He kuleana koʻikoʻi ko nā pesticides i ka mahiʻai ma nā kuaʻāina, akā ʻo ko lākou nui a hoʻohana pono ʻole paha e hiki ke hoʻopilikia maikaʻi ʻole i nā kulekele kaohi ʻana i nā maʻi malaria; Ua hana ʻia kēia noiʻi ma waena o nā kaiāulu mahiʻai ma ka hema o Côte d'Ivoire e hoʻoholo ai i nā pesticides e hoʻohana ʻia e nā mahiʻai kūloko a pehea e pili ai kēia i ka manaʻo o nā mahiʻai no ka malaria. ʻO ka hoʻomaopopo ʻana i ka hoʻohana ʻana i nā pesticides hiki ke kōkua i ka hoʻomohala ʻana i nā papahana hoʻomaopopo e pili ana i ka kaohi ʻana i nā makika a me ka hoʻohana ʻana i nā pesticides.
Ua mālama ʻia ke anamanaʻo ma waena o 1,399 mau ʻohana ma 10 mau kauhale. Ua anamanaʻo ʻia nā mahiʻai e pili ana i kā lākou hoʻonaʻauao ʻana, nā hana mahiʻai (e laʻa, ka hana ʻana i nā mea kanu, ka hoʻohana ʻana i nā pesticide), nā manaʻo o ka malaria, a me nā ʻano hana hoʻomalu namu like ʻole a lākou e hoʻohana ai. Ua loiloi ʻia ke kūlana socioeconomic (SES) o kēlā me kēia ʻohana ma muli o kekahi mau waiwai o ka ʻohana i hoʻoholo mua ʻia. Ua helu ʻia nā pilina helu ma waena o nā loli like ʻole, e hōʻike ana i nā kumu pilikia koʻikoʻi.
Ua pili nui ka pae hoʻonaʻauao o nā mahiʻai me ko lākou kūlana socioeconomic (p < 0.0001). Ua manaʻo ka hapa nui o nā ʻohana (88.82%) ʻo nā makika ke kumu nui o ka malaria a ua pili maikaʻi ka ʻike o ka malaria me ka pae hoʻonaʻauao kiʻekiʻe (OR = 2.04; 95% CI: 1.35, 3.10). Ua pili nui ka hoʻohana ʻana i nā kemika i loko me ke kūlana socioeconomic o ka ʻohana, ka pae hoʻonaʻauao, ka hoʻohana ʻana i nā ʻupena moe i mālama ʻia me ka insecticide a me nā insecticide mahiʻai (p < 0.0001). Ua ʻike ʻia ua hoʻohana nā mahiʻai i nā insecticide pyrethroid i loko o ka hale a hoʻohana i kēia mau insecticide e pale i nā mea kanu.
Hōʻike kā mākou noiʻi ʻo ka pae hoʻonaʻauao ke kumu nui e hoʻohuli ai i ka ʻike o ka poʻe mahiʻai i ka hoʻohana ʻana i nā pesticide a me ka kaohi ʻana i ka malaria. Manaʻo mākou e noʻonoʻo ʻia ka hoʻomaikaʻi ʻana i ke kamaʻilio ʻana e pili ana i ka hoʻokō ʻana i ka hoʻonaʻauao, me ke kūlana socioeconomic, ka loaʻa ʻana, a me ke komo ʻana i nā huahana kemika i kāohi ʻia i ka wā e hoʻomohala ai i ka hoʻokele pesticide a me nā hana hoʻokele maʻi vector no nā kaiāulu kūloko.
ʻO ka mahiʻai ke kumu nui o ka hoʻokele waiwai no nā ʻāina he nui o ʻApelika Komohana. I ka makahiki 2018 a me 2019, ʻo Côte d'Ivoire ka mea hana nui o ka koko a me nā nati cashew ma ka honua a ʻo ke kolu o ka mea hana kofe nui loa ma ʻApelika [1], me nā lawelawe mahiʻai a me nā huahana e helu ana no 22% o ka huahana kūloko nui (GDP) [2]. Ma ke ʻano he poʻe nona ka hapa nui o ka ʻāina mahiʻai, ʻo nā mea mahiʻai liʻiliʻi ma nā wahi kuaʻāina nā mea nui e kōkua i ka hoʻomohala waiwai o ka ʻāpana [3]. He nui ka hiki ke mahiʻai o ka ʻāina, me 17 miliona heketa o ka ʻāina mahiʻai a me nā ʻano kau like ʻole e makemake ana i ka hoʻololi ʻana o nā mea kanu a me ka mahi ʻana i ke kofe, koko, nati cashew, rubber, pulupulu, ʻuala, pama, cassava, laiki a me nā mea kanu [2]. Hāʻawi ka mahiʻai ikaika i ka laha ʻana o nā mea ʻino, ʻo ia hoʻi ma o ka hoʻonui ʻana i ka hoʻohana ʻana i nā pesticides no ka kaohi ʻana i nā mea ʻino [4], ʻoi aku hoʻi i waena o nā mahiʻai kuaʻāina, e pale i nā mea kanu a hoʻonui i nā hua mea kanu [5], a e kaohi i nā makika [6]. Eia nō naʻe, ʻo ka hoʻohana pono ʻole ʻana i nā insecticides kekahi o nā kumu nui o ke kūʻē ʻana i nā insecticides i nā mea lawe maʻi, ʻoi aku hoʻi ma nā wahi mahiʻai kahi e hiki ai i nā makika a me nā mea ʻino mai nā mea kanu ke hoʻopilikia ʻia e nā insecticides like [7,8,9,10]. Hiki i ka hoʻohana ʻana i nā pesticide ke hana i ka haumia e hoʻopilikia i nā hoʻolālā kaohi vector a me ke kaiapuni a no laila pono e nānā ʻia [11, 12, 13, 14, 15].
Ua aʻo ʻia ka hoʻohana ʻana o nā pesticides e nā mahiʻai i ka wā ma mua [5, 16]. Ua hōʻike ʻia ka pae o ka hoʻonaʻauao he kumu nui i ka hoʻohana pono ʻana i nā pesticides [17, 18], ʻoiai ua hoʻopili pinepine ʻia ka hoʻohana ʻana o nā pesticides e nā mahiʻai e ka ʻike empirical a i ʻole nā ʻōlelo aʻoaʻo mai nā mea kūʻai aku [5, 19, 20]. ʻO nā palena kālā kekahi o nā pale maʻamau e kaupalena ana i ke komo ʻana i nā pesticides a i ʻole nā mea pepehi kanaka, e alakaʻi ana i nā mahiʻai e kūʻai i nā huahana kū ʻole i ke kānāwai a i ʻole nā huahana kahiko, ʻoi aku ka liʻiliʻi o ke kumukūʻai ma mua o nā huahana kū kānāwai [21, 22]. ʻIke ʻia nā ʻano like ma nā ʻāina ʻē aʻe o ʻApelika Komohana, kahi i lilo ai ka loaʻa kālā haʻahaʻa i kumu no ke kūʻai ʻana a me ka hoʻohana ʻana i nā pesticides kūpono ʻole [23, 24].
Ma Côte d'Ivoire, hoʻohana nui ʻia nā pesticides ma nā mea kanu [25, 26], kahi e hoʻopilikia ai i nā hana mahiʻai a me nā heluna kanaka vector malaria [27, 28, 29, 30]. Ua hōʻike nā haʻawina ma nā wahi i loaʻa i ka malaria i kahi pilina ma waena o ke kūlana socioeconomic a me nā manaʻo o ka malaria a me nā pilikia o ka maʻi, a me ka hoʻohana ʻana i nā ʻupena moe i mālama ʻia me ka insecticide (ITN) [31,32,33,34,35,36,37]. Me kēia mau haʻawina, ua hoʻohaʻahaʻa ʻia nā hoʻoikaika e hoʻomohala i nā kulekele kaohi namu kikoʻī e ka nele o ka ʻike e pili ana i ka hoʻohana ʻana i ka pesticide ma nā wahi kuaʻāina a me nā mea e kōkua ai i ka hoʻohana pono ʻana i ka pesticide. Ua nānā kēia haʻawina i nā manaʻoʻiʻo malaria a me nā hoʻolālā kaohi namu ma waena o nā ʻohana mahiʻai ma Abeauville, ma ka hema o Côte d'Ivoire.
Ua mālama ʻia ke aʻo ʻana ma 10 mau kauhale ma ka ʻoihana ʻo Abeauville ma ka hema o Côte d'Ivoire (Kiʻi 1). He 292,109 ka poʻe noho ma ka Panalāʻau ʻo Agbowell ma kahi o 3,850 kilomita kuea a ʻo ia ka panalāʻau nui loa ma ka ʻāina ʻo Anyebi-Tiasa [38]. He aniau wela kona me ʻelua mau kau ua (ʻApelila a Iulai a ʻOkakopa a Nowemapa) [39, 40]. ʻO ka mahiʻai ka hana nui ma ka ʻāina a mālama ʻia e nā mahiʻai liʻiliʻi a me nā ʻoihana mahiʻai nui. ʻO kēia mau wahi he 10 e pili ana iā Aboude Boa Vincent (323,729.62 E, 651,821.62 N), Aboude Kuassikro (326,413.09 E, 651,573.06 N), Aboude Mandek (326,413.09 E , 60157) Abude. (330633.05E, 652372.90N), Amengbeu (348477.76E, 664971.70N), Damojiang (374,039.75 E, 661,579.59 N), Casigue 1 (363,140.145) (351,545.32 E., 642.06 2.37 N), ʻOfa (350 924.31 E, 654 607.17 N), ʻOfonbo (338 578.5) 1 E, 657 302.17 latitu ʻākau) a me Uji (363,990.74 longitude hikina, 648,587.44 latitu ʻākau).
Ua mālama ʻia ke aʻo ʻana ma waena o ʻAukake 2018 a me Malaki 2019 me ke komo ʻana o nā ʻohana mahiʻai. Ua loaʻa ka huina o nā kamaʻāina ma kēlā me kēia kauhale mai ka ʻoihana lawelawe kūloko, a ua koho wale ʻia he 1,500 poʻe mai kēia papa inoa. ʻO nā mea i komo i koho ʻia ma waena o 6% a me 16% o ka heluna kanaka o ke kauhale. ʻO nā ʻohana i komo i loko o ke aʻo ʻana, ʻo ia nā ʻohana mahiʻai i ʻae e komo. Ua mālama ʻia kahi noiʻi mua ma waena o 20 mau mahiʻai e loiloi inā pono e kākau hou ʻia kekahi mau nīnau. A laila ua hoʻopiha ʻia nā nīnau nīnau e nā mea hōʻiliʻili ʻikepili i aʻo ʻia a uku ʻia ma kēlā me kēia kauhale, ma ka liʻiliʻi hoʻokahi o lākou i koho ʻia mai ke kauhale ponoʻī. Ua hōʻoia kēia koho he loaʻa i kēlā me kēia kauhale ma ka liʻiliʻi hoʻokahi mea hōʻiliʻili ʻikepili i kamaʻāina i ke kaiapuni a ʻōlelo i ka ʻōlelo kūloko. Ma kēlā me kēia ʻohana, ua mālama ʻia kahi ninaninau maka-a-maka me ke poʻo o ka ʻohana (makua kāne a makuahine paha) a i ʻole, inā ʻaʻohe ke poʻo o ka ʻohana, kekahi pākeke ma luna o 18 mau makahiki. Aia i loko o ka nīnau nīnau he 36 mau nīnau i māhele ʻia i ʻekolu ʻāpana: (1) Ke kūlana demographic a me ka nohona-hoʻokele waiwai o ka ʻohana (2) Nā hana mahiʻai a me ka hoʻohana ʻana i nā pesticides (3) ʻIke e pili ana i ka malaria a me ka hoʻohana ʻana i nā insecticides no ka kaohi ʻana i nā makika [e nānā i ka Annex 1].
Ua hoʻopaʻa inoa ʻia nā pesticides i ʻōlelo ʻia e nā mahiʻai e ka inoa kālepa a ua hoʻokaʻawale ʻia e nā mea hana a me nā hui kemika me ka hoʻohana ʻana i ka Ivory Coast Phytosanitary Index [41]. Ua loiloi ʻia ke kūlana socioeconomic o kēlā me kēia ʻohana ma ka helu ʻana i kahi helu kuhikuhi waiwai [42]. Ua hoʻololi ʻia nā waiwai o ka ʻohana i nā loli dichotomous [43]. Pili nā helu kumu maikaʻi ʻole me ke kūlana socioeconomic haʻahaʻa (SES), ʻoiai pili nā helu kumu maikaʻi me ka SES kiʻekiʻe. Hōʻuluʻulu ʻia nā helu waiwai e hana i kahi helu holoʻokoʻa no kēlā me kēia ʻohana [35]. Ma muli o ka helu holoʻokoʻa, ua māhele ʻia nā ʻohana i ʻelima mau quintiles o ke kūlana socioeconomic, mai ka ʻilihune loa a i ka waiwai loa [e ʻike i ka faila hou 4].
No ka hoʻoholo ʻana inā ʻokoʻa nui kahi loli e ke kūlana socioeconomic, kauhale, a i ʻole ka pae hoʻonaʻauao o nā poʻo o ka home, hiki ke hoʻohana ʻia ka hoʻāʻo chi-square a i ʻole ka hoʻāʻo pololei a Fisher, e like me ke kūpono. Ua hoʻopili ʻia nā hiʻohiʻona regression logistic me nā loli wānana: pae hoʻonaʻauao, kūlana socioeconomic (ua hoʻololi ʻia nā mea āpau i nā loli dichotomous), kauhale (i hoʻokomo ʻia ma ke ʻano he mau loli categorical), pae kiʻekiʻe o ka ʻike e pili ana i ka malaria a me ka hoʻohana ʻana i ka pesticide i ka mahiʻai, a me ka hoʻohana ʻana i ka pesticide i loko o ka hale (hoʻopuka ma o ka aerosol). a i ʻole coil); pae hoʻonaʻauao, kūlana socio-economic a me ke kauhale, e hopena ana i ka ʻike kiʻekiʻe o ka malaria. Ua hana ʻia kahi kumu hoʻohālike regression hui logistic me ka hoʻohana ʻana i ka pūʻolo R lme4 (hana Glmer). Ua hana ʻia nā loiloi helu ma R 4.1.3 (https://www.r-project.org) a me Stata 16.0 (StataCorp, College Station, TX).
Ma waena o nā nīnauele 1,500 i mālama ʻia, ua kāpae ʻia he 101 mai ka loiloi ʻana no ka mea ʻaʻole i hoʻopau ʻia ka nīnau. ʻO ka hapa nui loa o nā ʻohana i noiʻi ʻia ma Grande Maury (18.87%) a ʻo ka haʻahaʻa loa ma Ouanghi (2.29%). ʻO nā ʻohana 1,399 i noiʻi ʻia i hoʻokomo ʻia i loko o ka loiloi e hōʻike ana i ka heluna kanaka o 9,023 mau kānaka. E like me ka mea i hōʻike ʻia ma ka Papa 1, 91.71% o nā poʻo ʻohana he kāne a he 8.29% he wahine.
Ma kahi o 8.86% o nā poʻo ʻohana i hele mai mai nā ʻāina pili e like me Benin, Mali, Burkina Faso a me Ghana. ʻO nā hui lāhui i hōʻike nui ʻia ʻo Abi (60.26%), Malinke (10.01%), Krobu (5.29%) a me Baulai (4.72%). E like me ka mea i manaʻo ʻia mai ka laʻana o nā mahiʻai, ʻo ka mahiʻai wale nō ke kumu loaʻa kālā no ka hapa nui o nā mahiʻai (89.35%), me ka cocoa e ulu pinepine ʻia ana i loko o nā ʻohana laʻana; Ua ulu pū ʻia nā mea kanu, nā mea kanu meaʻai, ka laiki, ka laholio a me ka maiʻa ma kahi ʻāina liʻiliʻi. ʻO nā poʻo ʻohana i koe he poʻe kālepa, nā mea pena kiʻi a me nā lawaiʻa (Papa 1). Hōʻike ʻia kahi hōʻuluʻulu manaʻo o nā ʻano o ka ʻohana ma ke kauhale ma ka faila Hoʻohui [e nānā i ka faila Hoʻohui 3].
ʻAʻole ʻokoʻa ka māhele hoʻonaʻauao ma muli o ke kāne (p = 0.4672). ʻO ka hapa nui o ka poʻe i pane mai ua loaʻa ka hoʻonaʻauao kula haʻahaʻa (40.80%), ukali ʻia e ka hoʻonaʻauao kula kiʻekiʻe (33.41%) a me ka heluhelu ʻole (17.97%). ʻO 4.64% wale nō i komo i ke kulanui (Papa 1). No nā wahine 116 i ninaninau ʻia, ʻoi aku ma mua o 75% i loaʻa ka hoʻonaʻauao kula haʻahaʻa, a ʻo ke koena ʻaʻole i hele i ke kula. ʻOkoʻa loa ka pae hoʻonaʻauao o nā mahiʻai ma nā kauhale (hoʻāʻo pololei a Fisher, p < 0.0001), a ʻo ka pae hoʻonaʻauao o nā poʻo o ka home ua pili pono me ko lākou kūlana socioeconomic (hoʻāʻo pololei a Fisher, p < 0.0001). ʻO ka ʻoiaʻiʻo, ʻo nā quintiles kūlana socioeconomic kiʻekiʻe loa he mau mahiʻai i ʻoi aku ka naʻauao, a ʻo ka ʻaoʻao ʻē aʻe, ʻo nā quintiles kūlana socioeconomic haʻahaʻa loa he mau mahiʻai heluhelu ʻole; Ma muli o ka huina waiwai, ua māhele ʻia nā ʻohana laʻana i ʻelima mau quintiles waiwai: mai ka ʻilihune loa (Q1) a i ka mea waiwai loa (Q5) [e nānā i ka faila hou 4].
Aia nā ʻokoʻa koʻikoʻi i ke kūlana male o nā poʻo o nā ʻohana o nā papa waiwai like ʻole (p < 0.0001): 83.62% he monogamous, 16.38% he polygamous (a hiki i 3 mau hoa kāne a wahine paha). ʻAʻohe ʻokoʻa koʻikoʻi i loaʻa ma waena o ka papa waiwai a me ka helu o nā hoa kāne a wahine paha.
Ua manaʻo ka hapa nui o ka poʻe i pane mai (88.82%) ʻo nā makika kekahi o nā kumu o ka malaria. 1.65% wale nō i pane mai ʻaʻole lākou i ʻike i ke kumu o ka malaria. ʻO nā kumu ʻē aʻe i ʻike ʻia, ʻo ia ka inu ʻana i ka wai lepo, ka ʻike ʻana i ka lā, ka ʻai maikaʻi ʻole a me ka luhi (Papa 2). Ma ka pae kauhale ma Grande Maury, ua manaʻo ka hapa nui o nā ʻohana ʻo ka inu ʻana i ka wai lepo ke kumu nui o ka malaria (ʻokoʻa helu ma waena o nā kauhale, p < 0.0001). ʻO nā hōʻailona nui ʻelua o ka malaria, ʻo ia ke kiʻekiʻe o ke kino (78.38%) a me ka melemele o nā maka (72.07%). Ua ʻōlelo pū nā mahiʻai i ka luaʻi ʻana, ka anemia a me ka pallor (e nānā i ka Papa 2 ma lalo).
Ma waena o nā hoʻolālā pale malaria, ua ʻōlelo ka poʻe pane i ka hoʻohana ʻana i nā lāʻau lapaʻau kuʻuna; akā naʻe, i ka wā maʻi, ua manaʻo ʻia nā lāʻau lapaʻau biomedical a me nā lāʻau lapaʻau kuʻuna malaria he mau koho kūpono (80.01%), me nā makemake e pili ana i ke kūlana socioeconomic. Pili koʻikoʻi (p < 0.0001). ): Makemake nā mahiʻai me ke kūlana socioeconomic kiʻekiʻe a hiki ke uku i nā lāʻau lapaʻau biomedical, makemake nā mahiʻai me ke kūlana socioeconomic haʻahaʻa i nā lāʻau lapaʻau kuʻuna; Ma kahi o ka hapalua o nā ʻohana e hoʻolilo ma ka awelika ma mua o 30,000 XOF i kēlā me kēia makahiki no ka lāʻau lapaʻau malaria (pili maikaʻi ʻole me SES; p < 0.0001). Ma muli o nā kuhi kumukūʻai pololei i hōʻike ʻia e ka poʻe ponoʻī, ʻoi aku ka nui o nā ʻohana me ke kūlana socioeconomic haʻahaʻa e hoʻolilo iā XOF 30,000 (ma kahi o US$50) i ka lāʻau lapaʻau malaria ma mua o nā ʻohana me ke kūlana socioeconomic kiʻekiʻe loa. Eia kekahi, ua manaʻo ka hapa nui o nā mea pane he ʻoi aku ka maʻalahi o nā keiki (49.11%) i ka malaria ma mua o nā pākeke (6.55%) (Papa 2), me kēia manaʻo i ʻoi aku ka maʻamau i waena o nā ʻohana ma ka quintile ʻilihune loa (p < 0.01).
No nā nahu makika, ua hōʻike ka hapa nui o nā mea komo (85.20%) i ka hoʻohana ʻana i nā ʻupena moe i mālama ʻia me ka lāʻau make pepeke, a lākou i loaʻa nui ai i ka wā o ka hoʻolaha ʻāina 2017. Ua hōʻike ʻia nā pākeke a me nā keiki e hiamoe ana ma lalo o nā ʻupena makika i mālama ʻia me ka lāʻau make pepeke ma 90.99% o nā ʻohana. ʻO ka pinepine o ka hoʻohana ʻana o ka ʻohana i nā ʻupena moe i mālama ʻia me ka lāʻau make pepeke ma luna o 70% ma nā kauhale āpau koe wale nō ke kauhale ʻo Gessigye, kahi i hōʻike wale ʻia he 40% o nā ʻohana e hoʻohana ana i nā ʻupena moe i mālama ʻia me ka lāʻau make pepeke. ʻO ka awelika o ka nui o nā ʻupena moe i mālama ʻia me ka lāʻau make pepeke nona kahi ʻohana ua pili pono a maikaʻi hoʻi me ka nui o ka ʻohana (Pearson's correlation coefficient r = 0.41, p < 0.0001). Ua hōʻike pū kā mākou mau hopena he ʻoi aku ka nui o ka hoʻohana ʻana o nā ʻohana me nā keiki ma lalo o 1 makahiki i nā ʻupena moe i mālama ʻia me ka lāʻau make pepeke ma ka home i hoʻohālikelike ʻia me nā ʻohana me ka ʻole o nā keiki a i ʻole me nā keiki makua (odds ratio (OR) = 2.08, 95% CI: 1.25–3.47).
Ma waho aʻe o ka hoʻohana ʻana i nā ʻupena moe i mālama ʻia me ka insecticide, ua nīnau ʻia nā mahiʻai e pili ana i nā ʻano hana kaohi namu ʻē aʻe i loko o ko lākou mau home a ma nā huahana mahiʻai i hoʻohana ʻia e kaohi i nā mea ʻino o nā mea kanu. ʻO 36.24% wale nō o nā mea komo i ʻōlelo i ka pīpī ʻana i nā pesticides i loko o ko lākou mau home (pili koʻikoʻi a maikaʻi me SES p < 0.0001). ʻO nā mea hoʻohui kemika i hōʻike ʻia mai ʻeiwa mau hōʻailona kalepa a ua hoʻolako nui ʻia i nā mākeke kūloko a me kekahi mau mea kūʻai aku ma ke ʻano o nā coils fumigating (16.10%) a me nā insecticide sprays (83.90%). Ua hoʻonui ʻia ka hiki o nā mahiʻai ke kapa i nā inoa o nā pesticides i pīpī ʻia ma ko lākou mau hale me ko lākou pae hoʻonaʻauao (12.43%; p < 0.05). Ua kūʻai mua ʻia nā huahana agrochemical i hoʻohana ʻia i loko o nā canisters a hoʻoheheʻe ʻia i loko o nā sprayers ma mua o ka hoʻohana ʻana, me ka hapa nui loa i manaʻo ʻia no nā mea kanu (78.84%) (Papa 2). ʻO ke kauhale ʻo Amangbeu ka hapa haʻahaʻa loa o nā mahiʻai e hoʻohana ana i nā pesticides i loko o ko lākou mau home (0.93%) a me nā mea kanu (16.67%).
ʻO ka nui loa o nā huahana insecticidal (nā sprays a i ʻole nā coils) i koi ʻia no kēlā me kēia ʻohana he 3, a ua pili pono ʻo SES me ka nui o nā huahana i hoʻohana ʻia (hoʻāʻo pololei a Fisher p <0.0001, akā naʻe i kekahi mau hihia ua ʻike ʻia kēia mau huahana he like); nā mea hana ma lalo o nā inoa kālepa like ʻole. Hōʻike ka Papa 2 i ke alapine o ka hoʻohana ʻana i ka pesticide i kēlā me kēia pule ma waena o nā mahiʻai e like me ko lākou kūlana socioeconomic.
ʻO nā Pyrethroids ka ʻohana kemika i hōʻike nui ʻia ma nā ʻōpala pesticides home (48.74%) a me nā mahiʻai (54.74%). Hana ʻia nā huahana mai kēlā me kēia pesticides a i ʻole i hui pū ʻia me nā pesticides ʻē aʻe. ʻO nā hui maʻamau o nā insecticides home he carbamates, organophosphates a me pyrethroids, ʻoiai ʻo neonicotinoids a me pyrethroids he mea maʻamau i waena o nā insecticides mahiʻai (Appendix 5). Hōʻike ka Kiʻi 2 i ka hapa o nā ʻohana like ʻole o nā pesticides i hoʻohana ʻia e nā mahiʻai, a ua hoʻokaʻawale ʻia nā mea āpau ma ke ʻano he Class II (pilikia waena) a i ʻole Class III (pilikia iki) e like me ka hoʻokaʻawale ʻana o nā pesticides o ka World Health Organization [44]. I kekahi manawa, ua ʻike ʻia ua hoʻohana ka ʻāina i ka insecticide deltamethrin, i manaʻo ʻia no nā kumu mahiʻai.
Ma ke ʻano o nā mea hana nui, ʻo propoxur a me deltamethrin nā huahana maʻamau i hoʻohana ʻia ma ka home a ma ke kula. Aia ka faila 5 i ka ʻike kikoʻī e pili ana i nā huahana kemika i hoʻohana ʻia e nā mahiʻai ma ka home a ma kā lākou mau mea kanu.
Ua ʻōlelo nā mahiʻai i nā ʻano hana kaohi namu ʻē aʻe, me nā peʻahi lau (pêpê ma ka ʻōlelo Abbey kūloko), ke puhi ʻana i nā lau, ka hoʻomaʻemaʻe ʻana i ka wahi, ka wehe ʻana i ka wai e kū ana, ka hoʻohana ʻana i nā mea pale namu, a i ʻole ka hoʻohana wale ʻana i nā pepa e pale aku ai i nā namu.
Nā mea e pili ana i ka ʻike o ka poʻe mahiʻai i ka malaria a me ka pīpī ʻana i nā mea pepehi kanaka i loko (loiloi regression logistic).
Ua hōʻike ka ʻikepili i kahi pilina koʻikoʻi ma waena o ka hoʻohana ʻana i ka lāʻau pepehi kanaka o ka home a me nā mea wānana ʻelima: ka pae hoʻonaʻauao, SES, ka ʻike o nā makika ma ke ʻano he kumu nui o ka malaria, ka hoʻohana ʻana i ka ITN, a me ka hoʻohana ʻana i ka lāʻau pepehi kanaka agrochemical. Hōʻike ka Kiʻi 3 i nā OR like ʻole no kēlā me kēia mea wānana. I ka wā i hoʻohui ʻia e ke kauhale, ua hōʻike nā mea wānana āpau i kahi pilina maikaʻi me ka hoʻohana ʻana i nā mea pīpī lāʻau pepehi kanaka i loko o nā hale (koe wale nō ka ʻike o nā kumu nui o ka malaria, kahi i pili like ʻole me ka hoʻohana ʻana i ka lāʻau pepehi kanaka (OR = 0.07, 95% CI: 0.03, 0.13). )) (Kiʻi 3). Ma waena o kēia mau mea wānana maikaʻi, ʻo kahi mea hoihoi ka hoʻohana ʻana i nā pesticides i ka mahiʻai. ʻO nā mahiʻai i hoʻohana i nā pesticides ma nā mea kanu he 188% ʻoi aku ka nui o ka hoʻohana ʻana i nā pesticides ma ka home (95% CI: 1.12, 8.26). Eia nō naʻe, ʻo nā hale me nā pae kiʻekiʻe o ka ʻike e pili ana i ka laha ʻana o ka malaria ʻaʻole lākou e hoʻohana i nā pesticides i loko o ka home. ʻOi aku ka nui o ka poʻe me nā pae hoʻonaʻauao kiʻekiʻe e ʻike ʻo nā makika ke kumu nui o ka malaria (OR = 2.04; 95% CI: 1.35, 3.10), akā ʻaʻohe pilina helu me ka SES kiʻekiʻe (OR = 1.51; 95% CI: 0.93, 2.46).
Wahi a ke poʻo o ka ʻohana, piʻi ka heluna makika i ka wā ua a ʻo ka pō ka manawa o nā nahu makika pinepine (85.79%). I ka nīnau ʻia ʻana o nā mahiʻai e pili ana i ko lākou manaʻo no ka hopena o ka pīpī ʻana i nā pepeke i nā heluna makika e lawe ana i ka malaria, ua hōʻoia ka 86.59% e ʻike ʻia ana ua ulu aʻe nā makika i ke kūʻē ʻana i nā pepeke insecticide. ʻO ka hiki ʻole ke hoʻohana i nā huahana kemika kūpono ma muli o ko lākou loaʻa ʻole ʻana ua manaʻo ʻia ʻo ia ke kumu nui no ka pono ʻole a i ʻole ka hoʻohana pono ʻole ʻana i nā huahana, kahi i manaʻo ʻia he mau kumu hoʻoholo ʻē aʻe. Ma ke ʻano kūikawā, ua pili ka mea hope me ke kūlana hoʻonaʻauao haʻahaʻa (p < 0.01), ʻoiai ke kāohi nei no SES (p < 0.0001). ʻO 12.41% wale nō o ka poʻe pane i manaʻo i ke kūʻē ʻana i nā makika ma ke ʻano he kumu hiki ke kūʻē i nā pepeke insecticide.
Aia kahi pilina maikaʻi ma waena o ke alapine (pinepine) o ka hoʻohana ʻana i nā mea pepehi pepeke ma ka home a me ka ʻike ʻana i ke kūʻē ʻana o nā makika i nā mea pepehi pepeke (p < 0.0001): ua hoʻokumu nui ʻia nā hōʻike o ke kūʻē ʻana o nā makika i nā mea pepehi pepeke ma ka hoʻohana ʻana i nā mea pepehi pepeke ma ka home e nā mahiʻai 3-4 mau manawa i ka pule (90.34%). Ma waho aʻe o ke alapine (pinepine), ua pili maikaʻi pū ka nui o nā pesticides i hoʻohana ʻia me nā manaʻo o nā mahiʻai i ke kūʻē ʻana i nā pesticides (p < 0.0001).
Ua kālele kēia haʻawina i ka ʻike o nā mahiʻai i ka malaria a me ka hoʻohana ʻana i nā pesticide. Hōʻike kā mākou mau hopena he kuleana koʻikoʻi ka hoʻonaʻauao a me ke kūlana socioeconomic i nā ʻano hana a me ka ʻike e pili ana i ka malaria. ʻOiai ua hele ka hapa nui o nā poʻo o ka home i ke kula haʻahaʻa, e like me nā wahi ʻē aʻe, he koʻikoʻi ka hapa o nā mahiʻai i hoʻonaʻauao ʻole ʻia [35, 45]. Hiki ke wehewehe ʻia kēia hanana ma ka ʻoiaʻiʻo inā hoʻomaka ka nui o nā mahiʻai e loaʻa i ka hoʻonaʻauao, pono ka hapa nui o lākou e haʻalele i ke kula e kākoʻo i ko lākou mau ʻohana ma o nā hana mahiʻai [26]. Akā, hōʻike kēia hanana he mea koʻikoʻi ka pilina ma waena o ke kūlana socioeconomic a me ka hoʻonaʻauao i ka wehewehe ʻana i ka pilina ma waena o ke kūlana socioeconomic a me ka hiki ke hana ma ka ʻike.
Ma nā wahi he nui i loaʻa i ka malaria, ua kamaʻāina nā mea komo i nā kumu a me nā hōʻailona o ka malaria [33,46,47,48,49]. Ua ʻae ʻia he maʻalahi nā keiki i ka malaria [31, 34]. Pili paha kēia ʻike i ka maʻalahi o nā keiki a me ke koʻikoʻi o nā hōʻailona malaria [50, 51].
Ua hōʻike ka poʻe i komo i ka hoʻolilo ʻana he $30,000 ka awelika, ʻaʻole i hoʻokomo ʻia ke kaʻa a me nā kumu ʻē aʻe.
ʻO ka hoʻohālikelike ʻana i ke kūlana socioeconomic o nā mahiʻai e hōʻike ana he nui aku ke kālā a nā mahiʻai me ke kūlana socioeconomic haʻahaʻa loa ma mua o nā mahiʻai waiwai loa. ʻO kēia paha no ka mea ʻike nā ʻohana me ke kūlana socioeconomic haʻahaʻa loa i nā kumukūʻai he kiʻekiʻe aʻe (ma muli o ko lākou kaumaha nui i nā kālā o ka ʻohana holoʻokoʻa) a i ʻole ma muli o nā pono e pili ana i ka hana aupuni a me ka ʻoihana pilikino (e like me ke ʻano me nā ʻohana waiwai nui aʻe). ): Ma muli o ka loaʻa ʻana o ka ʻinikua olakino, ʻoi aku ka haʻahaʻa o ke kālā no ka mālama ʻana i ka malaria (e pili ana i nā kumukūʻai āpau) ma mua o nā kumukūʻai no nā ʻohana i loaʻa ʻole ka pōmaikaʻi mai ka ʻinikua [52]. ʻO ka ʻoiaʻiʻo, ua hōʻike ʻia ua hoʻohana nui nā ʻohana waiwai loa i nā lāʻau lapaʻau biomedical i hoʻohālikelike ʻia me nā ʻohana ʻilihune loa.
ʻOiai ka manaʻo o ka hapa nui o nā mahiʻai he mau makika ke kumu nui o ka malaria, he hapa liʻiliʻi wale nō ka poʻe e hoʻohana ana i nā pesticides (ma o ka pīpī ʻana a me ka fumigation) i loko o ko lākou mau home, e like me nā mea i loaʻa ma Cameroon a me Equatorial Guinea [48, 53]. ʻO ka nele o ka hopohopo no nā makika i hoʻohālikelike ʻia me nā mea ʻino o ka mea kanu ma muli o ka waiwai waiwai o nā mea kanu. No ka palena ʻana i nā kumukūʻai, makemake ʻia nā ʻano hana haʻahaʻa e like me ke puhi ʻana i nā lau ma ka home a i ʻole ka pale wale ʻana i nā makika ma ka lima. Hiki i ka ʻawahia i ʻike ʻia ke kumu: ʻo ke ʻala o kekahi mau huahana kemika a me ka ʻoluʻolu ʻole ma hope o ka hoʻohana ʻana ke kumu e pale aku ai kekahi poʻe hoʻohana i kā lākou hoʻohana ʻana [54]. ʻO ka hoʻohana nui ʻana i nā insecticides i loko o nā hale (85.20% o nā hale i hōʻike ʻia e hoʻohana ana iā lākou) e kōkua pū ana i ka hoʻohana haʻahaʻa ʻana o nā insecticides e kūʻē i nā makika. ʻO ka loaʻa ʻana o nā ʻupena moe i mālama ʻia me ka insecticide i loko o ka hale e pili pono ana me ke alo o nā keiki ma lalo o 1 makahiki, malia paha ma muli o ke kākoʻo ʻana o ke keʻena antenatal no nā wahine hāpai e loaʻa ana i nā ʻupena moe i mālama ʻia me ka insecticide i ka wā o nā kūkākūkā antenatal [6].
ʻO nā Pyrethroids nā mea pepehi kanaka nui i hoʻohana ʻia i loko o nā ʻupena moe i mālama ʻia me ka insecticide [55] a hoʻohana ʻia e nā mahiʻai e kāohi i nā mea ʻino a me nā makika, e hāpai ana i nā hopohopo e pili ana i ka piʻi ʻana o ke kūʻē ʻana i ka insecticide [55, 56, 57,58,59]. Hiki i kēia hiʻohiʻona ke wehewehe i ka emi ʻana o ka ʻike o nā makika i nā insecticide i ʻike ʻia e nā mahiʻai.
ʻAʻole i pili ke kūlana socioeconomic kiʻekiʻe me ka ʻike maikaʻi o ka malaria a me nā makika ma ke ʻano he kumu. I ka hoʻohālikelike ʻana i nā ʻike mua a Ouattara a me nā hoa hana i ka makahiki 2011, ʻoi aku ka maikaʻi o ka poʻe waiwai e ʻike i nā kumu o ka malaria no ka mea he maʻalahi ko lākou komo ʻana i ka ʻike ma o ke kīwī a me ka lekiō [35]. Hōʻike kā mākou loiloi e wānana ana ka pae o ka hoʻonaʻauao kiʻekiʻe i ka ʻike maikaʻi o ka malaria. Hōʻoia kēia nānā ʻana he mea nui ka hoʻonaʻauao i ka ʻike o ka poʻe mahiʻai e pili ana i ka malaria. ʻO ke kumu o ka emi ʻana o ka hopena o ke kūlana socioeconomic no ka mea pinepine nā kauhale e kaʻana like i ke kīwī a me ka lekiō. Eia nō naʻe, pono e noʻonoʻo ʻia ke kūlana socioeconomic i ka wā e hoʻopili ai i ka ʻike e pili ana i nā hoʻolālā pale malaria home.
Ua pili pono ke kūlana socioeconomic kiʻekiʻe a me ka pae hoʻonaʻauao kiʻekiʻe me ka hoʻohana ʻana i nā pesticides home (spray a spray paha). ʻO ka mea kupanaha, ʻo ka hiki i nā mahiʻai ke ʻike i nā makika ma ke ʻano he kumu nui o ka malaria i hoʻopilikia maikaʻi ʻole i ke kumu hoʻohālike. Ua pili pono kēia wānana me ka hoʻohana ʻana i nā pesticides i ka wā i hui pū ʻia ai ma ka heluna kanaka holoʻokoʻa, akā ua pili maikaʻi ʻole me ka hoʻohana ʻana i nā pesticides i ka wā i hui pū ʻia e ke kauhale. Hōʻike kēia hopena i ke koʻikoʻi o ka mana o ka cannibalism ma ke ʻano kanaka a me ka pono e hoʻokomo i nā hopena random i ka loiloi. Hōʻike kā mākou noiʻi no ka manawa mua he ʻoi aku ka nui o nā mahiʻai me ka ʻike i ka hoʻohana ʻana i nā pesticides i ka mahiʻai ma mua o nā mea ʻē aʻe e hoʻohana i nā pesticides sprays a me nā coils ma ke ʻano he mau hoʻolālā kūloko e kāohi ai i ka malaria.
Ma muli o nā haʻawina i hala e pili ana i ka mana o ke kūlana socioeconomic ma nā manaʻo o nā mahiʻai e pili ana i nā pesticides [16, 60, 61, 62, 63], ua hōʻike nā ʻohana waiwai i ka ʻokoʻa kiʻekiʻe a me ka pinepine o ka hoʻohana ʻana i nā pesticides. Ua manaʻo ka poʻe pane ʻo ka pīpī ʻana i ka nui o ka insecticide ke ala maikaʻi loa e pale aku ai i ka ulu ʻana o ke kūʻē ʻana i nā makika, kahi mea e kūlike me nā hopohopo i hōʻike ʻia ma kahi ʻē [64]. No laila, ʻo nā huahana kūloko i hoʻohana ʻia e nā mahiʻai he like ke ʻano kemika ma lalo o nā inoa kalepa like ʻole, ʻo ia hoʻi, pono i nā mahiʻai ke hoʻokau mua i ka ʻike loea o ka huahana a me kāna mau mea hana. Pono hoʻi e uku ʻia ka makaʻala i ka ʻike o nā mea kūʻai aku, ʻoiai ʻo lākou kekahi o nā kumu kuhikuhi nui no nā mea kūʻai pesticide [17, 24, 65, 66, 67].
I mea e loaʻa ai ka hopena maikaʻi i ka hoʻohana ʻana i nā pesticides ma nā kaiāulu kuaʻāina, pono e kālele nā kulekele a me nā hana komo i ka hoʻomaikaʻi ʻana i nā hoʻolālā kamaʻilio, e noʻonoʻo ana i nā pae hoʻonaʻauao a me nā hana hana ma ke ʻano o ka hoʻololi ʻana i ka moʻomeheu a me ke kaiapuni, a me ka hāʻawi ʻana i nā pesticides palekana. E kūʻai ka poʻe ma muli o ke kumukūʻai (pehea ka nui o kā lākou hiki ke kūʻai) a me ka maikaʻi o ka huahana. Ke loaʻa ka maikaʻi ma ke kumukūʻai kūpono, manaʻo ʻia e piʻi nui ka noi no ka hoʻololi ʻana i ke ʻano i ke kūʻai ʻana i nā huahana maikaʻi. E aʻo i nā mahiʻai e pili ana i ka hoʻololi pesticide e uhaki i nā kaulahao o ke kūʻē ʻana i ka insecticide, e hoʻomaopopo ana ʻaʻole manaʻo ka hoʻololi ʻana he hoʻololi i ka hōʻailona huahana; (ʻoiai aia nā hōʻailona like ʻole i ka hui hana like), akā ʻo nā ʻokoʻa i nā mea hana. Hiki ke kākoʻo ʻia kēia hoʻonaʻauao e ka lepili huahana maikaʻi aʻe ma o nā hōʻike maʻalahi a maopopo.
Ma muli o ka hoʻohana nui ʻia ʻana o nā pesticides e nā mahiʻai kuaʻāina ma ka Panalāʻau ʻo Abbotville, ʻo ka hoʻomaopopo ʻana i nā hakahaka ʻike o nā mahiʻai a me nā manaʻo e pili ana i ka hoʻohana ʻana i nā pesticides i ke kaiapuni he mea ia e pono ai no ka hoʻomohala ʻana i nā papahana hoʻomaopopo holomua. Ua hōʻoia kā mākou noiʻi e noho mau ana ka hoʻonaʻauao i mea nui i ka hoʻohana pono ʻana i nā pesticides a me ka ʻike e pili ana i ka malaria. Ua manaʻo ʻia hoʻi ke kūlana socioeconomic o ka ʻohana he mea hana koʻikoʻi e noʻonoʻo ai. Ma waho aʻe o ke kūlana socioeconomic a me ka pae hoʻonaʻauao o ke poʻo o ka home, ʻo nā mea ʻē aʻe e like me ka ʻike e pili ana i ka malaria, ka hoʻohana ʻana i nā insecticides e kāohi i nā mea ʻino, a me nā manaʻo o ke kūʻē ʻana o nā makika i nā insecticides e hoʻohuli i nā manaʻo o nā mahiʻai i ka hoʻohana ʻana i nā insecticides.
ʻO nā ʻano hana e pili ana i ka mea pane e like me nā nīnau nīnau e pili ana i ka hoʻomanaʻo ʻana a me nā manaʻo makemake kaiāulu. He mea maʻalahi ke hoʻohana i nā ʻano o ka home e loiloi i ke kūlana socioeconomic, ʻoiai paha e pili pono kēia mau ana i ka manawa a me ka pōʻaiapili ʻāina i hoʻomohala ʻia ai a ʻaʻole paha e hōʻike like i ka ʻoiaʻiʻo o kēia wā o nā mea kikoʻī o ka waiwai moʻomeheu, e paʻakikī ai ka hoʻohālikelike ʻana ma waena o nā haʻawina. ʻOiaʻiʻo, aia paha he mau loli koʻikoʻi i ka nona ʻana o ka home i nā ʻāpana index ʻaʻole pono e alakaʻi i ka emi ʻana o ka ʻilihune waiwai.
ʻAʻole hoʻomanaʻo kekahi poʻe mahiʻai i nā inoa o nā huahana pesticide, no laila, ʻaʻole paha e hoʻohaʻahaʻa ʻia a hoʻonui ʻia paha ka nui o nā pesticides e hoʻohana ai nā mahiʻai. ʻAʻole i noʻonoʻo kā mākou noiʻi i nā manaʻo o nā mahiʻai e pili ana i ka pīpī pesticide a me ko lākou ʻike i nā hopena o kā lākou hana i ko lākou olakino a me ke kaiapuni. ʻAʻole hoʻi i hoʻokomo ʻia nā mea kūʻai aku i loko o ke aʻo ʻana. Hiki ke ʻimi ʻia nā kiko ʻelua i nā haʻawina e hiki mai ana.
Loaʻa nā ʻikepili i hoʻohana ʻia a/a i ʻole i kālailai ʻia i ka wā o ke aʻo ʻana o kēia manawa mai ka mea kākau pili ma ke noi kūpono.
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Ka manawa hoʻouna: ʻApelila-28-2024