san ko su waye ba kuma sirri ne kuma ana samun su ne kawai ga masu bincike da aka keɓe.
An ziyarci jimillar wuraren yin kaciya 1198. Daga cikin waɗannan wuraren yin kaciya da aka yi bincike a yankin binciken, kashi 52.5% (n = 629) na ƙungiyar LLIN + Bti ne da kuma kashi 47.5% (n = 569) na ƙungiyar LLIN kawai (RR = 1.10 [95% CI 0 .98–1.24], P = 0.088). Gabaɗaya, an rarraba wuraren yin kaciya na gida zuwa nau'ikan 12, waɗanda daga cikinsu mafi girman adadin wuraren yin kaciya sune gonakin shinkafa (24.5%, n = 294), sai kuma magudanar ruwa ta guguwa (21.0%, n = 252) da tukwane (8.3). %, n = 99), bakin kogi (8.2%, n = 100), kududdufi (7.2%, n = 86), kududdufi (7.0%, n = 84), famfon ruwa na ƙauye (6.8%, n = 81), kwafi na kofato (4.8%, n = 58), fadama (4.0%, n = 48), tukwane (5.2%, n = 62), tafkuna (1.9%, n = 23) da rijiyoyi (0.9%, n = 11).).
Gabaɗaya, an tattara jimillar tsutsotsin sauro 47,274 daga yankin binciken, tare da kaso 14.4% (n = 6,796) a cikin ƙungiyar LLIN + Bti idan aka kwatanta da 85.6% (n = 40,478) a cikin ƙungiyar LLIN kaɗai ((RR = 5.96) [95% CI 5.80–6.11], P ≤ 0.001). Waɗannan tsutsotsin sun ƙunshi nau'ikan sauro guda uku, nau'in da ya fi yawa shine Anopheles. (48.7%, n = 23,041), sai Culex spp. (35.0%, n = 16,562) da Aedes spp. (4.9%, n = 2340). Pupae ya ƙunshi kashi 11.3% na kudaje marasa girma (n = 5344).
Matsakaicin yawan tsutsotsi na Anopheles spp.. A cikin wannan binciken, adadin tsutsotsi a kowace cokali shine 0.61 [95% CI 0.41–0.81] L/tsami a cikin rukunin LLIN + Bti da 3.97 [95% CI 3.56–4.38] L/tsami a cikin rukunin LLIN kawai (zaɓi). fayil na 1: Hoto na S1). Matsakaicin yawan tsutsotsi na Anopheles spp. Ƙungiyar LLIN kaɗai ta fi ƙungiyar LLIN + Bti sau 6.5 girma (HR = 6.49; 95% CI 5.80–7.27; P < 0.001). Ba a gano sauro na Anopheles ba yayin magani. An tattara tsutsotsi a cikin ƙungiyar LLIN + Bti tun daga watan Janairu, wanda ya yi daidai da maganin Bti na ashirin. A cikin ƙungiyar LLIN + Bti, an sami raguwa sosai a farkon da ƙarshen yawan tsutsotsi.
Kafin fara maganin Bti (Maris), an kiyasta cewa matsakaicin yawan sauro na Anopheles da suka fara shiga farkon kamuwa da cutar shine 1.28 [95% CI 0.22–2.35] L/nutsewa a cikin rukunin LLIN + Bti da kuma 1.37 [95% CI 0.36–2.36] l/nutsewa a cikin rukunin LLIN + Bti. l/nutsewa. /nutsewa kawai hannun LLIN (Hoto na 2A). Bayan amfani da maganin Bti, matsakaicin yawan sauro na Anopheles da suka fara kamuwa da cutar a cikin rukunin LLIN + Bti gabaɗaya ya ragu a hankali daga 0.90 [95% CI 0.19–1.61] zuwa 0.10 [95% CI – 0.03–0.18] l/nutsewa. Yawan tsutsar Anopheles da suka fara kamuwa da cutar ya kasance ƙasa a cikin rukunin LLIN + Bti. A cikin rukunin LLIN kawai, canje-canje a cikin yawan Anopheles spp. An lura da tsutsotsin farko da matsakaicin yawansu ya kama daga 0.23 [95% CI 0.07–0.54] L/nutsewa zuwa 2.37 [95% CI 1.77–2.98] L/nutsewa. Gabaɗaya, matsakaicin yawan tsutsotsin farkon Anopheles a cikin rukunin LLIN kawai ya fi girma a kididdiga a 1.90 [95% CI 1.70–2.10] L/nutsewa, yayin da matsakaicin yawan tsutsotsin farkon Anopheles a cikin rukunin LLIN shine 0.38 [95% CI 0.28–0.47]) l/nutsewa. + rukunin Bti (RR = 5.04; 95% CI 4.36–5.85; P < 0.001).
Canje-canje a matsakaicin yawan tsutsotsin Anopheles. Gidan sauro na farko (A) da na ƙarshe (B) a cikin ƙungiyar bincike daga Maris 2019 zuwa Fabrairu 2020 a yankin Napier, arewacin Côte d'Ivoire. LLIN: gidan kwari mai ɗorewa Bti: Bacillus thuringiensis, Israel TRT: magani;
Matsakaicin yawan tsutsotsin Anopheles spp.. tsufa a cikin ƙungiyar LLIN + Bti. Yawan Bti kafin a fara magani shine 2.98 [95% CI 0.26–5.60] L/dip, yayin da yawan a cikin ƙungiyar LLIN kaɗai shine 1.46 [95% CI 0.26–2.65] l/rana Bayan amfani da Bti, yawan tsutsotsin Anopheles da suka fara bayyana a cikin ƙungiyar LLIN + Bti ya ragu daga 0.22 [95% CI 0.04–0.40] zuwa 0.03 [95% CI 0.00–0.06] L/dip (Hoto na 2B). A cikin rukunin LLIN kawai, yawan tsutsotsin Anopheles na ƙarshen zamani ya ƙaru daga 0.35 [95% CI - 0.15-0.76] zuwa 2.77 [95% CI 1.13-4.40] l/nutsewa tare da wasu bambance-bambance a cikin yawan tsutsotsin dangane da ranar da aka ɗauki samfurin. Matsakaicin yawan tsutsotsin Anopheles na ƙarshen zamani a cikin rukunin LLIN kawai shine 2.07 [95% CI 1.84–2.29] L/nutsewa, sau tara ya fi 0.23 [95% CI 0.11–0. 36] l/nutsewa a cikin LLIN. + rukunin Bti (RR = 8.80; 95% CI 7.40–10.57; P < 0.001).
Matsakaicin yawan Culex spp. Ƙimar ya kasance 0.33 [95% CI 0.21–0.45] L/dip a cikin ƙungiyar LLIN + Bti da 2.67 [95% CI 2.23–3.10] L/dip a cikin ƙungiyar LLIN kawai (ƙarin fayil na 2: Hoto na S2). Matsakaicin yawan Culex spp. Ƙungiyar LLIN kaɗai ta fi ƙungiyar LLIN + Bti girma sosai (HR = 8.00; 95% CI 6.90–9.34; P < 0.001).
Matsakaicin yawan ƙwayoyin Culex Culex spp. Kafin magani, Bti l/dip shine 1.26 [95% CI 0.10–2.42] l/dip a cikin ƙungiyar LLIN + Bti da 1.28 [95% CI 0.37–2.36] a cikin ƙungiyar LLIN guda ɗaya (Hoto na 3A). Bayan amfani da maganin Bti, yawan ƙwayoyin Culex na farko ya ragu daga 0.07 [95% CI - 0.001–0.] zuwa 0.25 [95% CI 0.006–0.51] L/dip. Ba a tattara tsutsotsin Culex daga wuraren tsutsotsin da aka yi wa magani da Bti ba tun daga watan Disamba. An rage yawan tsutsotsin Culex na farko zuwa 0.21 [95% CI 0.14–0.28] L/tsabta a cikin ƙungiyar LLIN + Bti, amma ya fi girma a cikin ƙungiyar LLIN kawai a 1.30 [95% CI 1.10–1.50] l/nutsewa. faɗuwa/rana. Yawan tsutsotsin Culex na farko a cikin ƙungiyar LLIN kaɗai ya ninka na ƙungiyar LLIN + Bti sau 6 (RR = 6.17; 95% CI 5.11–7.52; P < 0.001).
Canje-canje a matsakaicin yawan tsutsotsin Culex spp.. Gwaje-gwajen rayuwar farko (A) da ta farko (B) a cikin ƙungiyar bincike daga Maris 2019 zuwa Fabrairu 2020 a yankin Napier, arewacin Côte d'Ivoire. Gidan maganin kwari mai ɗorewa LLIN, Bti Bacillus thuringiensis Israel, maganin Trt
Kafin maganin Bti, matsakaicin yawan tsutsotsin Culex da suka fara shiga cikin rukunin LLIN + Bti da kuma rukunin LLIN shine 0.97 [95% CI 0.09–1.85] da kuma 1.60 [95% CI – 0.16–3.37] l/nutsewa daidai da haka (Hoto na 3B)). Matsakaicin yawan nau'in Culex da suka fara shiga cikin rukunin bayan fara maganin Bti. Yawan da ke cikin rukunin LLIN + Bti a hankali ya ragu kuma ya yi ƙasa da na rukunin LLIN kawai, wanda ya kasance mai yawa sosai. Matsakaicin yawan tsutsotsin Culex da suka fara shiga cikin rukunin LLIN shine 0.12 [95% CI 0.07–0.15] L/nutsewa a cikin rukunin LLIN + Bti da kuma 1.36 [95% CI 1.11–1.61] L/nutsewa a cikin rukunin LLIN kawai. Matsakaicin yawan tsutsotsin Culex da suka fara bayyana a farkon lokacin sun fi yawa a cikin rukunin LLIN kawai fiye da na rukunin LLIN + Bti (RR = 11.19; 95% CI 8.83–14.43; P < 0.001).
Kafin maganin Bti, matsakaicin yawan 'yan jaki ga kowace 'yar kwaro 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 (Hoto na 4). Jimillar yawan 'yan jaki shine 0.10 [95% CI 0.06–0.14] a cikin rukunin LLIN + Bti da 0.84 [95% CI 0.75–0.92] a cikin rukunin LLIN kawai. Maganin Bti ya rage matsakaicin yawan 'yan jaki a cikin rukunin LLIN + Bti sosai idan aka kwatanta da rukunin LLIN kawai (OR = 8.30; 95% CI 6.37–11.02; P < 0.001). A cikin rukunin LLIN + Bti, ba a tattara 'yan jaki ba bayan Nuwamba.
Canje-canje a matsakaicin yawan 'yan karnuka. An gudanar da binciken ne daga Maris 2019 zuwa Fabrairu 2020 a yankin Napier da ke arewacin Côte d'Ivoire. Gidan maganin kwari mai ɗorewa LLIN, Bti Bacillus thuringiensis Israel, maganin Trt
An tattara jimillar sauro manya 3456 daga yankin binciken. Sauro sun kasance cikin nau'ikan 17 na nau'ikan 5 (Anopheles, Culex, Aedes, Eretmapodites) (Tebur 1). A cikin cututtukan zazzabin cizon sauro, An. gambiae sl shine nau'in da ya fi yawa tare da kashi 74.9% (n = 2587), sai kuma An. gambiae sl. funestus (2.5%, n = 86) da An 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 haɗa mutane nli tare da LLIN kawai. Duk da haka, An. gambiae da An. funestus sun kasance a cikin rukunin LLIN + Bti da rukunin LLIN kaɗai.
A cikin binciken da aka fara kafin a yi amfani da Bti a wurin da aka yi kiwo (watanni 3), an kiyasta cewa matsakaicin adadin sauro na dare ga kowane mutum (b/p/n) a cikin rukunin LLIN + Bti ya kai 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] (Hoto na 5). A cikin rukunin LLIN + Bti, lalacewar sauro na Culex ya ragu kuma ya kasance ƙasa duk da kololuwar 1.95 [95% CI 1.35–2.54] bpp a watan Satumba bayan amfani da Bti na 12. Duk da haka, a cikin rukunin LLIN kawai, matsakaicin adadin cizon sauro ya ƙaru a hankali kafin ya kai kololuwa a watan Satumba a 11.33 [95% CI 7.15–15.50] bp/n. Jimillar yawan cizon sauro ya yi ƙasa sosai a cikin ƙungiyar LLIN + Bti idan aka kwatanta da ƙungiyar LLIN kaɗai a kowane lokaci yayin binciken (HR = 3.66; 95% CI 3.01–4.49; P < 0.001).
Yawan cizon sauro a yankin bincike na yankin Napier a arewacin Côte d'Ivoire daga Maris 2019 zuwa Fabrairu 2020 LLIN Gidan maganin kwari mai ɗorewa, Bti Bacillus thuringiensis Israel, maganin Trt, cizon b/p/dare/mutum/dare
Anopheles gambiae shine mafi yawan masu kamuwa da cutar malaria a yankin da aka yi binciken. Saurin cizon An. A farkon binciken, matan Gambia suna da ƙimar b/p/n na 0.64 [95% CI 0.27–1.00] a cikin ƙungiyar LLIN + Bti da 0.74 [95% CI 0.30–1.17] a cikin ƙungiyar LLIN kawai (Hoto na 6). A lokacin lokacin shiga tsakani na Bti, an lura da mafi girman aikin cizon a watan Satumba, wanda ya yi daidai da mataki na goma sha biyu na maganin Bti, tare da kololuwar 1.46 [95% CI 0.87–2.05] b/p/n a cikin ƙungiyar LLIN + Bti da kololuwar 9 .65 [95% CI 0.87–2.05] w/n 5.23–14.07] ƙungiyar LLIN kawai. Jimlar saurin cizon An. Yawan kamuwa da cutar a Gambia ya yi ƙasa sosai a cikin ƙungiyar 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/no). (RR = 3.66; 95% CI 3.01–4.49; P < 0.001).
Saurin cizon Anna. gambiae sl, sashen bincike a yankin Napier, arewacin Cote d'Ivoire, daga Maris 2019 zuwa Fabrairu 2020 Gidan maganin kwari mai ɗorewa wanda aka yi wa magani da LLIN, Bti Bacillus thuringiensis Israel, Maganin Trt, cizon b/p/dare/ mutum/dare
Jimillar amps 646. An raba Gambia. Gabaɗaya, kaso na tsaron gida. Adadin daidaito a Gambia ya kasance >70% a duk tsawon lokacin binciken, ban da watan Yuli, lokacin da aka yi amfani da ƙungiyar LLIN kawai (Ƙarin fayil na 3: Hoto na S3). Duk da haka, matsakaicin ƙimar haihuwa a yankin binciken shine 74.5% (n = 481). A cikin ƙungiyar LLIN+Bti, ƙimar daidaito ya kasance a babban mataki, sama da 80%, ban da watan Satumba, lokacin da ƙimar daidaito ya faɗi zuwa 77.5%. Duk da haka, an lura da bambance-bambance a cikin matsakaicin ƙimar haihuwa a cikin rukunin LLIN kawai, tare da mafi ƙarancin ƙimar haihuwa da aka kiyasta shine 64.5%.
Daga 389 Ann. Wani bincike da aka yi kan raka'o'in jini daban-daban daga Gambia ya gano cewa kashi 80.5% (n = 313) sun fito ne daga mutane, kashi 6.2% (n = 24) na mata sun ci jini iri-iri (na mutum da na gida) da kuma kashi 5.1% (n = 20) na jini da aka ci. Abincin dabbobi (shanu, tumaki da awaki) da kuma kashi 8.2% (n = 32) na samfuran da aka yi nazari a kansu ba su da kyau ga abincin jini. A cikin rukunin LLIN + Bti, adadin mata da suka karɓi jinin ɗan adam ya kai kashi 25.7% (n = 100) idan aka kwatanta da kashi 54.8% (n = 213) a cikin rukunin LLIN kawai (Ƙarin fayil 5: Tebur S5).
An gwada jimillar amfili 308 na P. gambiae don gano mambobi na hadaddun nau'in da kuma kamuwa da cutar P. falciparum (Ƙarin fayil na 4: Tebur S4). Nau'i biyu masu alaƙa suna rayuwa tare a yankin binciken, wato An. gambiae ss (95.1%, n = 293) da An. coluzzii (4.9%, n = 15). Anopheles gambiae ss sun yi ƙasa sosai a cikin ƙungiyar LLIN + Bti fiye da na ƙungiyar LLIN kaɗai (66.2%, n = 204) (RR = 2.29 [95% CI 1.78–2.97], P < 0.001). An sami irin wannan kaso na sauro na Anopheles a cikin rukunin LLIN + Bti (3.6%, n = 11) da kuma rukunin LLIN kawai (1.3%, n = 4) (RR = 2.75 [95% CI 0.81–11 .84], P = .118). Yaɗuwar kamuwa da cutar Plasmodium falciparum tsakanin An. SL a Gambia shine 11.4% (n = 35). Yawan kamuwa da cutar Plasmodium falciparum. Yawan kamuwa da cutar a Gambia ya yi ƙasa sosai a cikin rukunin LLIN + Bti (2.9%, n = 9) fiye da na rukunin LLIN kawai (8.4%, n = 26) (RR = 2.89 [95% CI 1. 31–7.01], P = 0.006). ). Idan aka kwatanta da sauro na Anopheles, sauro na Anopheles gambiae suna da mafi girman kaso na kamuwa da cutar Plasmodium a kashi 94.3% (n=32). coluzzii kawai 5.7% (n=5) (RR = 6.4 [95% CI 2.47–21.04], P <0.001).
An yi bincike kan jimillar mutane 2,435 daga gidaje 400. Matsakaicin yawan mutane shine mutane 6.1 a kowace gida. Adadin mallakar LLIN a tsakanin gidaje shine 85% (n = 340), idan aka kwatanta da 15% (n = 60) ga 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 ƙungiyar LLIN + Bti idan aka kwatanta da 36.2% (n = 882) a cikin ƙungiyar LLIN kaɗai (RR = 1.12 [95% CI 1.02–1.23], P = 0.013). Matsakaicin yawan amfani da yanar gizo a yankin binciken shine 38.4% (n = 1842). Adadin yara 'yan ƙasa da shekara biyar da ke amfani da intanet iri ɗaya ne a cikin ƙungiyoyin binciken guda biyu, inda yawan amfani da intanet ya kai kashi 41.2% (n = 195) a cikin rukunin LLIN + Bti da kuma kashi 43.2% (n = 186) a cikin rukunin LLIN kawai. (HR = 1.05 [95% CI 0.85–1.29], P = 0.682). Daga cikin yara 'yan shekara 5 zuwa 15, babu wani bambanci a cikin yawan amfani da intanet tsakanin kashi 36.3% (n = 250) a cikin rukunin LLIN + Bti da kuma kashi 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 haura shekaru 15 suna amfani da ragar gado da kashi 42.7% (n = 554) ba sau da yawa a cikin ƙungiyar LLIN + Bti fiye da 33.4% (n = 439) a cikin ƙungiyar LLIN kawai (RR = 1.26 [95% CI 1.11–1.43], P <0.001).
An samu jimillar mutane 2,484 da suka kamu da cutar a Cibiyar Lafiya ta Napier tsakanin Maris 2018 da Fabrairu 2020. Yawan masu kamuwa da cutar zazzabin cizon sauro a cikin al'umma ya kai kashi 82.0% na dukkan wadanda suka kamu da cutar (n = 2038). Yawan masu kamuwa da cutar zazzabin cizon sauro a cikin wannan yanki na shekara-shekara a wannan fanni shine 479.8 da 297.5 kafin da kuma bayan maganin Bti (Tebur 2).
Lokacin Saƙo: Yuli-01-2024