Samun dama zuwamaganin kwari- gidajen sauro da aka yi wa magani da kuma aiwatar da IRS a matakin gida sun taimaka wajen rage yawan mace-macen da ake samu a tsakanin mata masu shekaru haihuwa a Ghana. Wannan binciken ya kara karfafa bukatar samar da cikakken martani kan yaki da zazzabin cizon sauro don taimakawa wajen kawar da zazzabin cizon sauro a Ghana.
An ɗauko bayanai na wannan binciken ne daga Binciken Alamomin Zazzabin Maleriya na Ghana (GMIS). GMIS wani bincike ne da Hukumar Kididdiga ta Ghana ta gudanar daga Oktoba zuwa Disamba na 2016. A cikin wannan binciken, mata masu shekaru 15-49 ne kawai suka shiga cikin binciken. Matan da ke da bayanai kan dukkan masu canji an haɗa su cikin binciken.
A binciken da aka yi a shekarar 2016, MIS ta Ghana ta yi amfani da tsarin ɗaukar samfurin rukuni mai matakai da yawa a duk yankuna 10 na ƙasar. An raba ƙasar zuwa azuzuwa 20 (yankuna 10 da nau'in zama - birni/ƙarƙashi). An ayyana rukuni a matsayin yankin ƙidayar ƙidayar jama'a (CE) wanda ya ƙunshi kusan gidaje 300-500. A matakin farko na ɗaukar samfurin, ana zaɓar rukuni don kowane rukuni tare da yuwuwar daidaitawa da girma. An zaɓi jimillar rukuni 200. A matakin ɗaukar samfurin na biyu, an zaɓi adadi mai iyaka na gidaje 30 bazuwar daga kowace rukuni da aka zaɓa ba tare da maye gurbinsu ba. Duk lokacin da zai yiwu, mun yi hira da mata masu shekaru 15-49 a kowace gida [8]. Binciken farko ya yi hira da mata 5,150. Duk da haka, saboda rashin amsawa kan wasu canje-canje, an haɗa jimillar mata 4861 a cikin wannan binciken, wanda ke wakiltar kashi 94.4% na mata a cikin samfurin. Bayanan sun haɗa da bayanai kan gidaje, gidaje, halayen mata, rigakafin zazzabin cizon sauro, da ilimin zazzabin cizon sauro. An tattara bayanai ta amfani da tsarin tambayoyi na sirri da kwamfuta ke amfani da shi (CAPI) akan allunan hannu da takardu. Manajan bayanai suna amfani da tsarin Ƙidayar Jama'a da Tsarin Bincike (CSPro) don gyara da sarrafa bayanai.
Babban sakamakon wannan binciken shine rahoton da aka bayar na yaduwar cutar malaria a tsakanin mata masu shekaru 15-49, wanda aka bayyana a matsayin mata waɗanda suka ba da rahoton samun aƙalla wani lokaci na cutar malaria a cikin watanni 12 da suka gabata kafin binciken. Wato, an yi amfani da rahoton yaduwar cutar malaria a tsakanin mata masu shekaru 15-49 a matsayin wakilcin ainihin RDT na malaria ko kuma tasirin microscopy a tsakanin mata saboda waɗannan gwaje-gwajen ba su samuwa a tsakanin mata a lokacin binciken ba.
Shige-shigen sun haɗa da samun gidajen sauro masu maganin kwari (ITN) a gida da kuma amfani da IRS a gida a cikin watanni 12 da suka gabata kafin binciken. Iyalan da suka sami dukkan hanyoyin magance matsalar an ɗauke su a matsayin waɗanda suka haɗu. An bayyana gidaje masu samun gidajen sauro masu maganin kwari a matsayin mata da ke zaune a gidaje waɗanda ke da aƙalla gidan sauro ɗaya da aka yi wa maganin kwari, yayin da aka bayyana gidaje masu IRS a matsayin mata da ke zaune a gidaje waɗanda aka yi wa maganin kwari a cikin watanni 12 kafin binciken mata.
Binciken ya binciki nau'ikan abubuwa guda biyu masu rikitarwa, wato halayen iyali da halayen mutum ɗaya. Ya haɗa da halayen gida; yanki, nau'in zama (ƙarami-birane), jinsi na shugaban gida, girman gida, amfani da wutar lantarki na gida, nau'in man girki (mai ƙarfi ko mara ƙarfi), babban kayan bene, babban kayan bango, kayan rufin gida, tushen ruwan sha (wanda aka inganta ko ba a inganta ba), nau'in bayan gida (wanda aka inganta ko ba a inganta ba) da kuma nau'in arzikin gida (matalauta, matsakaici da mai arziki). An sake tsara nau'ikan halayen gida bisa ga ƙa'idodin rahoton DHS a cikin rahotannin GMIS na 2016 da 2014 na Binciken Lafiyar Jama'a na Ghana (GDHS) [8, 9]. Halayen mutum da aka yi la'akari da su sun haɗa da shekarun matar a yanzu, matakin ilimi mafi girma, matsayin ciki a lokacin hirar, matsayin inshorar lafiya, addini, bayanai game da kamuwa da cutar zazzabin cizon sauro a cikin watanni 6 kafin hirar, da kuma matakin ilimin matar game da batutuwan zazzabin cizon sauro. An yi amfani da tambayoyi biyar na ilimi don tantance ilimin mata, ciki har da ilimin mata game da musabbabin cutar malaria, alamun cutar malaria, hanyoyin rigakafin cutar malaria, maganin zazzabin cizon sauro, da kuma wayar da kan jama'a cewa tsarin inshorar lafiya na Ghana (NHIS) yana kula da cutar malaria. Matan da suka samu maki 0-2 ana ɗaukarsu a matsayin marasa ilimi, matan da suka sami maki 3 ko 4 ana ɗaukarsu a matsayin masu ilimi matsakaici, kuma matan da suka sami maki 5 ana ɗaukarsu a matsayin suna da cikakken ilimi game da cutar malaria. An danganta bambancin da ke tsakanin mutane da samun gidajen sauro da aka yi wa magani da maganin kwari, IRS, ko kuma yawan kamuwa da cutar malaria a cikin wallafe-wallafe.
An taƙaita halayen asalin mata ta amfani da mitoci da kaso don masu canji na rukuni, yayin da aka taƙaita masu canji masu ci gaba ta amfani da hanyoyi da karkacewa na yau da kullun. An tattara waɗannan halaye ta hanyar matsayin shiga tsakani don bincika yiwuwar rashin daidaito da tsarin alƙaluma waɗanda ke nuna yiwuwar nuna bambanci mai rikitarwa. An yi amfani da taswirar contour don bayyana yawan cutar malaria da aka ruwaito kai tsaye tsakanin mata da kuma ɗaukar nauyin hanyoyin biyu ta wurin wurin. An yi amfani da ƙididdigar gwajin Scott Rao chi-square, wanda ke lissafin halayen ƙirar bincike (misali, rarrabawa, rarrabawa, da nauyin samfur), don tantance alaƙar da ke tsakanin yawan cutar malaria da aka ruwaito kai da kuma samun damar shiga duka hanyoyin shiga da halayen mahallin. An ƙididdige yawan cutar malaria da aka ruwaito kai tsaye a matsayin adadin matan da suka fuskanci aƙalla wani lokaci na malaria a cikin watanni 12 kafin binciken da aka raba da jimillar adadin matan da suka cancanta da aka tantance.
An yi amfani da wani samfurin Poisson regression da aka gyara don kimanta tasirin samun damar shiga tsakani na kula da zazzabin cizon sauro akan yawan mace-macen da aka ruwaito da kansu16, bayan daidaitawa don yuwuwar juyewar yuwuwar magani (IPTW) da nauyin bincike ta amfani da samfurin "svy-linearization" a cikin Stata IC. (Stata Corporation, College Station, Texas, Amurka). An kiyasta yuwuwar juyewar nauyin magani (IPTW) don shiga tsakani "i" da mace "j" kamar haka:
Ana daidaita ma'aunin nauyi na ƙarshe da aka yi amfani da shi a cikin samfurin Poisson regression kamar haka:
Daga cikinsu, \(fw_{ij}\) shine ma'aunin nauyi na ƙarshe na j na mutum ɗaya da kuma sa baki i, \(sw_{ij}\) shine samfurin nauyin j na mutum ɗaya da kuma sa baki i a cikin GMIS na 2016.
An yi amfani da umarnin bayan kimantawa "gergins, dydx (intervention_i)" a cikin Stata don kimanta bambancin gefe (tasirin) na shiga tsakani "i" akan yawan cutar malaria da aka ruwaito kai tsaye tsakanin mata bayan an daidaita samfurin Poisson mai nauyi don sarrafawa. duk sun lura da canje-canje masu rikitarwa.
An kuma yi amfani da samfuran koma-baya daban-daban guda uku a matsayin nazarin jijiyoyi: koma-baya ta hanyar amfani da hanyoyi biyu, koma-baya ta hanyar yiwuwar komawa, da kuma samfuran komawa-baya ta layi don kimanta tasirin kowace hanyar magance zazzabin cizon sauro kan yawan mace-macen da aka ruwaito kai tsaye a tsakanin matan Ghana. An kiyasta tazara ta amincewa da kashi 95% ga duk kimanta yawan mace-macen, rabon kamuwa, da kuma kimanta tasirin. Duk nazarin kididdiga a cikin wannan binciken an dauke su da mahimmanci a matakin alpha na 0.050. An yi amfani da Stata IC sigar 16 (StataCorp, Texas, Amurka) don nazarin kididdiga.
A cikin samfura huɗu na koma-baya, yawan mace-macen da aka ruwaito kansu ba su yi ƙasa sosai ba a tsakanin mata masu karɓar ITN da IRS idan aka kwatanta da mata masu karɓar ITN kaɗai. Bugu da ƙari, a cikin samfurin ƙarshe, mutanen da ke amfani da ITN da IRS ba su nuna raguwa mai yawa a yawan mace-macen ba idan aka kwatanta da mutanen da ke amfani da IRS kaɗai.
Tasirin samun damar yin amfani da magungunan hana zazzabin cizon sauro ga mata, rahoton da aka bayar ya nuna yawan mace-macen da ake samu ta fuskar iyali
Tasirin hanyoyin magance cutar malaria akan yadda mata ke kamuwa da cutar malaria, bisa ga halayen mata.
Wani fakitin dabarun hana yaduwar cutar malaria ya taimaka sosai wajen rage yawan mace-macen da ake samu a tsakanin mata masu shekaru haihuwa a Ghana. Rahotannin da aka bayar na cewa yawan mace-macen ya ragu da kashi 27% tsakanin mata masu amfani da gidajen sauro da aka yi wa magani da IRS. Wannan binciken ya yi daidai da sakamakon wani gwaji da aka gudanar wanda ya nuna raguwar yawan kamuwa da cutar malaria a tsakanin masu amfani da IRS idan aka kwatanta da wadanda ba sa amfani da IRS a yankin da ke da yawan kamuwa da cutar malaria amma kuma yana da matukar muhimmanci wajen samun damar amfani da ITN a Mozambique [19]. A arewacin Tanzania, an hada gidajen sauro da aka yi wa magani da IRS don rage yawan kamuwa da cutar Anopheles da kuma yawan allurar rigakafin kwari [20]. Wani bincike da aka gudanar a lardin Nyanza da ke yammacin Kenya ya kuma tallafawa dabarun hana yaduwar cutar, wanda ya gano cewa feshi a cikin gida da gidajen sauro da aka yi wa magani da kwari sun fi inganci fiye da magungunan kwari. Haɗin na iya samar da ƙarin kariya daga zazzabin malaria. Ana la'akari da hanyoyin sadarwa daban-daban [21].
Wannan binciken ya kiyasta cewa kashi 34% na mata sun kamu da cutar maleriya a cikin watanni 12 da suka gabata kafin binciken, tare da kimantawar tazara ta amincewa da kashi 95% na 32-36%. Mata da ke zaune a gidaje masu samun gidajen sauro da aka yi wa magani (33%) suna da ƙarancin adadin kamuwa da cutar maleriya da kansu fiye da mata da ke zaune a gidaje marasa samun gidajen sauro da aka yi wa magani (39%). Hakazalika, mata da ke zaune a gidaje da aka fesa wa magani sun sami rahoton kamuwa da cutar maleriya da kashi 32%, idan aka kwatanta da kashi 35% a gidajen da ba a fesa ba. Ba a inganta gidajen sauro ba kuma yanayin tsaftar ba shi da kyau. Yawancinsu suna waje kuma ruwa mai datti yana taruwa a cikinsu. Waɗannan wuraren da ba su da tsafta suna samar da wuri mai kyau don kiwo ga sauro na Anopheles, babban abin da ke haifar da cutar maleriya a Ghana. Sakamakon haka, gidajen sauro da yanayin tsafta ba su inganta ba, wanda ya haifar da ƙaruwar yaduwar cutar maleriya a cikin al'umma kai tsaye. Ya kamata a ƙara himma don inganta gidajen sauro da yanayin tsafta a cikin gidaje da al'ummomi.
Wannan binciken yana da wasu muhimman iyakoki da dama. Da farko, binciken ya yi amfani da bayanan bincike na sassa daban-daban, wanda hakan ya sa ya yi wuya a auna dalilin. Don shawo kan wannan iyakancewa, an yi amfani da hanyoyin kididdiga na dalilai don kimanta matsakaicin tasirin magani na maganin. Binciken ya daidaita aikin magani kuma yana amfani da manyan masu canji don kimanta yiwuwar sakamako ga matan da iyalansu suka sami maganin (idan babu maganin) da kuma matan da iyalansu ba su sami maganin ba.
Na biyu, samun gidajen sauro da aka yi wa magani da maganin kwari ba lallai bane ya nuna amfani da gidajen sauro da aka yi wa magani da maganin kwari ba, don haka dole ne a yi taka tsantsan yayin fassara sakamakon da sakamakon wannan binciken. Na uku, sakamakon wannan binciken kan cutar malaria da aka ruwaito kanta a tsakanin mata alama ce ta yaɗuwar cutar malaria a tsakanin mata a cikin watanni 12 da suka gabata, don haka matakin ilimin mata game da malaria, musamman waɗanda ba a gano su ba, na iya zama abin da ba daidai ba.
A ƙarshe, binciken bai yi la'akari da yawan kamuwa da cutar malaria da ake samu a kowane mutum a cikin lokacin da aka yi amfani da shi na shekara ɗaya ba, ko kuma daidai lokacin da aka samu barkewar cutar malaria da kuma hanyoyin magance ta. Ganin iyakokin nazarin lura, gwaje-gwaje masu ƙarfi da aka yi bazuwar za su zama muhimmin abin la'akari da su a binciken da za a yi nan gaba.
Iyalan da suka sami ITN da IRS suna da ƙarancin rahoton kamuwa da cutar maleriya idan aka kwatanta da iyalan da ba su sami ko ɗaya daga cikinsu ba. Wannan binciken yana goyon bayan kira ga haɗa ƙoƙarin shawo kan cutar maleriya don bayar da gudummawa wajen kawar da cutar maleriya a Ghana.
Lokacin Saƙo: Oktoba-15-2024