Ana tallata gidajen sauro masu dauke da pyrethroid clofenpyr (CFP) da pyrethroid piperonyl butoxide (PBO) a ƙasashe masu fama da cutar malaria don inganta sarrafa zazzabin cizon sauro da sauro masu juriya ga pyrethroid ke yadawa. CFP maganin kashe kwari ne wanda ke buƙatar kunnawa ta hanyar cytochrome P450 monooxygenase (P450), kuma PBO yana ƙara ingancin pyrethroids ta hanyar hana ayyukan waɗannan enzymes a cikin sauro masu juriya ga pyrethroid. Don haka, hana P450 ta PBO na iya rage tasirin gidajen sauro na pyrethroid-CFP lokacin da ake amfani da su a gida ɗaya da gidajen sauro na pyrethroid-PBO.
An gudanar da gwaje-gwaje guda biyu na gwaji don tantance nau'ikan pyrethroid-CFP ITN guda biyu daban-daban (Interceptor® G2, PermaNet® Dual) kaɗai kuma tare da haɗin gwiwar pyrethroid-PBO ITN (DuraNet® Plus, PermaNet® 3.0). Tasirin amfani da kwayoyin halittar Pyrethroid Resistance Popular Vectors a kudancin Benin. A cikin binciken guda biyu, an gwada dukkan nau'ikan raga a cikin jiyya ɗaya da biyu. An kuma gudanar da gwaje-gwajen halittu don tantance juriyar magunguna na yawan vector a cikin bukka da kuma nazarin hulɗar da ke tsakanin CFP da PBO.
Yawan vector ya kasance mai saurin kamuwa da cutar CFP amma ya nuna matakan juriya ga pyrethroids, amma an shawo kan wannan juriyar ta hanyar fallasa ga PBO kafin kamuwa da cutar. An rage mace-macen vector sosai a cikin bukkoki ta amfani da haɗin ragar pyrethroid-CFP da ragar pyrethroid-PBO idan aka kwatanta da bukkoki ta amfani da ragar pyrethroid-CFP guda biyu (74% ga Interceptor® G2 vs. 85%, PermaNet® Dual 57% vs. 83% ), p < 0.001). Kafin fallasa ga PBO ya rage gubar CFP a cikin gwaje-gwajen kwayoyin halitta na kwalba, yana nuna cewa wannan tasirin na iya zama saboda adawa tsakanin CFP da PBO. Mutuwar vector ta fi yawa a cikin bukkoki ta amfani da haɗin ragar da ke ɗauke da ragar pyrethroid-CFP idan aka kwatanta da bukkoki ba tare da ragar pyrethroid-CFP ba, kuma lokacin da aka yi amfani da ragar pyrethroid-CFP su kaɗai a matsayin ragar biyu. Lokacin da aka yi amfani da su tare, mace-mace ta fi yawa (83-85%).
Wannan binciken ya nuna cewa ingancin ragar pyrethroid-CFP ya ragu lokacin da aka yi amfani da shi tare da pyrethroid-PBO ITN idan aka kwatanta da amfani da shi kaɗai, yayin da ingancin haɗin ragar da ke ɗauke da ragar pyrethroid-CFP ya fi girma. Waɗannan sakamakon sun nuna cewa fifita rarraba hanyoyin sadarwar pyrethroid-CFP fiye da sauran nau'ikan hanyoyin sadarwa zai haɓaka tasirin sarrafa vector a cikin irin waɗannan yanayi.
Gidajen sauro masu maganin kwari (ITNs) waɗanda ke ɗauke da magungunan kashe kwari na pyrethroid sun zama ginshiƙin yaƙi da maleriya a cikin shekaru ashirin da suka gabata. Tun daga shekarar 2004, an samar da gidajen sauro kimanin biliyan 2.5 da aka yi wa magani da maganin kwari ga ƙasashen Afirka da ke kudu da hamadar Sahara [1], wanda ya haifar da ƙaruwar adadin mutanen da ke kwana a ƙarƙashin gidajen sauro masu maganin kwari daga kashi 4% zuwa kashi 47% [2]. Tasirin wannan aiwatarwa ya kasance mai mahimmanci. An kiyasta cewa an hana kamuwa da cutar maleriya kusan biliyan 2 da mace-mace miliyan 6.2 a duk duniya tsakanin 2000 da 2021, tare da nazarin ƙira da ke nuna cewa gidajen sauro masu maganin kwari su ne babban abin da ya haifar da wannan fa'ida [2, 3]. Duk da haka, waɗannan ci gaba suna zuwa da farashi mai rahusa: saurin juyin halittar juriyar pyrethroid a cikin yawan ƙwayoyin cuta na maleriya. Kodayake gidajen sauro masu maganin kwari na pyrethroid na iya samar da kariya ta mutum ɗaya daga maleriya a yankunan da ƙwayoyin cuta ke nuna juriyar pyrethroid [4], nazarin ƙira ya annabta cewa a matakan juriya mafi girma, gidajen sauro masu maganin kwari za su rage tasirin cututtuka [5]. Saboda haka, juriyar pyrethroid na ɗaya daga cikin manyan barazanar da ke barazana ga ci gaba mai ɗorewa a fannin shawo kan cutar malaria.
A cikin 'yan shekarun nan, an ƙirƙiri wani sabon ƙarni na gidajen sauro masu maganin kwari, waɗanda ke haɗa pyrethroids da wani sinadari na biyu, don inganta sarrafa zazzabin cizon sauro da sauro masu juriya ga pyrethroid ke yadawa. Sabon nau'in ITN na farko ya ƙunshi synergist piperonyl butoxide (PBO), wanda ke ƙarfafa pyrethroids ta hanyar hana enzymes masu guba da ke da alaƙa da juriya ga pyrethroid, musamman tasirin cytochrome P450 monooxygenases (P450s) [6]. An kuma sami sabbin ƙwayoyin cuta da aka yi wa magani da fluprone (CFP), wani maganin kwari na azole tare da sabon tsarin aiki wanda ke niyya ga numfashin ƙwayoyin halitta. Bayan nuna ingantaccen tasirin entomological a cikin gwaje-gwajen gwaji na hut [7, 8], an gudanar da jerin gwaje-gwajen da aka sarrafa bazuwar rukuni (cRCT) don kimanta fa'idodin lafiyar jama'a na waɗannan gidajen sauro idan aka kwatanta da gidajen sauro masu magani ta amfani da pyrethroids kaɗai da kuma samar da shaidar da ta dace don ba da shawarwari daga Hukumar Lafiya ta Duniya (WHO) [9]. Bisa ga shaidar inganta tasirin cututtuka daga CRCTs a Uganda [11] da Tanzania [12], WHO ta amince da gidajen magani masu maganin kwari na pyrethroid-PBO [10]. An kuma buga kwanan nan pyrethroid-CFP ITN bayan gwaje-gwajen RCTs masu kama da juna a Benin [13] da Tanzania [14] sun nuna cewa samfurin ITN (Interceptor® G2) ya rage yawan kamuwa da cutar zazzabin cizon sauro na yara da kashi 46% da 44%, bi da bi. 10]. ].
Bayan sabbin ƙoƙarin da Asusun Duniya da sauran manyan masu ba da gudummawar cutar maleriya suka yi don magance juriyar maganin kwari ta hanyar hanzarta gabatar da sabbin gidajen sauro [15], ana amfani da gidajen sauro na pyrethroid-PBO da pyrethroid-CFP a yankunan da cutar ta fi kamari. Yana maye gurbin gidajen sauro na gargajiya. gidajen sauro da aka yi wa magani waɗanda ke amfani da pyrethroids kawai. Tsakanin 2019 da 2022, adadin gidajen sauro na PBO pyrethroid da aka samar wa yankin kudu da hamadar Sahara ya karu daga kashi 8% zuwa 51% [1], yayin da gidajen sauro na PBO pyrethroid, gami da gidajen sauro na CFP pyrethroid, ana sa ran gidajen sauro na "dual action" za su kai kashi 56% na jigilar kayayyaki. Shiga kasuwar Afirka nan da shekarar 2025[16]. A matsayin shaida na ingancin gidajen sauro na pyrethroid-PBO da pyrethroid-CFP suna ci gaba da girma, ana sa ran waɗannan gidajen sauro za su kasance a ko'ina a cikin shekaru masu zuwa. Saboda haka, akwai buƙatar cike gibin bayanai game da ingantaccen amfani da gidajen sauro da aka yi wa maganin kwari don cimma babban tasiri idan aka ƙara girmansu don cikakken amfani da su.
Ganin yadda ƙwayoyin cuta na pyrethroid CFP da ƙwayoyin cuta na pyrethroid PBO ke yaɗuwa a lokaci guda, Shirin Kula da Zazzabin Maleriya na Ƙasa (NMCP) yana da tambaya ɗaya ta binciken aiki: Shin za a rage ingancinsa - PBO ITN? Dalilin wannan damuwa shine PBO yana aiki ta hanyar hana enzymes na P450 sauro [6], yayin da CFP maganin kashe kwari ne wanda ke buƙatar kunnawa ta hanyar P450s [17]. Saboda haka, ana hasashen cewa lokacin da aka yi amfani da pyrethroid-CFP ITN da pyrethroid-CFP ITN a gida ɗaya, tasirin hana PBO akan P450 na iya rage tasirin pyrethroid-CFP ITN. Nazarin dakin gwaje-gwaje da dama sun nuna cewa kafin fallasa ga PBO yana rage guba mai tsanani na CFP ga ƙwayoyin cuta na sauro a cikin gwaje-gwajen biovisa kai tsaye [18,19,20,21,22]. Duk da haka, lokacin gudanar da bincike tsakanin cibiyoyin sadarwa daban-daban a fagen, hulɗar da ke tsakanin waɗannan sinadarai za ta fi rikitarwa. Nazarin da ba a buga ba ya bincika tasirin amfani da nau'ikan gidajen sauro daban-daban da aka yi wa maganin kwari tare. Saboda haka, nazarin da aka yi a fannin tantance tasirin amfani da haɗin gidajen sauro na pyrethroid-CFP da pyrethroid-PBO da aka yi wa maganin kwari a cikin gida ɗaya zai taimaka wajen tantance ko ƙiyayya tsakanin waɗannan nau'ikan gidajen sauro na iya haifar da matsala ta aiki da kuma taimakawa wajen tantance mafi kyawun dabarun da za a yi amfani da su don yankunan da aka rarraba su iri ɗaya.
Lokacin Saƙo: Satumba-21-2023