ʻO ka hoʻoulu ʻana o loko (IRS) ka mea nui o ka visceral leishmaniasis (VL) vector control hoʻoikaika ma India.He liʻiliʻi ka ʻike e pili ana i ka hopena o nā mana IRS ma nā ʻano ʻohana like ʻole.Ma ʻaneʻi mākou loiloi inā loaʻa i ka IRS ka hoʻohana ʻana i nā insecticides i ke koena like a me nā hopena wawao no nā ʻano ʻohana āpau ma ke kauhale.Ua hoʻomohala pū mākou i nā palapala ʻāina pilikia ākea a me nā kumu hoʻohālike o ka namu e pili ana i nā hiʻohiʻona o ka hale, ka ʻike pesticide, a me ke kūlana IRS e nānā i ka puʻunaue spatiotemporal o nā vectors ma ka pae microscale.
Ua mālama ʻia ke aʻo ʻana ma nā kauhale ʻelua o Mahnar block ma ka moku ʻo Vaishali o Bihar.Ua loiloi ʻia ka mana o VL vectors (P. argentipes) e IRS me ka hoʻohana ʻana i ʻelua insecticides [dichlorodiphenyltrichloroethane (DDT 50%) a me nā pyrethroids synthetic (SP 5%)].Ua loiloi ʻia ka hopena o ke koena kino o nā lāʻau insecticides ma nā ʻano pā like ʻole me ka hoʻohana ʻana i ke ʻano bioassay cone e like me ka manaʻo o ka World Health Organization.Ua nānā ʻia ka naʻau o ka iʻa kālā maoli i nā insecticides me ka hoʻohana ʻana i ka bioassay in vitro.Ua nānā ʻia ka nui o nā makika ma mua a ma hope o ka IRS ma nā hale noho a me nā hale holoholona me ka hoʻohana ʻana i nā pahele māmā i hoʻokomo ʻia e nā Centers for Disease Control mai 6:00 pm a 6:00 am Ua kūkulu ʻia ke kumu hoʻohālike maikaʻi loa no ka nānā ʻana i nā makika me ka hoʻohana ʻana i nā loiloi logistic regression. kālailai.Ua hoʻohana ʻia ka ʻenehana loiloi spatial e pili ana i ka GIS no ka palapala ʻana i ka hoʻohele ʻana i ka naʻau pesticide vector e ke ʻano o ka home, a ua hoʻohana ʻia ke kūlana IRS o ka home e wehewehe i ka māhele spatiotemporal o ka ʻoʻo kālā.
Pili loa nā makika kālā iā SP (100%), akā hōʻike i ke kūʻē kiʻekiʻe iā DDT, me ka nui o ka make o 49.1%.Ua hōʻike ʻia ʻo SP-IRS i ʻoi aku ka maikaʻi o ka lehulehu ma mua o DDT-IRS ma waena o nā ʻano ʻohana āpau.Ua ʻokoʻa ka hopena o ke koena ma nā ʻaoʻao pā like ʻole;ʻaʻohe o nā mea lāʻau i hoʻokō i ka IRS i ʻōlelo ʻia e ka World Health Organization i ka lōʻihi o ka hana.Ma nā manawa a pau ma hope o ka IRS, ʻoi aku ka nui o ka emi ʻana o nā pōpoki pilau ma muli o SP-IRS ma waena o nā hui o ka hale (ʻo ia hoʻi, nā mea hoʻopuehu a me nā mea mālama) ma mua o DDT-IRS.Hōʻike ka palapala ʻāina pilikia spatial i ʻoi aku ka maikaʻi o ka mana o SP-IRS i nā makika ma mua o DDT-IRS ma nā wahi pilikia a pau o ka home.Ua ʻike ʻia ka loiloi loiloi logistic regression he ʻelima mau kumu pilikia i pili ikaika me ka nui o ka ʻōpae kālā.
E hāʻawi nā hopena i kahi ʻike maikaʻi aʻe o nā hana IRS i ka mālama ʻana i ka leishmaniasis visceral ma Bihar, hiki ke kōkua i ke alakaʻi ʻana i nā hana e hiki mai ana e hoʻomaikaʻi i ke kūlana.
ʻO Visceral leishmaniasis (VL), ʻike ʻia hoʻi ʻo kala-azar, he maʻi i lawe ʻia e ka maʻi maʻi i lawe ʻia e nā protozoan parasites o ka genus Leishmania.I loko o ka ʻĀpana ʻĀina (IS), kahi o ke kanaka wale nō ka mea hoʻokipa, hoʻoili ʻia ka parasite (ʻo ia hoʻi ʻo Leishmania donovani) i nā kānaka ma o ka nahu ʻana o nā makika wahine maʻi (Phlebotomus argentipes) [1, 2].Ma India, ʻike nui ʻia ʻo VL ma nā mokuʻāina ʻehā a me ka hikina: Bihar, Jharkhand, West Bengal a me Uttar Pradesh.Ua hōʻike ʻia kekahi mau maʻi ma Madhya Pradesh (Central India), Gujarat (Western India), Tamil Nadu a me Kerala (South India), a me nā wahi sub-Himalayan o ke kūkulu ʻākau o India, me Himachal Pradesh a me Jammu a me Kashmir.3].Ma waena o nā mokuʻāina endemic, ʻo Bihar ka hopena nui me 33 mau moku i hoʻopilikia ʻia e VL e helu ana ma mua o 70% o ka nui o nā hihia ma India i kēlā me kēia makahiki [4].Ma kahi o 99 miliona mau kānaka ma ka ʻāina e pilikia ana, me ka awelika o ka makahiki he 6,752 mau hihia (2013-2017).
Ma Bihar a me nā wahi ʻē aʻe o India, hilinaʻi nā hana hoʻomalu VL i ʻekolu mau kumu nui: ʻike mua i ka hihia, mālama pono, a me ka hoʻokele vector me ka hoʻohana ʻana i ka insecticide spraying (IRS) i nā hale a me nā hale holoholona [4, 5].Ma ke ʻano he hopena ʻaoʻao o nā hoʻolaha antimalarial, ua lanakila ka IRS i ka VL i ka makahiki 1960 me ka hoʻohana ʻana i ka dichlorodiphenyltrichloroethane (DDT 50% WP, 1 g ai/m2), a ua hoʻokele maikaʻi ʻia ka mana programmatic VL ma 1977 a me 1992 [5, 6].Eia naʻe, ua hōʻoia ʻia nā haʻawina hou ua hoʻomohala ʻia ka ʻōpae silverbellied i ke kū'ē ākea i ka DDT [4,7,8].I ka makahiki 2015, ua hoʻololi ka National Vector Borne Disease Control Program (NVBDCP, New Delhi) i ka IRS mai DDT i synthetic pyrethroids (SP; alpha-cypermethrin 5% WP, 25 mg ai/m2) [7, 9].Ua hoʻonohonoho ka World Health Organization (WHO) i kahi pahuhopu e hoʻopau i ka VL ma 2020 (ʻo ia hoʻi <1 hihia no 10,000 poʻe i kēlā me kēia makahiki ma ke alanui/block level) [10].Ua hōʻike ʻia kekahi mau haʻawina e ʻoi aku ka maikaʻi o ka IRS ma mua o nā ʻano mana vector ʻē aʻe i ka hōʻemi ʻana i nā density lele one [11,12,13].Wahi a kekahi kumu hoʻohālike hou i nā kūlana maʻi maʻi kiʻekiʻe (ʻo ia hoʻi, pre-control epidemic rate of 5/10,000), kahi IRS kūpono e uhi ana i ka 80% o nā hale hiki ke hoʻokō i nā pahuhopu hoʻopau i hoʻokahi a ʻekolu mau makahiki ma mua [14].Hoʻopili ʻo VL i nā kaiāulu ʻilihune ʻilihune ma nā wahi endemic a ʻo kā lākou mana vector e hilinaʻi wale ʻia ma IRS, akā ʻaʻole i aʻo ʻia ke koena o ka hopena o kēia ana mana i nā ʻano ʻano ʻohana like ʻole ma ke kula ma nā wahi hana [15, 16].Eia kekahi, ma hope o ka hana koʻikoʻi e hakakā iā VL, ua mau ke ahulau ma kekahi mau kauhale no kekahi mau makahiki a lilo i wahi wela [17].No laila, pono e loiloi i ke koena o ka IRS ma ka nānā ʻana i ka nui o ka makika ma nā ʻano hale like ʻole.Eia kekahi, ʻo ka palapala ʻāina pilikia geospatial microscale e kōkua i ka hoʻomaopopo maikaʻi ʻana a me ka hoʻopaʻa ʻana i ka heluna namu ma hope o ka hana ʻana.ʻO nā ʻōnaehana ʻike honua (GIS) he hui pū ʻana o nā ʻenehana palapala kikohoʻe e hiki ai i ka mālama ʻana, ka uhi ʻana, ka manipulation, ka nānā ʻana, ka hoʻihoʻi ʻana a me ka ʻike ʻana i nā pūʻulu like ʻole o ka ʻike honua a me ka socio-demographic data no nā kumu like ʻole [18, 19, 20]..Hoʻohana ʻia ka ʻōnaehana hoʻonohonoho honua (GPS) e aʻo i ke kūlana spatial o nā ʻāpana o ka ʻili honua [21, 22].Ua hoʻohana ʻia nā mea hana hoʻohālike spatial GIS a me GPS i kekahi mau hiʻohiʻona epidemiological, e like me ka loiloi maʻi spatial a me ke kino a me ka wānana outbreak, ka hoʻokō ʻana a me ka loiloi ʻana i nā hoʻolālā hoʻomalu, ka launa pū ʻana o nā pathogens me nā kumu kaiapuni, a me ka palapala ʻāina pilikia.[20,23,24,25,26].ʻO ka ʻike i hōʻiliʻili ʻia a loaʻa mai nā palapala ʻāina pilikia geospatial hiki ke hoʻomaʻamaʻa i nā hana hoʻomalu kūpono a me ka maikaʻi.
Ua loiloi kēia haʻawina i ke koena o ka pono a me ka hopena o ka hana DDT a me SP-IRS ma ka pae ʻohana ma lalo o ka National VL Vector Control Program ma Bihar, India.ʻO nā pahuhopu hou aʻe, ʻo ia ka hoʻomohala ʻana i kahi palapala ʻāina pilikia ākea a me nā kumu hoʻohālike noʻonoʻo namu e pili ana i nā hiʻohiʻona o ka noho ʻana, ka hiki ʻole o ka insecticide vector, a me ke kūlana IRS o ka hale e nānā i ka hierarchy o ka māhele spatiotemporal o nā makika microscale.
Ua mālama ʻia ke aʻo ʻana ma Mahnar poloka o ka moku ʻo Vaishali ma ke kapa ʻākau o ka Ganga (Fig. 1).ʻO Makhnar kahi'āpana nui loa, me ka awelika o 56.7 mau hihia o VL i kēlā me kēia makahiki (170 mau hihia ma 2012-2014),ʻo 2.5-3.7 mau hihia i kēlā me kēia makahiki 10,000;Ua koho ʻia ʻelua kauhale: Chakeso ma ke ʻano he kahua hoʻomalu (Fig. 1d1; ʻaʻohe hihia o VL i nā makahiki ʻelima i hala iho nei) a ʻo Lavapur Mahanar ma ke ʻano he wahi hopena (Fig. 1d2; ʻoi loa ka hopena, me 5 a ʻoi aku paha nā hihia ma 1000 poʻe i kēlā me kēia makahiki. ).i nā makahiki 5 i hala iho nei).Ua koho ʻia nā kauhale ma muli o ʻekolu mau kumu nui: kahi a me ka hiki ke loaʻa (ʻo ia hoʻi aia ma kahi kahawai me ka maʻalahi o ke komo ʻana i ka makahiki holoʻokoʻa), nā hiʻohiʻona demographic a me ka helu o nā ʻohana (ʻo ia hoʻi he 200 mau ʻohana; He 202 a me 204 mau ʻohana ʻo Chaqueso me ka nui o ka home) .4.9 a me 5.1 kanaka) a me Lavapur Mahanar) a me ke ano o ka hale (HT) a me ke ano o ko lakou puunaue ana (oia hoi na HT huikau like ole).Aia nā kauhale aʻo ʻelua ma loko o 500 m o ke kaona ʻo Maknar a me ka haukapila apana.Ua hōʻike ʻia ka haʻawina ua komo nui nā kamaʻāina o nā kauhale aʻo i nā hana noiʻi.ʻO nā hale ma ke kauhale hoʻomaʻamaʻa [ʻo ia nā lumi moe 1-2 me 1 balkona i hoʻopili ʻia, 1 lumi kuke, 1 lumi ʻauʻau a me 1 hale paʻa (i hoʻopili ʻia a wehe ʻia paha)] i loko o nā pā pōhaku lepo / lepo a me nā papahele adobe, nā pā pōhaku me ka lime ciment plaster.a me nā papahele sima, nā paia pōhaku lepo ʻole a pena ʻole ʻia, nā papahele pālolo a me ka hale pili.ʻO ka ʻāina ʻo Vaishali holoʻokoʻa he ʻāina subtropical humid me ka wā ua (Iulai a ʻAukake) a me kahi kau maloʻo (Novema a Dekemaba).ʻO ka awelika o ka ua makahiki he 720.4 mm (ka pae 736.5-1076.7 mm), ka haʻahaʻa pili 65 ± 5% (kahi 16-79%), ka mahana o kēlā me kēia mahina 17.2-32.4 ° C.ʻO Mei a me Iune ka mahina wela loa (39–44 °C ka mahana), a ʻo Ianuali ke anuanu loa (7–22 °C).
Hōʻike ka palapala ʻāina o ka wahi aʻo i kahi o Bihar ma ka palapala ʻāina o India (a) a me kahi o ka moku ʻo Vaishali ma ka palapala ʻāina o Bihar (b).Makhnar Block (c) Ua koho ʻia ʻelua mau kauhale no ke aʻo ʻana: ʻo Chakeso ke kahua hoʻomalu a ʻo Lavapur Makhnar ke kahua hana.
Ma ke ʻano he ʻāpana o ka National Kalaazar Control Program, ua alakaʻi ʻo Bihar Society Health Board (SHSB) i ʻelua pōʻai o ka IRS makahiki i ka makahiki 2015 a me 2016 (ka puni mua, Pepeluali-Malaki; pōʻai lua, Iune-Iulai)[4].No ka hōʻoia ʻana i ka hoʻokō pono ʻana o nā hana IRS āpau, ua hoʻomākaukau ʻia kahi hoʻolālā hana micro e ka Rajendra Memorial Medical Institute (RMRIMS; Bihar), ʻo Patna, kahi lālā o ka ʻĀina ʻĀina o ka ʻImi Kauka (ICMR; New Delhi).nodal institute.Ua koho ʻia nā kauhale IRS ma muli o ʻelua mau kumu nui: ka mōʻaukala o nā hihia o VL a me retrodermal kala-azar (RPKDL) ma ke kauhale (ʻo ia hoʻi, nā kauhale me 1 a ʻoi aku paha nā hihia i kēlā me kēia manawa i nā makahiki 3 i hala, me ka makahiki o ka hoʻokō ʻana. )., nā kauhale ʻaʻohe hopena e pili ana i "nā wahi wela" (ʻo ia hoʻi nā kauhale i hōʻike mau i nā hihia no ≥ 2 mau makahiki a i ʻole ≥ 2 mau hihia no 1000 poʻe) a me nā kauhale endemic hou (ʻaʻohe hihia i nā makahiki 3 i hala) i ka makahiki hope o ka makahiki hoʻokō i hōʻike ʻia ma [17].ʻO nā kauhale e pili ana e hoʻokō i ka pōʻai mua o ka ʻauhau ʻāina, ua komo pū nā kauhale hou i ka lua o ka papa hana ʻauhau ʻāina.I ka makahiki 2015, ua mālama ʻia ʻelua pōʻai o IRS me DDT (DDT 50% WP, 1 g ai/m2) ma nā kauhale aʻo hana.Mai ka makahiki 2016, ua hana ʻia ʻo IRS me ka hoʻohana ʻana i nā pyrethroids synthetic (SP; alpha-cypermethrin 5% VP, 25 mg ai/m2).Hoʻohana ʻia ka pīpī ʻana me ka hoʻohana ʻana i ka paila Hudson Xpert (13.4 L) me kahi pale kaomi, kahi kīwī kahe ʻokoʻa (1.5 bar) a me kahi 8002 flat jet nozzle no nā wahi porous [27].Ua nānā ʻo ICMR-RMRIMS, Patna (Bihar) iā IRS ma ka home a me ke kauhale a hāʻawi i ka ʻike mua e pili ana i ka IRS i nā kamaʻāina ma o nā microphones i loko o nā lā 1-2 mua.Hoʻolako ʻia kēlā me kēia hui IRS me kahi mākaʻikaʻi (i hāʻawi ʻia e RMRIMS) e nānā i ka hana o ka hui IRS.Hoʻouna ʻia nā Ombudsmen, me nā hui IRS i nā ʻohana āpau e hoʻomaopopo a hōʻoia i nā poʻo o nā ʻohana e pili ana i nā hopena maikaʻi o ka IRS.I loko o ʻelua mau hōʻike noiʻi IRS, hiki i ka 80% ka nui o ka uhi ʻana o ka home ma nā kauhale aʻo.Ua hoʻopaʻa ʻia ke kūlana hoʻopuʻi (ʻo ia hoʻi, ʻaʻohe pulupulu, ʻūpī ʻāpana, a me ka pulupulu piha; wehewehe ʻia ma ka waihona hou 1: Pākaukau S1) i hoʻopaʻa ʻia no nā ʻohana a pau ma ke kauhale i hoʻopaʻa ʻia i ka wā o ka IRS.
Ua mālamaʻia ke aʻoʻana mai Iune 2015 a hiki i Iulai 2016. Ua hoʻohana ka IRS i nā kikowaena maʻi no ka hana mua (ʻo ia hoʻi, nā wiki 2 ma mua o ka hanaʻana; ka nānāʻana i ke kumu) a ma hope o ka hanaʻana (ie, 2, 4, a me 12 wiki ma hope o ka hana; ka nānā ʻana) ka nānā ʻana, ka hoʻopaʻa ʻana, a me ka pale ʻana i ka lele one ma kēlā me kēia puni IRS.i loko o kēlā me kēia hale Hoʻokahi pō (ʻo ia hoʻi mai ka hola 18:00 a hiki i ka hola 6:00) pahele māmā [28].Ua hoʻokomo ʻia nā pahele māmā i loko o nā lumi moe a me nā hale mālama holoholona.Ma ke kauhale kahi i mālama ʻia ai ke aʻo ʻana, ua hoʻāʻo ʻia nā ʻohana 48 no ka nui o ka lele one ma mua o IRS (12 ʻohana i kēlā me kēia lā no 4 mau lā a hiki i ka lā ma mua o ka lā IRS).Ua koho ʻia ʻo 12 no kēlā me kēia o nā hui nui ʻehā o nā ʻohana (ʻo ia hoʻi ka pālolo palolo (PMP), nā hale sima a me ka pā lime (CPLC), nā hale brick i hamo ʻole ʻia a pena ʻole ʻia (BUU) a me nā hale pili ʻia (TH).Ma hope mai, koho ʻia nā ʻohana 12 wale nō (mai loko o 48 mau home pre-IRS) e hoʻomau i ka hōʻiliʻili ʻana i ka ʻikepili nui namu ma hope o ka hālāwai IRS.Wahi a WHO, ua koho ʻia nā ʻohana 6 mai ka hui intervention (nā hale e loaʻa ana ka mālama IRS) a me ka pūʻulu sentinel (nā hale ma nā kauhale intervention, nā mea nona ka ʻae ʻana i ka IRS) [28].Ma waena o ka pūʻulu hoʻomalu (nā hale ma nā kauhale kokoke i loaʻa ʻole i ka IRS ma muli o ka nele o VL), 6 wale nō ʻohana i koho ʻia e nānā i ka nui o nā makika ma mua a ma hope o ʻelua mau kau IRS.No nā pūʻulu mākaʻikaʻi mānoanoa ʻekolu (ʻo ia hoʻi, ka hoʻopaʻa ʻana, ka mālama ʻana a me ka mālama ʻana), ua koho ʻia nā ʻohana mai ʻekolu mau pūʻulu pae pilikia (ʻo ia hoʻi, haʻahaʻa, waena a kiʻekiʻe; ʻelua mau hale mai kēlā me kēia pae pilikia) a ua hoʻokaʻawale ʻia nā hiʻohiʻona pilikia HT (modules a me nā hale. hōʻike ʻia ma ka Papa 1 a me ka Papa 2, kēlā me kēia) [29, 30].Ua koho ʻia ʻelua ʻohana no kēlā me kēia pae pilikia e pale aku i nā manaʻo hoʻohālikelike a me ka hoʻohālikelike ʻana ma waena o nā hui.I loko o ka pūʻulu hana, ua nānā ʻia ka nui o nā makika post-IRS i ʻelua ʻano o ka home IRS: mālama piha ʻia (n = 3; 1 home ma kēlā me kēia pae pilikia) a mālama ʻia (n = 3; 1 home no kēlā me kēia pae pilikia).).hui pilikia).
Ua hoʻoili ʻia nā makika a pau i hopu ʻia i loko o nā paipu hoʻāʻo i ke keʻena hoʻokolohua, a ua pepehi ʻia nā pahu hoʻāʻo me ka pulupulu pulupulu i hoʻonā ʻia i ka chloroform.Ua hoʻokaʻawale ʻia nā ʻeleʻele kālā a hoʻokaʻawale ʻia mai nā namu a me nā namu ʻē aʻe e pili ana i nā ʻano morphological me ka hoʻohana ʻana i nā code ʻike maʻamau [31].ʻO nā ʻōpae kālā kāne a me nā wahine a pau i kāʻei ʻia i loko o ka waiʻona 80%.Ua helu ʻia ka nui o ka makika i kēlā me kēia pahele/pō me ka hoʻohana ʻana i kēia ʻano: ka huina o nā makika i hōʻiliʻili ʻia/ka helu o nā pahele māmā i hoʻonohonoho ʻia i kēlā me kēia pō.ʻO ka pākēneka o ka hoʻololi ʻana i ka nui namu (SFC) ma muli o IRS me ka hoʻohana ʻana iā DDT a me SP ua manaʻo ʻia me ka hoʻohana ʻana i kēia ʻano kumu [32]:
kahi ʻo A ke kumu kumu SFC no nā ʻohana wawao, ʻo B ka IRS mean SFC no nā ʻohana wawao, C ka manaʻo kumu SFC no nā ʻohana mālama/kiaʻi, a ʻo D ka manaʻo SFC no nā ʻohana home mālama IRS/sentinel.
ʻO nā hopena hopena o ka hana, i hoʻopaʻa ʻia e like me nā waiwai maikaʻi ʻole a maikaʻi, e hōʻike ana i ka emi ʻana a me ka hoʻonui ʻana i ka SFC ma hope o IRS.Inā noho like ka SFC ma hope o IRS me ka SFC kumu, ua helu ʻia ka hopena o ka hana ʻana ma ke ʻano he zero.
Wahi a ka World Health Organization Pesticide Evaluation Scheme (WHOPES), ua loiloi ʻia ka naʻau o ka ʻoʻo silverleg maoli i nā pesticides DDT a me SP me ka hoʻohana ʻana i nā bioassays in vitro [33].Ua hōʻike ʻia nā ʻōpae kālā wahine olakino olakino a hānai ʻole ʻia (18-25 SF no kēlā me kēia hui) i nā pesticides i loaʻa mai ke Kulanui Sains Malaysia (USM, Malaysia; hoʻonohonoho ʻia e ka World Health Organization) me ka hoʻohana ʻana i ka World Health Organization Pesticide Sensitivity Test Kit [4,9, 33. ,34].Ua ho'āʻo ʻia kēlā me kēia pūʻulu bioassays pesticide (ʻehā mau hoʻāʻo hou ʻana, holo like kēlā me kēia me ka mana).Ua hana ʻia nā hoʻāʻo ʻana me ka pepa i hoʻopili ʻia me ka riella (no DDT) a me ka aila silicone (no SP) i hāʻawi ʻia e USM.Ma hope o 60 mau minuke o ka hoʻolaha ʻana, ua hoʻokomo ʻia nā makika i loko o nā paipu WHO a hāʻawi ʻia me ka pulupulu pulupulu i hoʻomoʻa ʻia i loko o kahi hopena kōpaʻa he 10%.Ua ʻike ʻia ka nui o nā makika i make ma hope o 1 hola a me ka make hope ma hope o 24 mau hola.Hōʻike ʻia ke kūlana kūʻē e like me nā alakaʻi o ka World Health Organization: ʻo ka make ʻana o 98-100% e hōʻike ana i ka maʻalahi, 90-98% e hōʻike ana i ke kūʻē hiki ke koi i ka hōʻoia, a <90% e hōʻike ana i ke kū'ē [33, 34].Ma muli o ka make ma ka pūʻulu mana mai 0 a 5%, ʻaʻole i hana ʻia kahi hoʻoponopono make.
Ua loiloi ʻia ka bioefficacy a me ke koena o nā hopena o nā insecticides ma luna o nā nalo maoli ma lalo o nā kūlana kula.I loko o ʻekolu mau hale hana (hoʻokahi me ka pālolo pālolo a i ʻole PMP, ka pāpaʻi sima a me ka uhi lime a i ʻole CPLC, nā pōhaku lepo ʻole a pena ʻole ʻia a i ʻole BUU) ma 2, 4 a me 12 pule ma hope o ka pulu ʻana.Ua hana ʻia kahi bioassay maʻamau o WHO ma nā cones i loaʻa nā pahele māmā.hoʻokumu ʻia [27, 32].Ua kāpae ʻia ka hoʻomehana ʻana o ka hale ma muli o nā paia ʻole.I loko o kēlā me kēia kānana, ua hoʻohana ʻia nā cones 12 ma nā hale hoʻokolohua āpau (ʻehā cones no ka home, hoʻokahi no kēlā me kēia ʻano ʻili o ka pā).E hoʻopili i nā cones i kēlā me kēia pā o ka lumi ma nā kiʻekiʻe kiʻekiʻe: hoʻokahi ma ka pae poʻo (mai 1.7 a 1.8 m), ʻelua ma ka pae pūhaka (mai 0.9 a 1 m) a hoʻokahi ma lalo o ke kuli (mai 0.3 a 0.5 m).He ʻumi mau makika wahine hānai ʻole (10 no kēlā me kēia cone; hōʻiliʻili ʻia mai kahi pā hoʻomalu me ka hoʻohana ʻana i ka aspirator) i hoʻokomo ʻia i loko o kēlā me kēia keʻena cone plastic WHO (hoʻokahi cone no kēlā me kēia ʻano hale) ma ke ʻano he mana.Ma hope o 30 mau minuke o ka wehe ʻana, e wehe pono i nā makika mai laila;ke keʻena conical e hoʻohana ana i ka elbow aspirator a hoʻoili iā lākou i loko o nā paipu WHO i loaʻa ka 10% solution sugar no ka hānai ʻana.Hoʻopaʻa ʻia ka make hope ma hope o 24 mau hola ma 27 ± 2°C a me 80 ± 10% haʻahaʻa haʻahaʻa.Hoʻoponopono ʻia ka nui o ka make me nā helu ma waena o 5% a me 20% me ka hoʻohana ʻana i ka formula Abbott [27] penei:
ʻo ka P ka heluna make i hoʻololi ʻia, ʻo P1 ka pākēneka make i ʻike ʻia, a ʻo C ka pākēneka o ka make.Ua hoʻolei ʻia nā hoʻāʻo me ka mana make ma mua o 20% a hoʻihoʻi hou [27, 33].
Ua mālama ʻia kahi noiʻi ʻohana piha ma ke kauhale wawao.Ua hoʻopaʻa ʻia ka wahi GPS o kēlā me kēia hale me kona ʻano hoʻolālā a me kona ʻano waiwai, hale noho, a me ke kūlana hana.Ua hoʻomohala ka paepae GIS i kahi geodatabase kikohoʻe e pili ana i nā papa palena ma ke kauhale, ka moku, ka moku a me ka mokuʻāina.Hoʻopili ʻia nā wahi ʻohana a pau me ka hoʻohana ʻana i nā papa kuhikuhi GIS pae kauhale, a hoʻopili ʻia kā lākou ʻike kikoʻī a hōʻano hou ʻia.Ma kēlā me kēia kahua hale, ua loiloi ʻia ka pilikia ma muli o ka HT, insecticide vector susceptibility, a me ke kūlana IRS (Table 1) [11, 26, 29, 30].A laila ua hoʻololi ʻia nā helu wahi hale a pau i palapala ʻāina me ka hoʻohana ʻana i ke kaupaona ʻana o ka mamao inverse (IDW; ka hoʻoholo ʻana e pili ana i ka awelika ʻāina o ka hale o 6 m2, mana 2, helu paʻa o nā wahi a puni = 10, me ka hoʻohana ʻana i ka radius hulina hulina, kānana pass haʻahaʻa).and cubic convolution mapping) spatial interpolation technology [35].Ua hana ʻia ʻelua ʻano palapala ʻāina pilikia koʻikoʻi: HT-based thematic maps and pesticide vector sensitivity and IRS status (ISV and IRSS) thematic map.Ua hui pū ʻia nā palapala ʻāina pilikia ʻelua me ka hoʻohana ʻana i ka loiloi overlay paona [36].I loko o kēia kaʻina hana, ua hoʻokaʻawale ʻia nā papa raster i nā papa makemake maʻamau no nā pae pilikia like ʻole (ʻo ia hoʻi, kiʻekiʻe, waena, a haʻahaʻa/ʻaʻohe pilikia).Ua hoʻonui ʻia kēlā me kēia papa raster reclassified e ke kaumaha i hāʻawi ʻia iā ia ma muli o ke koʻikoʻi pili o nā ʻāpana e kākoʻo ana i ka nui o ka makika (e pili ana i ka prevalence ma nā kauhale aʻo, nā wahi hānai namu, a me ka hoʻomaha a me ka hānai ʻana) [26, 29]., 30, 37].Ua kaupaona ʻia nā palapala ʻāina pilikia ʻelua i ka 50:50 no ka mea ua hāʻawi like lākou i ka nui o ka makika (Faila hou 1: Papa S2).Ma ka hōʻuluʻulu ʻana i nā palapala ʻāina i hoʻopaʻa ʻia ma luna o ke kaupaona ʻana, ua hana ʻia kahi palapala ʻāina pilikia composite hope loa a ʻike ʻia ma ke kahua GIS.Hōʻike ʻia ka palapala ʻāina koʻikoʻi hope a wehewehe ʻia ma nā huaʻōlelo o Sand Fly Risk Index (SFRI) i helu ʻia me ka hoʻohana ʻana i kēia ʻano:
I loko o ke kumu hoʻohālike, ʻo P ka waiwai helu pilikia, ʻo L ka waiwai pilikia holoʻokoʻa no nā wahi o kēlā me kēia ʻohana, a ʻo H ka waiwai pilikia kiʻekiʻe loa no ka ʻohana ma ka wahi aʻo.Hoʻomākaukau a hana mākou i nā papa GIS a me ka nānā ʻana me ka hoʻohana ʻana iā ESRI ArcGIS v.9.3 (Redlands, CA, USA) e hana i nā palapala ʻāina pilikia.
Ua alakaʻi mākou i nā loiloi regression he nui e nānā i nā hopena i hui pū ʻia o HT, ISV, a me IRSS (e like me ka wehewehe ʻana ma ka Papa 1) ma ka nui o nā namu hale (n = 24).ʻO nā hiʻohiʻona hale a me nā mea pilikia e pili ana i ka hana IRS i hoʻopaʻa ʻia i loko o ke aʻo ʻana ua mālama ʻia ma ke ʻano he wehewehe wehewehe, a ua hoʻohana ʻia ka nui o ka namu ma ke ʻano he pane pane.Hana ʻia nā loiloi hoʻihoʻi Univariate Poisson no kēlā me kēia ʻano wehewehe wehewehe e pili ana i ka nui o ka sandfly.I ka wā o ka loiloi univariate, ua hoʻoneʻe ʻia nā mea ʻokoʻa ʻole a loaʻa ka waiwai P ʻoi aku ma mua o 15% mai ka loiloi regression lehulehu.No ka nānā ʻana i nā pilina, ua hoʻokomo pū ʻia nā huaʻōlelo pili no nā hui like ʻole o nā ʻano nui (ʻike ʻia i ka loiloi univariate) i ka manawa like i loko o ka loiloi regression lehulehu, a ua wehe ʻia nā huaʻōlelo nonsignificant mai ke kumu hoʻohālike i ke ʻano stepwise e hana i ke kumu hoʻohālike hope.
Ua hoʻokō ʻia ka loiloi pilikia pae hale ma nā ʻano ʻelua: ka loiloi ʻana i ka pae o ka home a me ka loiloi spatial hui o nā wahi pilikia ma ka palapala ʻāina.Ua manaʻo ʻia nā manaʻo koʻikoʻi o ka home me ka hoʻohana ʻana i ka loiloi hoʻoponopono ma waena o nā kuhi pilikia o ka home a me ka nui o ka lele one (ʻohi ʻia mai 6 mau hale kiaʻi a me 6 mau hale hana; he mau pule ma mua a ma hope o ka hoʻokō ʻana o IRS).Ua manaʻo ʻia nā ʻāpana pilikia ākea me ka hoʻohana ʻana i ka helu awelika o nā makika i hōʻiliʻili ʻia mai nā hale like ʻole a hoʻohālikelike ʻia ma waena o nā pūʻulu pilikia (ʻo ia hoʻi nā wahi pilikia haʻahaʻa, waena a kiʻekiʻe).I kēlā me kēia puni IRS, koho ʻia nā ʻohana he 12 (4 ʻohana ma kēlā me kēia pae ʻekolu o nā wahi pilikia; mālama ʻia nā hōʻiliʻili pō i kēlā me kēia 2, 4, a me 12 pule ma hope o IRS) i koho ʻia e hōʻiliʻili i nā makika no ka hoʻāʻo ʻana i ka palapala ʻāina pilikia.Ua hoʻohana ʻia nā ʻikepili home like (ʻo ia hoʻi, HT, VSI, IRSS a me mean mosquito density) no ka hoʻāʻo ʻana i ke kumu hoʻohālike hope.Ua mālama ʻia kahi loiloi hoʻoponopono maʻalahi ma waena o nā mākaʻikaʻi kahua a me ka nui o nā makika hale i wānana ʻia.
Ua helu ʻia nā ʻikepili wehewehe e like me mean, liʻiliʻi, kiʻekiʻe, 95% mau manawa hilinaʻi (CI) a me nā pākēneka e hōʻuluʻulu i ka ʻikepili entomological a me IRS.Ka helu awelika a me ka nui o ka make o nā ʻōpala kālā (ke koena insecticidal agent) me ka hoʻohana ʻana i nā hoʻāʻo parametric [hōʻike hoʻohālikelike i hoʻohālikelike ʻia (no ka ʻikepili puʻupuʻu maʻamau)] a me nā hoʻāʻo non-parametric (Wilcoxon i kau inoa ʻia) e hoʻohālikelike i ka maikaʻi ma waena o nā ʻano o ka ʻili i nā hale (iee , BUU vs. CPLC, BUU vs. PMP, a me CPLC vs. PMP) ho'āʻo no ka ʻikepili puʻunaue ʻole).Ua hana ʻia nā loiloi āpau me ka hoʻohana ʻana i ka polokalamu SPSS v.20 (SPSS Inc., Chicago, IL, USA).
Ua helu ʻia ka uhi ʻana o ka hale ma nā kauhale i ka wā o ka IRS DDT a me SP.He 205 mau ʻohana i loaʻa ka IRS ma kēlā me kēia pōʻai, me 179 mau ʻohana (87.3%) i ka pōʻai DDT a me 194 mau ʻohana (94.6%) i ka puni SP no ka mana VL vector.ʻOi aku ka nui o nā ʻohana i mālama ʻia me nā pesticides i ka wā SP-IRS (86.3%) ma mua o ka DDT-IRS (52.7%).He 26 (12.7%) ka nui o nā ʻohana i haʻalele i IRS i ka wā o ka SP he 11 (5.4%).I loko o nā pōʻai DDT a me SP, ʻo ka heluna o nā ʻohana i mālama hapa ʻia he 71 (34.6% o ka nui o nā ʻohana i mālama ʻia) a me 17 ʻohana (8.3% o ka nui o nā ʻohana i mālama ʻia).
Wahi a nā alakaʻi kūʻē pesticide ʻo WHO, ʻo ka heluna o ka ʻoʻo kālā kālā ma ke kahua wawao ua hiki ke maʻalahi i ka alpha-cypermethrin (0.05%) e like me ka awelika o ka make i hōʻike ʻia i ka wā o ka hoʻokolokolo (24 hola) he 100%.ʻO 85.9% (95% CI: 81.1–90.6%) ka helu kīkēkē i ʻike ʻia.No DDT, he 22.8% (95% CI: 11.5–34.1%) ka helu kuʻi ʻana i nā hola 24, a ʻo ka nui o ka make ʻana o ka hoʻāʻo uila he 49.1% (95% CI: 41.9–56.3%).Ua hōʻike ʻia nā hopena ua hoʻomohala nā silverfoots i ke kūpaʻa piha ʻana iā DDT ma ke kahua hana.
Ma ka papa ʻaina 3 hōʻuluʻulu i nā hopena o ka bioanalysis o nā cones no nā ʻano ʻano like ʻole o ka ʻili (nā manawa like ʻole ma hope o IRS) i mālama ʻia me DDT a me SP.Ua hōʻike kā mākou ʻikepili ma hope o 24 mau hola, ʻelua insecticides (BUU vs. CPLC: t(2)= – 6.42, P = 0.02; BUU vs. PMP: t(2) = 0.25, P = 0.83; CPLC vs PMP: t( 2)= 1.03, P = 0.41 (no DDT-IRS a me BUU) CPLC: t(2)= − 5.86, P = 0.03 a me PMP: t(2) = 1.42, P = 0.29; (2) = 3.01, P = 0.10 a me SP: t(2) = 9.70, P = 0.01 ua emi mau ka nui o ka make i ka manawa No SP-IRS: 2 pule ma hope o ka ho'opā 'ana no nā 'ano pā a pau. a me 4 pule ma hope o ka hoʻopā ʻana no nā pā CPLC wale nō (ʻo ia ka 82.5 Ma ka hui DDT, ʻoi aku ka make ma lalo o 70% no nā ʻano pā āpau i nā manawa āpau ma hope o ka bioassay IRS ʻO ka awelika o ka make hoʻokolohua ma hope o 12 He 25.1% a me 63.2% ka nui o ka make me DDT (no ka PMP 2 pule ma hope o IRS), 36.9% (no CPLC 4 pule ma hope o IRS), a me 28.9% (). no CPLC 4 mau pule ma hope o ka IRS he 55% (no BUU, 2 pule ma hope o IRS), 32.5% (no PMP, 4 pule ma hope o IRS) a me 20% (no PMP, 4 pule ma hope o IRS);US IRS).No SP, he 97.2% (no CPLC, 2 pule ma hope o IRS), 82.5% (no CPLC, 4 pule ma hope o IRS), a he 67.5% (no CPLC, 4 pule ma hope o IRS).12 mau pule ma hope o IRS).US IRS).mau pule ma hope o IRS);ʻo ka haʻahaʻa haʻahaʻa he 94.4% (no BUU, 2 pule ma hope o IRS), 75% (no PMP, 4 pule ma hope o IRS), a me 58.3% (no PMP, 12 pule ma hope o IRS).No nā insecticides ʻelua, ʻoi aku ka wikiwiki o ka make ma luna o nā ʻili i mālama ʻia e ka PMP ma mua o nā wahi i mālama ʻia e CPLC a me BUU.
Hōʻuluʻulu ka Papa 4 i nā hopena hana (ʻo ia hoʻi, nā loli ma hope o ka IRS i ka nui o ka namu) o nā puni IRS ma DDT a me SP (Faila hou 1: Kiʻi S1).No ka DDT-IRS, he 34.1% ka emi ana o na kinikini ma hope o ka manawa IRS (ma 2 pule), 25.9% (ma 4 pule), a me 14.1% (ma 12 pule).No SP-IRS, ʻo 90.5% ka hoʻemi ʻana (ma nā wiki 2), 66.7% (ma nā wiki 4), a me 55.6% (ma nā wiki 12).ʻO ka hāʻule nui loa o ka nui o ka ʻōpae kālā ma nā hale kiaʻi i ka wā hōʻike DDT a me SP IRS he 2.8% (ma 2 pule) a me 49.1% (ma 2 pule), kēlā me kēia.I loko o ka wā SP-IRS, ua like ka emi ʻana (ma mua a ma hope) o nā pheasants ʻōpū keʻokeʻo i ka hoʻoulu ʻana i nā hale (t(2)= – 9.09, P <0.001) a me nā hale kiaʻi (t(2) = – 1.29, P = 0.33).ʻOi aku ka kiʻekiʻe i hoʻohālikelike ʻia me DDT-IRS i nā manawa āpau 3 ma hope o IRS.No nā lāʻau lāʻau lāʻau ʻelua, ua hoʻonui ʻia ka nui o nā pōpoki kala i nā hale kiaʻi 12 pule ma hope o IRS (ʻo ia hoʻi, 3.6% a me 9.9% no SP a me DDT, kēlā me kēia).I ka wā o SP a me DDT ma hope o nā hālāwai IRS, ua hōʻiliʻili ʻia nā ʻōpae kālā 112 a me 161 mai nā mahiʻai kiaʻi.
ʻAʻole i ʻike ʻia nā ʻokoʻa nui o ka nui o ka ʻōpae kālā ma waena o nā hui ʻohana (ʻo ia hoʻi, ka ʻūhā vs. : i nā pule IRS ma hope o DDT, t(2) = − 0.59, P = 0.62).ʻO ka ʻokoʻa, ua ʻike ʻia nā ʻokoʻa nui o ka nui o ka ʻōpae kālā ma waena o ka pūʻulu hoʻoheheʻe a me ka pūʻulu hoʻomalu (t(2) = – 11.28, P = 0.01) a ma waena o ka pūʻulu hoʻoheheʻe a me ka pūʻulu hoʻomalu (t(2) = – 4, 42, P = 0.05).IRS i kekahi mau pule ma hope o SP.No SP-IRS, ʻaʻohe ʻokoʻa koʻikoʻi i ʻike ʻia ma waena o nā ʻohana kiaʻi a me nā ʻohana mana (t(2)= -0.48, P = 0.68).Hōʻike ka Kiʻi 2 i ka awelika o ka ʻōpū o nā pheasant pheasant i ʻike ʻia ma nā mahiʻai i mālama piha ʻia me nā huila IRS.ʻAʻohe ʻokoʻa koʻikoʻi o ka mānoanoa o nā pheasants i hoʻokele piha ʻia ma waena o nā hale mālama piha a hapa ʻia (ʻo 7.3 a me 2.7 i kēlā me kēia pahele/pō).ʻO DDT-IRS a me SP-IRS, ʻo ia hoʻi), a ua kāpī ʻia kekahi mau hale me nā insecticides ʻelua (mean 7.5 a me 4.4 i kēlā me kēia pō no DDT-IRS a me SP-IRS, kēlā me kēia) (t(2) ≤ 1.0, P > 0.2).Eia naʻe, ʻokoʻa loa ka mānoanoa o ka ʻōpae kālā i loko o nā mahiʻai i hoʻoheheʻe ʻia piha a hapa ʻia ma waena o ka SP a me DDT IRS puni (t(2) ≥ 4.54, P ≤ 0.05).
Manaʻo ʻia ka nui o ka nui o nā ʻēheu kala kala i loko o nā hale mālama piha a hapa ʻia ma ke kauhale ʻo Mahanar, Lavapur, i nā pule 2 ma mua o IRS a me 2, 4 a me 12 mau pule ma hope o ka puni IRS, DDT a me SP.
Ua hoʻomohala ʻia kahi palapala ʻāina ākea ākea (kauhale ʻo Lavapur Mahanar; ʻāpana āpau: 26,723 km2) no ka ʻike ʻana i nā wahi pilikia ākea haʻahaʻa, waena a kiʻekiʻe e nānā i ka puka ʻana a me ke ala hou ʻana o ka ʻoʻo kālā ma mua a me kekahi mau pule ma hope o ka hoʻokō ʻana o IRS (Fig. 3. , 4)...ʻO ka helu kiʻekiʻe loa no nā ʻohana i ka wā i hana ʻia ai ka palapala ʻāina pilikia, ua helu ʻia ʻo "12" (ʻo ia hoʻi, "8" no nā palapala ʻāina pilikia HT a me "4" no nā palapala ʻāina pilikia pili VSI a me IRSS).ʻO ka helu haʻahaʻa i helu ʻia he "zero" a i ʻole "ʻaʻohe pilikia" koe wale nā palapala DDT-VSI a me IRSS i loaʻa ka helu haʻahaʻa o 1. Ua hōʻike ʻia ka palapala ʻāina pilikia e pili ana i ka HT he wahi nui (ie 19,994.3 km2; 74.8%) o Lavapur ʻO ke kauhale ʻo Mahanar kahi wahi pilikia nui kahi e hālāwai ai nā kamaʻāina a puka hou mai nā makika.ʻOkoʻa ka uhi ʻāina ma waena o nā ʻāpana kiʻekiʻe (DDT 20.2%; SP 4.9%), waena (DDT 22.3%; SP 4.6%) a me nā ʻāpana haʻahaʻa/ʻaʻohe pilikia (DDT 57.5%; SP 90.5) %) ( t (2) = 12.7, P <0.05) ma waena o nā pakuhi pilikia o DDT a me SP-IS a me IRSS (Fig. 3, 4).Ua hōʻike ʻia ka palapala ʻāina koʻikoʻi composite hope loa i ʻoi aku ka maikaʻi o ka palekana o SP-IRS ma mua o DDT-IRS ma nā pae āpau o nā wahi pilikia HT.Ua ho'emi 'ia ka wahi pilikia nui no HT ma lalo o 7% (1837.3 km2) ma hope o SP-IRS a ua lilo ka hapa nui o ia wahi ('o ia ho'i, 53.6%) i wahi pilikia ha'aha'a.I loko o ka wā DDT-IRS, ʻo ka pākēneka o nā wahi kiʻekiʻe a me nā wahi haʻahaʻa i loiloi ʻia e ka palapala ʻāina pilikia i hui pū ʻia he 35.5% (9498.1 km2) a me 16.2% (4342.4 km2).Ua ana ʻia ka nui o ka lele one ma nā ʻohana mālama ʻia a mālama ʻia ma mua a me kekahi mau pule ma hope o ka hoʻokō ʻana o IRS a nānā ʻia ma kahi palapala ʻāina pilikia i hui ʻia no kēlā me kēia puni o IRS (ie, DDT a me SP) (Fig. 3, 4).Aia ka ʻaelike maikaʻi ma waena o nā helu pilikia o ka home a me ka awelika o nā ʻōpae kālā i hoʻopaʻa ʻia ma mua a ma hope o IRS (Fig. 5).ʻO nā koina R2 (P <0.05) o ka hoʻoponopono kūlike i helu ʻia mai nā pōʻai ʻelua o IRS: 0.78 2 pule ma mua o DDT, 0.81 2 pule ma hope o DDT, 0.78 4 mau pule ma hope o DDT, 0.83 ma hope o DDT-DDT 12 pule, DDT Huina ma hope o SP he 0.85, 0.82 2 pule ma mua o SP, 0.38 2 pule ma hope o SP, 0.56 4 pule ma hope o SP, 0.81 12 pule ma hope o SP a me 0.79 2 pule ma hope o SP holoʻokoʻa (Hoʻohui waihona 1: Papa S3).Ua hōʻike ʻia nā hopena ua hoʻonui ʻia ka hopena o ka hana SP-IRS ma nā HT a pau i nā pule 4 ma hope o IRS.ʻAʻole pono ka DDT-IRS no nā HT a pau i nā manawa a pau ma hope o ka hoʻokō ʻana o IRS.Ua hōʻuluʻulu ʻia nā hopena o ka loiloi kahua o ka ʻāpana ʻāina pilikia i hoʻohui ʻia ma ka Papa 5. No nā puni IRS, ʻoi aku ka kiʻekiʻe o ka nui o ka ʻōpae a me ka pākēneka o ka nui o ka nui ma nā wahi kiʻekiʻe (ʻo ia hoʻi, >55%) ʻoi aku ka kiʻekiʻe ma mua o nā wahi haʻahaʻa. nā wahi pilikia ma nā wahi manawa hope-IRS.Kuhi ʻia nā wahi o nā ʻohana entomological (ʻo ia hoʻi nā mea i koho ʻia no ka hōʻiliʻili makika) a ʻike ʻia ma ka waihona hou 1: Kiʻi S2.
ʻEkolu ʻano o nā palapala ʻāina pilikia spatial e pili ana i ka GIS (ʻo ia hoʻi HT, IS a me IRSS a me ka hui pū ʻana o HT, IS a me IRSS) e ʻike i nā wahi pilikia o ka pilau ma mua a ma hope o DDT-IRS ma ke kauhale o Mahnar, Lavapur, ka moku ʻo Vaishali (Bihar)
ʻEkolu mau ʻano palapala ʻāina pilikia spatial ma muli o GIS (ʻo ia ka HT, IS a me IRSS a me ka hui pū ʻana o HT, IS a me IRSS) no ka ʻike ʻana i nā wahi pilikia o ka ʻoʻo i ke kālā (hoʻohālikelike ʻia me Kharbang)
Ua helu ʻia ka hopena o DDT-(a, c, e, g, i) a me SP-IRS (b, d, f, h, j) ma nā pae like ʻole o nā pūʻulu pilikia ʻano home ma ke koho ʻana i ka "R2" ma waena o nā pilikia o ka home. .ʻO ka manaʻo o nā hōʻailona o ka home a me ka awelika nui o P. argentipes 2 mau pule ma mua o ka hoʻokō IRS a me 2, 4 a me 12 mau pule ma hope o ka hoʻokō ʻana o IRS ma ke kauhale ʻo Lavapur Mahnar, ka moku ʻo Vaishali, Bihar
Hōʻuluʻulu ʻo Papa 6 i nā hopena o ka loiloi univariate o nā mea pilikia āpau e pili ana i ka nui o ka flake.Ua ʻike ʻia nā mea pilikia a pau (n = 6) i pili nui me ka nui o ka makika hale.Ua ʻike ʻia ʻo ka pae koʻikoʻi o nā ʻano like ʻole āpau i hana i nā waiwai P ma lalo o 0.15.No laila, ua mālama ʻia nā ʻano wehewehe wehewehe āpau no ka nānā ʻana i ka regression he nui.ʻO ka hui kūpono maikaʻi loa o ke kumu hoʻohālike hope i hana ʻia ma muli o ʻelima mau kumu pilikia: TF, TW, DS, ISV, a me IRSS.Hōʻike ka papa 7 i nā kikoʻī o nā ʻāpana i koho ʻia i ke kumu hoʻohālike hope loa, a me nā lakiō i hoʻoponopono ʻia, 95% mau manawa hilinaʻi (CIs), a me nā waiwai P.He mea koʻikoʻi loa ke kŘkohu hope, me ka waiwai R2 o 0.89 (F(5)=27 .9, P<0.001).
Hoʻokaʻawale ʻia ʻo TR mai ke kumu hoʻohālike hope loa no ka mea liʻiliʻi loa (P = 0.46) me nā ʻano wehewehe wehewehe ʻē aʻe.Ua hoʻohana ʻia ke kumu hoʻohālike i hoʻomohala ʻia e wānana i ka nui o nā lele one ma muli o ka ʻikepili mai 12 mau hale like ʻole.Ua hōʻike ʻia nā hopena hōʻoia i ka pilina ikaika ma waena o nā makika i ʻike ʻia ma ke kula a me nā makika i wānana ʻia e ke kumu hoʻohālike (r = 0.91, P <0.001).
ʻO ka pahuhopu ka hoʻopau ʻana iā VL mai nā mokuʻāina endemic o India e 2020 [10].Mai ka 2012, ua holomua nui ʻo India i ka hōʻemi ʻana i ka hanana a me ka make o VL [10].ʻO ka hoʻololi ʻana mai DDT a SP ma 2015 he hoʻololi nui i ka mōʻaukala o IRS ma Bihar, India [38].No ka hoʻomaopopo ʻana i ka pilikia spatial o VL a me ka nui o kāna mau vectors, ua mālama ʻia nā haʻawina macro-level.Eia nō naʻe, ʻoiai ua hoʻonui nui ʻia ka hoʻolaha ʻana o VL prevalence ma ka ʻāina, ua hana ʻia ka noiʻi liʻiliʻi ma ka micro level.Eia kekahi, ma ka micro level, ʻaʻole kūlike ka ʻikepili a ʻoi aku ka paʻakikī o ka nānā ʻana a hoʻomaopopo.I ka maikaʻi o kā mākou ʻike, ʻo kēia haʻawina ka hōʻike mua e loiloi i ke koena efficacy a me ka hopena intervention o IRS me ka hoʻohana ʻana i nā insecticides DDT a me SP ma waena o nā HT ma lalo o ka National VL Vector Control Program ma Bihar (India).ʻO kēia hoʻi ka hoʻāʻo mua e hoʻomohala i kahi palapala ʻāina pilikia a me ke kumu hoʻohālike noʻonoʻo namu e hōʻike i ka puʻunaue spatiotemporal o nā makika ma ka microscale ma lalo o nā kūlana intervention IRS.
Ua hōʻike ʻia kā mākou hopena ua kiʻekiʻe ka lawe ʻana i ka SP-IRS i ka home ma nā ʻohana āpau a ua hoʻokō piha ʻia ka hapa nui o nā hale.Ua hōʻike ʻia nā hualoaʻa bioassay ʻo nā lele one kālā ma ke kauhale aʻo ua paʻakikī loa i ka beta-cypermethrin akā haʻahaʻa i ka DDT.ʻO ka awelika o ka make ʻana o ka ʻōpae kālā mai DDT ma lalo o 50%, e hōʻike ana i kahi kiʻekiʻe o ke kūʻē ʻana iā DDT.Kūlike kēia me nā hopena o nā haʻawina mua i hana ʻia i nā manawa like ʻole ma nā kauhale like ʻole o VL-endemic states o India, me Bihar [8,9,39,40].Ma waho aʻe o ka naʻau pesticide, ʻo ke koena o ka hopena o nā pesticides a me nā hopena o ka hoʻopili ʻana he ʻike nui pū kekahi.He mea nui ka lōʻihi o nā hopena koena no ka pōʻaiapili polokalamu.Hoʻoholo ia i nā wā ma waena o nā pōʻai o IRS i mālama ʻia ka heluna kanaka a hiki i ka hoʻoheheʻe ʻana aʻe.Ua hōʻike ʻia nā hopena bioassay Cone i nā ʻokoʻa koʻikoʻi o ka make ma waena o nā ʻano ʻili o ka pā i nā manawa like ʻole ma hope o IRS.ʻO ka make ma nā wahi i mālama ʻia e DDT ma lalo o ka pae ʻoluʻolu o WHO (ʻo ia hoʻi, ≥80%), akā ma nā pā i mālama ʻia e SP, ua mau ka make a hiki i ka pule ʻehā ma hope o IRS;Mai kēia mau hualoaʻa, ʻike maopopo ʻia ʻoiai ʻo ka ʻōpae silverleg i loaʻa ma ka wahi aʻo ʻana he maʻalahi loa iā SP, ʻokoʻa ka hopena o ke koena o SP ma muli o HT.E like me DDT, ʻaʻole hoʻi e hoʻokō ʻo SP i ka lōʻihi o ka hopena i kuhikuhi ʻia ma nā alakaʻi WHO [41, 42].Ma muli paha o ka hoʻokō pono ʻole ʻana o ka IRS (ʻo ia hoʻi ka hoʻoneʻe ʻana i ka pamu i ka wikiwiki kūpono, ka mamao mai ka pā, ka nui o ka hoʻokuʻu ʻana a me ka nui o nā kulu wai a me ko lākou waiho ʻana ma ka pā), a me ka hoʻohana pono ʻole ʻana i nā pesticides (ʻo ia hoʻi. hoʻomākaukau hoʻonā) [11,28,43].Eia nō naʻe, ʻoiai ua mālama ʻia kēia haʻawina ma lalo o ka nānā pono ʻana a me ka hoʻomalu ʻana, ʻo ke kumu ʻē aʻe o ka hālāwai ʻole ʻana i ka World Health Organization i ʻōlelo ʻia i ka lā hoʻopau ʻana, ʻo ia paha ka maikaʻi o ka SP (ʻo ia hoʻi, ka pākēneka o ka mea hana a i ʻole "AI") i lilo i ka QC.
ʻO nā ʻano ʻili ʻekolu i hoʻohana ʻia e loiloi i ka hoʻomau ʻana o ka pesticide, ua ʻike ʻia nā ʻokoʻa nui o ka make ma waena o BUU a me CPLC no ʻelua pesticides.ʻO kekahi ʻike hou aʻe, ua hōʻike ʻo CPLC i ka maikaʻi o ke koena o ka hana ma kahi kokoke i nā manawa āpau ma hope o ka pulupulu ʻana i ukali ʻia e nā papa BUU a me PMP.Eia nō naʻe, ʻelua pule ma hope o IRS, ua hoʻopaʻa ʻo PMP i ka helu kiʻekiʻe a me ka lua o ka make nui loa mai DDT a me SP.Hōʻike kēia hopena ʻaʻole mau ka pesticide i waiho ʻia ma ka ʻili o ka PMP no ka manawa lōʻihi.ʻO kēia ʻokoʻa i ka maikaʻi o nā koena pesticides ma waena o nā ʻano pā ma muli paha o nā kumu like ʻole, e like me ke ʻano o nā kemika o ka pā (piʻi ka pH e hiki ai i kekahi mau lāʻau pesticides ke wāwahi wikiwiki), ka helu absorption (ke kiʻekiʻe ma nā paia lepo), loaʻa. ʻO ka hoʻoheheʻe ʻana o ka bacteria a me ka wikiwiki o ka hoʻohaʻahaʻa ʻana i nā mea pā, a me ka mahana a me ka haʻahaʻa [44, 45, 46, 47, 48, 49].Kākoʻo kā mākou mau hualoaʻa i kekahi mau noiʻi ʻē aʻe e pili ana i ke koena o ka hopena o nā ʻili i mālama ʻia i ka insecticide e kūʻē i nā maʻi maʻi like ʻole [45, 46, 50, 51].
Ua hōʻike ʻia nā manaʻo manaʻo o ka emi ʻana o ka makika ma nā hale mālama ʻia he ʻoi aku ka maikaʻi o SP-IRS ma mua o DDT-IRS i ka hoʻomalu ʻana i nā makika ma nā manawa āpau ma hope o ka IRS (P <0.001).No nā pōʻai SP-IRS a me DDT-IRS, ʻo 55.6-90.5% a me 14.1-34.1% ka nui o ka emi ʻana no nā hale mālama ʻia mai 2 a 12 pule.Ua hōʻike pū ʻia kēia mau hopena i nā hopena koʻikoʻi i ka nui o P. argentipes i nā hale kiaʻi i ʻike ʻia i loko o 4 mau pule o ka hoʻokō IRS;Ua hoʻonui ʻia nā argentipes ma nā puni ʻelua o IRS 12 mau pule ma hope o IRS;Eia nō naʻe, ʻaʻohe ʻokoʻa koʻikoʻi o ka nui o nā makika ma nā hale kiaʻi ma waena o nā puni ʻelua o IRS (P = 0.33).ʻAʻole hōʻike ʻia nā hualoaʻa mai ka helu helu helu ʻana o nā ʻōpae kālā ma waena o nā hui ʻohana i kēlā me kēia pōʻai, ʻaʻohe ʻokoʻa koʻikoʻi o ka DDT ma waena o nā hui ʻehā ʻehā (ʻo ia hoʻi, sprayed vs. sentinel; sprayed vs. control; sentinel vs. control; complete vs. partial).).ʻElua pūʻulu ʻohana IRS a me SP-IRS (ʻo ia hoʻi, he sentinel vs. control and full vs. partial).Eia nō naʻe, ʻike ʻia nā ʻokoʻa nui o ka nui o nā ʻōpae kālā ma waena o nā pōʻai DDT a me SP-IRS i loko o nā mahiʻai i hoʻoheheʻe ʻia.ʻO kēia nānā ʻana, i hui pū ʻia me ka helu ʻana i nā hopena intervention i nā manawa he nui ma hope o ka IRS, e hōʻike ana he kūpono ka SP no ka hoʻomalu ʻana i ka makika ma nā hale i mālama ʻia a mālama ʻole ʻia, akā ʻaʻole mālama ʻia.Eia nō naʻe, ʻoiai ʻaʻohe ʻokoʻa koʻikoʻi i ka helu o nā makika ma nā hale kiaʻi ma waena o ka puni DDT-IRS a me SP IRS, ʻoi aku ka haʻahaʻa o ka awelika o nā makika i hōʻiliʻili ʻia i ka pōʻai DDT-IRS i hoʻohālikelike ʻia me ka puni SP-IRS.ʻOi aku ka nui ma mua o ka nui.Hōʻike kēia hopena e loaʻa paha ka hopena heluna kanaka i ka hoʻomake ʻana i ka makika i loko o nā hale i hoʻolele ʻia ka IRS ma waena o ka heluna kanaka.Wahi a nā hopena, ua ʻoi aku ka maikaʻi o ka pale ʻana o SP i ka nahu namu ma mua o DDT i nā lā mua ma hope o IRS.Eia kekahi, aia ka alpha-cypermethrin i ka pūʻulu SP, loaʻa i ka huhū pili a me ka ʻawaʻawa pololei i nā makika a kūpono ia no IRS [51, 52].ʻO kēia paha kekahi o nā kumu nui i loaʻa ai ka hopena liʻiliʻi o ka alpha-cypermethrin i nā outpost.Ua ʻike ʻia kekahi haʻawina [52] ʻoiai ua hōʻike ka alpha-cypermethrin i nā pane e kū nei a me nā helu kiʻekiʻe o ke kīkēkē ʻana i nā hoʻokolohua hoʻokolohua a me nā hale hale, ʻaʻole i hoʻopuka ka pūhui i ka pane hoʻopaʻapaʻa i nā makika ma lalo o nā kūlana hoʻokolohua hoʻomalu.hale kaʻa.pūnaewele puni honua.
I loko o kēia haʻawina, ua kūkulu ʻia ʻekolu ʻano palapala ʻāina pilikia;Ua loiloi ʻia nā manaʻo koʻikoʻi koʻikoʻi o ka pae hale a me ka pae ʻāina ma o ka nānā ʻana i ke kula o ka nui o ka ʻōpae silverleg.Ua hōʻike ʻia ka ʻike ʻana o nā ʻāpana pilikia e pili ana i ka HT ʻo ka hapa nui o nā wahi kauhale (>78%) o Lavapur-Mahanara aia ma ka pae kiʻekiʻe o ka pilikia o ka hiki ʻana mai o ka nahu a me ka puka hou ʻana.ʻO kēia paha ke kumu nui i kaulana ai ʻo Rawalpur Mahanar VL.ʻO ka ISV a me IRSS holoʻokoʻa, a me ka palapala ʻāina i hui pū ʻia, ua ʻike ʻia e hana i kahi haʻahaʻa haʻahaʻa o nā wahi ma lalo o nā wahi pilikia nui i ka wā o ka puni SP-IRS (akā ʻaʻole ka puni DDT-IRS).Ma hope o SP-IRS, ua hoʻololi ʻia nā wahi nui o nā ʻāpana pilikia kiʻekiʻe a haʻahaʻa e pili ana i ka GT i nā ʻāpana haʻahaʻa haʻahaʻa (ʻo ia hoʻi, 60.5%; nā manaʻo koho palapala ʻāina pilikia), ʻaneʻane ʻehā manawa haʻahaʻa (16.2%) ma mua o DDT.- Aia ke kūlana ma ka palapala hoʻoweliweli portfolio IRS ma luna.Hōʻike kēia hopena i ka IRS ke koho kūpono no ka hoʻomalu namu, akā ʻo ke kiʻekiʻe o ka pale e pili ana i ka maikaʻi o ka insecticide, ka ʻike (i ka vector target), ka ʻae ʻia (i ka manawa o IRS) a me kāna noi;
Ua hōʻike ʻia nā hopena loiloi pilikia o ka hale i ka ʻaelike maikaʻi (P <0.05) ma waena o nā kuhi pilikia a me ka nui o ka ʻoʻo silverleg i hōʻiliʻili ʻia mai nā hale like ʻole.Hōʻike kēia i nā ʻāpana pilikia o ka home i ʻike ʻia a me kā lākou mau helu pilikia i kūpono no ka helu ʻana i ka nui o ka ʻōpae kālā.He ≥ 0.78 ka waiwai R2 o ka helu aelike post-IRS DDT, ua like a oi aku paha ma mua o ka waiwai mamua-IRS (ie, 0.78).Ua hōʻike nā hualoaʻa i ka maikaʻi o DDT-IRS ma nā wahi pilikia a pau o HT (ʻo ia hoʻi, kiʻekiʻe, waena, a haʻahaʻa).No ka puni SP-IRS, ua ʻike mākou ua loli ke kumukūʻai o R2 i ka lua a me ka ʻehā o nā pule ma hope o ka hoʻokō ʻana o IRS, ʻelua mau pule ma mua o ka hoʻokō IRS a me 12 mau pule ma hope o ka hoʻokō IRS ua aneane like;Hōʻike kēia hopena i ka hopena koʻikoʻi o ka hoʻolaha ʻana o SP-IRS i nā makika, ka mea i hōʻike i ka emi ʻana o ka manawa ma hope o IRS.Ua hōʻike ʻia ka hopena o SP-IRS a ua kūkākūkā ʻia ma nā mokuna mua.
Ua hōʻike ʻia nā hualoaʻa mai ka loiloi kahua o nā ʻāpana pilikia o ka palapala ʻāina i hoʻohui ʻia i ka wā o ka puni IRS, ua hōʻiliʻili ʻia ka helu kiʻekiʻe o nā ʻōpae kālā ma nā ʻāpana pilikia nui (ʻo ia hoʻi, >55%), a ukali ʻia e nā ʻāpana waena a haʻahaʻa.ʻO ka hōʻuluʻulu manaʻo, ua hōʻike ʻia ka loiloi pilikia spatial pili i ka GIS he mea hana hoʻoholo kūpono no ka hōʻuluʻulu ʻana i nā papa like ʻole o ka ʻikepili spatial pakahi a i hui pū ʻia e ʻike i nā wahi pilikia o ka lele one.Hāʻawi ka palapala ʻāina pilikia i hoʻomohala ʻia i ka ʻike piha o nā kūlana ma mua a ma hope o ka hana ʻana (ʻo ia hoʻi, ke ʻano o ka home, ke kūlana IRS, a me nā hopena wawao) ma kahi e noiʻi ai i ka hana koke a i ʻole ka hoʻomaikaʻi ʻana, ʻoi aku ma ka micro level.He kūlana kaulana loa.ʻO kaʻoiaʻiʻo, ua hoʻohana kekahi mau haʻawina i nā mea hana GIS e palapala i ka pilikia o nā pūnaewele hoʻoulu vector a me ka hoʻolaha ākea o nā maʻi ma ka pae macro [24, 26, 37].
Ua helu helu ʻia nā hiʻohiʻona hale a me nā mea pilikia no ka IRS-based interventions no ka hoʻohana ʻana i ka hoʻopaʻa ʻana i ka nui o ka ʻōpae kālā.ʻOiai ua pili nui nā kumu ʻeono (ʻo ia hoʻi, TF, TW, TR, DS, ISV, a me IRSS) me ka nui o ka ʻōpae silverleg i nā ʻano loiloi univariate, hoʻokahi wale nō o lākou i koho ʻia i ka hoʻohālike hoʻihoʻi lehulehu hope loa o ka ʻelima.Hōʻike nā hopena i nā hiʻohiʻona hoʻokele pio a me nā kumu hana o IRS TF, TW, DS, ISV, IRSS, a me nā mea ʻē aʻe ma ka wahi aʻo i kūpono no ka nānā ʻana i ka puka ʻana, hoʻihoʻi ʻana a me ka hana hou ʻana o ka ʻōpae kālā.I ka nui o ka regression analysis, ʻaʻole i ʻike ʻia ʻo TR he mea nui a no laila ʻaʻole i koho ʻia i ke kumu hoʻohālike hope.He mea koʻikoʻi loa ke kumu hoʻohālike hope, me nā ʻāpana i koho ʻia e wehewehe ana i ka 89% o ka nui o ka ʻoʻo silverleg.Ua hōʻike ʻia nā hopena pololei o ke kŘkohu i ka pilina ikaika ma waena o nā ʻōpae kālā i wānana ʻia a i ʻike ʻia.Kākoʻo kā mākou mau hopena i nā noiʻi mua e kūkākūkā ana i nā mea pili i ka socioeconomic a me nā pilikia o ka hale e pili ana i ka hoʻolaha ʻana o VL a me ka hoʻohele spatial o vector ma ke kuaʻāina ʻo Bihar [15, 29].
Ma kēia noiʻi ʻana, ʻaʻole mākou i loiloi i ka waiho ʻana o ka pesticide ma nā paia i hoʻoheheʻe ʻia a me ka maikaʻi (ʻo ia hoʻi) o ka pesticide i hoʻohana ʻia no IRS.Hiki i nā ʻano like ʻole o ka maikaʻi a me ka nui o ka pesticide ke hoʻopilikia i ka make namu a me ka maikaʻi o nā hana IRS.No laila, ʻokoʻa paha ka make ma waena o nā ʻano o ka ʻili a me nā hopena i waena o nā hui home mai nā hopena maoli.Ma ka noʻonoʻo ʻana i kēia mau mea, hiki ke hoʻolālā ʻia kahi noiʻi hou.ʻO ka loiloi o ka nui o nā wahi i pilikia (me ka hoʻohana ʻana i ka palapala ʻāina pilikia GIS) o nā kauhale aʻo e pili ana i nā wahi ākea ma waena o nā kauhale, kahi e hoʻopili ai i ka hoʻokaʻawale ʻana o nā ʻāpana pilikia (ʻo ia hoʻi ka ʻike ʻana o nā ʻāpana) a hoʻonui i nā ʻāpana pilikia like ʻole;Eia nō naʻe, ua mālama ʻia kēia haʻawina ma ka micro level, no laila he liʻiliʻi ka hopena o ka ʻāina hakahaka i ka hoʻokaʻawale ʻana i nā wahi pilikia;Eia kekahi, ʻo ka ʻike ʻana a me ka loiloi ʻana i nā ʻāpana pilikia like ʻole i loko o ka huina o ke kauhale hiki ke hāʻawi i kahi manawa e koho ai i nā wahi no ke kūkulu hale hou e hiki mai ana (ʻoi aku ka koho ʻana o nā wahi haʻahaʻa haʻahaʻa).ʻO ka holoʻokoʻa, hāʻawi nā hopena o kēia noiʻi i nā ʻike like ʻole i aʻo ʻole ʻia ma ka pae microscopic ma mua.ʻO ka mea nui loa, ʻo ka hōʻike kikoʻī o ka palapala ʻāina pilikia o ke kauhale e kōkua i ka ʻike ʻana a me ka hui pū ʻana i nā ʻohana ma nā wahi pilikia like ʻole, ke hoʻohālikelike ʻia me nā anana ʻāina kuʻuna, maʻalahi kēia ʻano, kūpono, kumukūʻai a me ka liʻiliʻi o ka hana, hāʻawi i ka ʻike i nā mea hoʻoholo.
Hōʻike kā mākou mau hopena i ka loaʻa ʻana o ka iʻa kālā maoli ma ke kauhale aʻo i ke kūʻē (ʻo ia hoʻi, kūʻē loa) iā DDT, a ua ʻike ʻia ka puka ʻana o ka makika ma hope koke o ka IRS;ʻIke ʻia ʻo Alpha-cypermethrin ke koho kūpono no ka mana IRS o nā vectors VL ma muli o kona 100% make a me ka maikaʻi o ka hana ʻana i nā silverflies, a me kona ʻae ʻana i ke kaiāulu maikaʻi aʻe i hoʻohālikelike ʻia me DDT-IRS.Eia naʻe, ua ʻike mākou he ʻokoʻa ka make makika ma nā pā i mālama ʻia e SP ma muli o ke ʻano o ka ʻili;ʻike ʻia ka maikaʻi ʻole o ke koena a ua ʻōlelo ʻo WHO i ka manawa ma hope o ka loaʻa ʻole o IRS.Hāʻawi kēia haʻawina i kahi hoʻomaka maikaʻi no ke kūkākūkā ʻana, a ʻo kāna mau hopena e pono ai ka noiʻi hou ʻana e ʻike i nā kumu kumu maoli.Ua hōʻike ʻia ka pololei wānana o ke kumu hoʻohālike hoʻohālikelike o nā ʻano o ka hale, ka ʻike insecticide o nā vectors a me ke kūlana IRS no ka hoʻohālikelike ʻana i ka density lele one ma nā kauhale endemic VL ma Bihar.Hōʻike pū kā mākou haʻawina ʻo ka hoʻopili ʻia ʻana o GIS-based spatial risk mapping (macro level) hiki ke lilo i mea hana pono no ka ʻike ʻana i nā wahi pilikia e nānā i ka puka ʻana a me ka puka hou ʻana o nā one ma mua a ma hope o nā hālāwai IRS.Eia hou, hāʻawi nā palapala 'āina pilikia i ka hoʻomaopopo piha ʻana i ka nui a me ke ʻano o nā wahi pilikia ma nā pae like ʻole, ʻaʻole hiki ke aʻo ʻia ma o nā loiloi kahua kuʻuna a me nā ʻano ohi ʻikepili maʻamau.Hiki ke kōkua i nā ʻepekema a me nā mea noiʻi olakino olakino e hoʻomohala a hoʻokō i nā hoʻolālā hoʻokele hou (ʻo ia hoʻi ka hana hoʻokahi a i ʻole ka mana vector hoʻohui ʻia) e hiki ai i nā hui like ʻole o ka home ma muli o ke ʻano o nā pae pilikia.Eia hou, kōkua ka palapala ʻāina pilikia i ka hoʻokaʻawale ʻana a me ka hoʻohana ʻana i nā kumuwaiwai mana i ka manawa kūpono a me kahi e hoʻomaikaʻi ai i ka pono o ka papahana.
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