He mea nui ka pesticides i ka mahiai kuaaina, aka, o ko lakou nui a hoohana hewa paha, hiki ke hoopilikia i na kulekele hoomalu malaria vector;Ua mālama ʻia kēia haʻawina ma waena o nā kaiāulu mahiʻai ma ka ʻaoʻao 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 ʻike o ka poʻe mahiʻai no ka maʻi malaria.Hiki i ka hoʻomaopopo ʻana i ka hoʻohana ʻana i ka pesticide ke kōkua i ka hoʻomohala ʻana i nā papahana ʻike e pili ana i ka hoʻomalu namu a me ka hoʻohana ʻana i ka pesticide.
Ua mālama ʻia ka noiʻi ma waena o 1,399 mau ʻohana ma 10 mau kauhale.Ua noiʻi ʻia ka poʻe mahiʻai e pili ana i kā lākou hoʻonaʻauao ʻana, nā hana mahiʻai (e laʻa, ka hoʻohua ʻana, ka hoʻohana ʻana i nā pesticide), ka ʻike ʻana i ka maʻi maʻi maʻi, a me nā ʻano hana hoʻomalu namu hale a lākou e hoʻohana ai.ʻIke ʻia ke kūlana socioeconomic (SES) o kēlā me kēia ʻohana ma muli o kekahi mau waiwai o ka home i koho mua ʻia.Ua helu ʻia nā pilina helu ma waena o nā ʻano like ʻole, e hōʻike ana i nā kumu pilikia nui.
Pili ka pae hoʻonaʻauao o ka poʻe mahiʻai me ko lākou kūlana socioeconomic (p <0.0001).Ua manaʻo ka hapa nui o nā ʻohana (88.82%) ʻo ka makika ke kumu nui o ka maʻi maʻi a ua pili maikaʻi ka ʻike no ka maʻi maʻi me ka pae hoʻonaʻauao kiʻekiʻe (OR = 2.04; 95% CI: 1.35, 3.10).Hoʻohana nui ʻia ka hoʻohana kemika i loko me ke kūlana socioeconomic home, pae hoʻonaʻauao, hoʻohana ʻana i nā ʻupena moe i mālama ʻia i nā pepeke a me nā mea kanu lāʻau mahiʻai (p <0.0001).Ua ʻike ʻia ka poʻe mahiʻai e hoʻohana i nā insecticides pyrethroid i loko o ka hale a hoʻohana i kēia mau lāʻau lāʻau no ka pale ʻana i nā mea kanu.
Hōʻike kā mākou haʻawina ʻo ka pae hoʻonaʻauao ka mea nui e hoʻohuli ai i ka ʻike o ka poʻe mahiʻai i ka hoʻohana ʻana i ka pesticide a me ka hoʻopaʻa ʻana i ka malaria.Manaʻo mākou e noʻonoʻo ʻia ka kamaʻilio maikaʻi ʻana e pili ana i ka loaʻa ʻana o ka hoʻonaʻauao, me ke kūlana socioeconomic, ka loaʻa ʻana, a me ka loaʻa ʻana o nā huahana kemika hoʻomalu ʻia e noʻonoʻo ʻia i ka wā e hoʻomohala ai i ka hoʻokele pesticide a me nā hana hoʻokele maʻi vector-borne no nā kaiāulu kūloko.
ʻO ka mahiʻai ka mea hoʻokele waiwai nui no nā ʻāina he nui o West Africa.I ka makahiki 2018 a me 2019, ʻo Côte dʻIvoire ka mea hana nui o ka honua i ka koko a me ka cashew nuts 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 waiwai nui o ka home (GDP) [2] .ʻO ka poʻe nona ka hapa nui o ka ʻāina mahiʻai, ʻo ka poʻe liʻiliʻi ma nā kuaʻāina ka mea kōkua nui i ka hoʻokele waiwai o ka ʻāpana [3].Loaʻa i ka ʻāina ka waiwai mahiʻai nui, me 17 miliona mau ʻeka o nā ʻāina mahiʻai a me nā ʻano like ʻole o ka wā e makemake ana i ka hoʻololi ʻana i nā mea kanu a me ka mahi ʻana i ke kofe, koko, cashew nuts, rubber, cotton, yams, palm, cassava, raiki a me nā mea kanu [2].Hāʻawi ka mahiʻai koʻikoʻi i ka laha ʻana o nā pests, ma o ka hoʻonui ʻana i ka hoʻohana ʻana i nā pesticides no ka mālama ʻana i nā pest [4], ʻoi aku ma waena o nā mahiʻai kuaʻāina, e pale i nā mea kanu a hoʻonui i nā hua hua [5], a me ka hoʻomalu ʻana 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 ka insecticide i nā maʻi maʻi, ʻoi aku hoʻi i nā wahi mahiʻai kahi e hiki ai i nā makika a me nā mea ʻai meaʻai ke kau i ke kaomi koho mai nā insecticides like [7,8,9,10].Hiki i ka hoʻohana ʻana i ka pesticide ke hana i ka pollution e hoʻopilikia i nā hoʻolālā hoʻokele vector a me ke kaiapuni a no laila pono e nānā [11, 12, 13, 14, 15].
Ua aʻo ʻia ka hoʻohana ʻana i ka pesticide e nā mahiʻai i ka wā i hala [5, 16].Ua hōʻike ʻia ka pae o ka hoʻonaʻauao he kumu nui i ka hoʻohana pono ʻana i nā pesticides [17, 18], ʻoiai ʻo ka hoʻohana ʻana i ka pesticide e ka poʻe mahiʻai e hoʻohuli pinepine ʻia e ka ʻike empirical a i ʻole nā ʻōlelo aʻoaʻo mai nā mea kūʻai aku [5, 19, 20].ʻO nā kaohi kālā kekahi o nā mea pale maʻamau e kaupalena ana i ka loaʻa ʻana o nā pesticides a i ʻole nā insecticides, e alakaʻi ana i ka poʻe mahiʻai e kūʻai aku i nā huahana ʻae ʻole a i ʻole nā huahana kahiko, ʻoi aku ka liʻiliʻi ma mua o nā huahana kānāwai [21, 22].ʻIke ʻia nā ʻano like ʻole ma nā ʻāina ʻē aʻe o West Africa, kahi kumu haʻahaʻa 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 i nā mea kanu [25, 26], e pili ana i nā hana mahiʻai a me nā heluna malaria vector [27, 28, 29, 30].Ua hōʻike nā haʻawina ma nā wahi malaria-endemic i kahi pilina ma waena o ke kūlana socioeconomic a me nā manaʻo o ka maʻi malaria a me nā pilikia o ka maʻi, a me ka hoʻohana ʻana i nā ʻupena moe insecticide-treated (ITN) [31,32,33,34,35,36,37].ʻOiai ʻo kēia mau haʻawina, ua hoʻohaʻahaʻa ʻia ka hoʻoikaika ʻana e hoʻomohala i nā kulekele hoʻomalu namu ma muli o ka nele o ka ʻike e pili ana i ka hoʻohana ʻana i ka pesticide ma nā kuaʻāina a me nā kumu e kōkua ai i ka hoʻohana pono ʻana i ka pesticide.Ua nānā kēia haʻawina i nā manaʻoʻiʻo malaria a me nā hoʻolālā hoʻomalu namu ma waena o nā hale mahiʻai ma Abeauville, hema Côte d'Ivoire.
Ua hana ʻia ke aʻo ʻana ma nā kauhale 10 ma ke keʻena ʻo Abeauville ma ka ʻaoʻao hema o Côte d'Ivoire (Fig. 1).Aia ʻo Agbowell Province he 292,109 mau kānaka ma kahi o 3,850 kilomika square a ʻo ia ka ʻāina nui loa ma ka ʻāina ʻo Anyebi-Tiasa [38].He anuanu kona me nā kau ua ʻelua (ʻApelila a Iulai a ʻOkakopa a Nowemapa) [39, 40].ʻO ka mahiʻai ka hana nui ma ka ʻāina a lawe ʻia e nā mea mahiʻai liʻiliʻi a me nā ʻoihana agro-industrial nui.ʻO kēia mau wahi he 10 me 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 , 6013.09 E , 6013 72.90N), Amengbeu (348477.76E, 664971.70 N), Damojiang (374,039.75 E, 661,579.59 N), Casigue 1 (363,140.15 E, 634,256.47 N), Lovezzi 1 (351,545.32 E ., 642.06 2.37 N , 4.7 N ), Ofonbo (338 578.5) 1 E, 657 302.17 latitu akau) a me Uji (363,990.74 lonitu hikina, 648,587.44 latitu akau).
Ua mālama ʻia ka haʻawina ma waena o ʻAukake 2018 a me Malaki 2019 me ke komo ʻana o nā ʻohana mahiʻai.Ua loaʻa mai ka heluna o nā kamaʻāina ma kēlā me kēia kauhale mai ke keʻena lawelawe kūloko, a ua koho wale ʻia ka poʻe 1,500 mai kēia papa inoa.ʻO ka poʻe i hoʻokomo ʻia ma waena o 6% a me 16% o ka heluna kauhale.ʻO nā hale i komo i loko o ka haʻawina ʻo ia nā ʻohana mahiʻai i ʻae e komo.Ua mālama ʻia kahi noiʻi mua ma waena o 20 mau mahiʻai no ka loiloi inā pono e kākau hou ʻia kekahi mau nīnau.A laila ua hoʻopau ʻia nā nīnau nīnau e nā ʻohi ʻikepili i hoʻomaʻamaʻa ʻia a uku ʻia i kēlā me kēia kauā, a ʻo ka liʻiliʻi o kekahi o lākou i kiʻi ʻia mai ke kauhale ponoʻī.Ua hōʻoia kēia koho i loaʻa i kēlā me kēia kauhale i hoʻokahi mea ʻohi ʻikepili i kamaʻāina i ke kaiapuni a ʻōlelo i ka ʻōlelo kūloko.I loko o kēlā me kēia hale, ua mālama ʻia kahi hālāwai ninaninau he alo a he alo me ke poʻo o ka ʻohana (makuakane a makuahine paha) a i ʻole, inā ʻaʻole ke poʻo o ka hale, he kanaka makua ʻē aʻe ma mua o 18 mau makahiki.Aia i loko o ka nīnau nīnau he 36 mau nīnau i māhele ʻia i ʻekolu mau ʻāpana: (1) Ke kūlana demographic a me ka socio-economic o ka home (2) Nā hana mahiʻai a me ka hoʻohana ʻana i nā pesticides (3) Ka ʻike no ka maʻi malaria a me ka hoʻohana ʻana i nā insecticides no ka hoʻopaʻa ʻana i ka makika [e nānā i ka Annex 1] .
ʻO nā pesticides i ʻōlelo ʻia e ka poʻe mahiʻai ua helu ʻia e ka inoa kālepa a hoʻopaʻa ʻia e nā mea hana a me nā hui kemika e hoʻohana ana i ka Ivory Coast Phytosanitary Index [41].Ua helu ʻia ke kūlana socioeconomic o kēlā me kēia ʻohana ma ka helu ʻana i kahi helu waiwai [42].Ua hoʻololi ʻia nā waiwai o ka hale i nā mea hoʻololi dichotomous [43].Hoʻopili ʻia nā helu kumu maikaʻi ʻole me ke kūlana socioeconomic haʻahaʻa (SES), akā pili nā helu kumu maikaʻi me SES kiʻekiʻe.Ua hōʻuluʻulu ʻia nā helu waiwai e loaʻa i ka helu helu no kēlā me kēia ʻohana [35].Ma muli o ka huina helu, ua māhele ʻia nā ʻohana i ʻelima mau kuinile o ke kūlana socioeconomic, mai ka poʻe ʻilihune a hiki i ka poʻe waiwai loa [e nānā i ka waihona hou 4].
No ka hoʻoholo ʻana inā ʻokoʻa ka ʻokoʻa o kahi ʻano ʻokoʻa ma ke kūlana socioeconomic, kauhale, a i ʻole ka pae hoʻonaʻauao o nā poʻo ʻohana, hiki ke hoʻohana ʻia ka hōʻike chi-square a i ʻole ka hoʻāʻo pololei a Fisher, inā kūpono.Ua hoʻokomo ʻia nā ʻano hoʻohālike logistic regression me nā ʻano hoʻololi wānana aʻe: pae hoʻonaʻauao, kūlana socioeconomic (ua hoʻololi ʻia a pau i mau hoʻololi dichotomous), kauhale (i hoʻokomo ʻia me nā ʻano hoʻololi), kiʻekiʻe o ka ʻike e pili ana i ka maʻi 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 (output). ma o ka aerosol).a i ʻole wili);pae hoʻonaʻauao, kūlana socio-economic a me kauhale, e hopena i ka ʻike kiʻekiʻe o ka maʻi malaria.Ua hana ʻia kahi ʻano hoʻohālikelike hoʻohālikelike logistic me ka hoʻohana ʻana i ka pūʻulu R lme4 (hana Glmer).Ua hana ʻia nā ʻikepili helu ma R 4.1.3 (https://www.r-project.org) a me Stata 16.0 (StataCorp, College Station, TX).
No nā nīnauele 1,500 i hana ʻia, ua kāpae ʻia ka 101 mai ka nānā ʻana no ka mea ʻaʻole i pau ka nīnau nīnau.ʻO ka hapa kiʻekiʻe 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 hoʻopaʻa ʻia i loko o ka loiloi e hōʻike ana i ka heluna kanaka o 9,023 mau kānaka.E like me ka hōʻike ʻana ma ka Papa 1, 91.71% o nā poʻo hale 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 ka poʻe mahiʻai, ʻo ka mahiʻai wale nō ke kumu e loaʻa ai ka loaʻa kālā no ka hapa nui o ka poʻe mahiʻai (89.35%), me ka ulu pinepine ʻana o ka koko ma nā hale hoʻohālike;Hoʻoulu ʻia nā mea kanu, nā meaʻai, ka laiki, ka lāʻau a me ka plantain ma kahi liʻiliʻi o ka ʻāina.ʻO nā poʻo ʻohana i koe he poʻe ʻoihana, mea pena a me nā lawaiʻa (Papa 1).Hōʻike ʻia ka hōʻuluʻulu manaʻo o nā ʻano ʻohana ma ke kauhale ma ka waihona Hoʻohui [e nānā i ka faila hou 3].
ʻAʻole ʻokoʻa ka māhele hoʻonaʻauao ma muli o ke kāne (p = 0.4672).Loaʻa ka hapa nui o ka poʻe pane i ka hoʻonaʻauao kula mua (40.80%), a ma hope o ke kula kiʻekiʻe (33.41%) a me ka ʻike ʻole (17.97%).ʻO 4.64% wale nō i komo i ke kulanui (Papa 1).ʻO nā wāhine 116 i noiʻi ʻia, ʻoi aku ma mua o 75% i loaʻa i kahi kula haʻahaʻa, a ʻo ke koena ʻaʻole i hele i ke kula.'Oko'a ka pae ho'ona'auao o ka po'e mahi'ai ma waena o nā kauhale (ka ho'ā'o pololei a Fisher, p <0.0001), a ua pili maika'i ka pae ho'ona'auao o nā po'o hale me ko lākou kūlana socioeconomic (Fisher's exact test, p <0.0001).ʻO ka ʻoiaʻiʻo, ʻo nā quintiles kūlana socioeconomic kiʻekiʻe ka hapa nui o ka poʻe mahiʻai i hoʻonaʻauao ʻia, a ʻo ka mea ʻē aʻe, ʻo ka haʻahaʻa haʻahaʻa socioeconomic kūlana quintiles he poʻe mahiʻai ʻike ʻole;Ma muli o ka nui o ka waiwai, ua māhele ʻia nā ʻohana laʻana i ʻelima mau kuini waiwai: mai ka poʻe ʻilihune (Q1) a i ka poʻe waiwai loa (Q5) [e ʻike i ka faila hou 4].
Aia nā ʻokoʻa nui 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).ʻAʻohe ʻokoʻa koʻikoʻi i ʻike ʻia ma waena o ka papa waiwai a me ka helu o nā kāne.
ʻO ka hapa nui o ka poʻe pane (88.82%) manaʻo ʻo ka makika kekahi o nā kumu o ka maʻi maʻi.ʻO 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 wai lepo, ka ʻike ʻana i ka lā, ka ʻai maikaʻi ʻole a me ka luhi (Paukū 2).Ma ka pae kauhale ma Grande Maury, ua manao ka hapanui o na hale i ka inu wai lepo ke kumu nui o ka ma'i malaria (ka 'oko'a helu ma waena o na kauhale, p <0.0001).ʻO nā hōʻailona nui ʻelua o ka maʻi maʻi he kiʻekiʻe ka wela o ke kino (78.38%) a me ka melemele o nā maka (72.07%).Ua ʻōlelo pū ka poʻe mahiʻai i ka luaʻi, anemia a me ka ʻeleʻele (e nānā i ka Papa 2 ma lalo).
Ma waena o nā hoʻolālā pale ʻana i ka maʻi 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 maʻi malaria maʻamau i nā koho kūpono (80.01%), me nā makemake e pili ana i ke kūlana socioeconomic.Pili nui (p <0.0001).): ʻOi aku ka makemake o ka poʻe mahiʻai me ke kūlana socioeconomic kiʻekiʻe a hiki ke loaʻa i nā lāʻau lapaʻau biomedical, makemake ka poʻe 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 ma ka mālama ʻana i ka maʻi malaria (pili maikaʻi ʻole me SES; p <0.0001).Ma muli o nā kuhi kumu kūʻai pololei i hōʻike ʻia, ʻoi aku ka nui o nā ʻohana me ke kūlana socioeconomic haʻahaʻa loa e hoʻolilo iā XOF 30,000 (ma kahi o US $50) ʻoi aʻe ma ka mālama ʻana i ka maʻi malaria ma mua o nā hale me ke kūlana socioeconomic kiʻekiʻe.Eia kekahi, ʻo ka hapa nui o ka poʻe pane i manaʻoʻiʻo ʻoi aku ka maʻalahi o nā keiki (49.11%) i ka maʻi maʻi ma mua o nā pākeke (6.55%) (Table 2), me kēia manaʻo ʻoi aku ka maʻamau i waena o nā hale i ka quintile ʻilihune (p <0.01).
No ka nahu namu, ua hōʻike ka hapa nui o ka poʻe i komo (85.20%) i ka hoʻohana ʻana i nā ʻupena moe i mālama ʻia i ka insecticide, ka mea i loaʻa iā lākou i ka wā o ka hoʻolaha ʻana i ka ʻāina i ka makahiki 2017.Ua hōʻike ʻia ka moe ʻana o nā mākua a me nā keiki ma lalo o nā ʻupena makika i mālama ʻia i ka insecticide ma 90.99% o nā hale.ʻOi aku ka nui o ka hoʻohana ʻana i nā ʻupena moe i mālama ʻia i ka inika ma luna o 70% ma nā kauhale a pau koe wale nō ke kauhale ʻo Gessigye, kahi i hōʻike ʻia ai he 40% wale nō o nā hale e hoʻohana ana i nā ʻupena moe i mālama ʻia i ka iniseti.ʻO ka awelika o nā ʻupena moe i mālama ʻia i ka lāʻau lāʻau i hoʻohana ʻia e kekahi ʻohana ua pili nui a maikaʻi hoʻi me ka nui o ka home (Pearson's correlation coefficient r = 0.41, p <0.0001).Ua hōʻike pū ʻia kā mākou hopena i nā ʻohana me nā keiki ma lalo o ka makahiki 1 e hoʻohana i nā ʻupena moe i mālama ʻia i ka insecticide ma ka home i hoʻohālikelike ʻia me nā hale me nā keiki ʻole a i ʻole nā keiki nui (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 i ka lāʻau insecticide, ua nīnau ʻia ka poʻe mahiʻai e pili ana i nā ʻano hana hoʻomalu namu ʻē aʻe i ko lākou mau home a me nā huahana mahiʻai i hoʻohana ʻia no ke kāohi ʻana i nā mea kanu.ʻO 36.24% wale nō o ka poʻe i komo i haʻi i ka pīpī ʻana i nā pesticides ma ko lākou mau home (ka pilina koʻikoʻi a maikaʻi me SES p <0.0001).ʻO nā mea kemika i hōʻike ʻia mai ʻeiwa mau makamae 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 ʻōpala insecticide (83.90%).Ua piʻi ka hiki i ka poʻe mahiʻai ke inoa i nā inoa o nā pesticides i kāpī ʻia ma ko lākou mau hale me ko lākou pae naʻauao (12.43%; p <0.05).Ua kūʻai mua ʻia nā huahana agrochemical i hoʻohana ʻia i loko o nā pahu a hoʻoheheʻe ʻia i loko o nā mea hoʻoheheʻe ma mua o ka hoʻohana ʻana, me ka hapa nui loa o nā mea kanu (78.84%) (Paukū 2).ʻO ke kauhale ʻo Amangbeu ka hapa haʻahaʻa o ka poʻe mahiʻai e hoʻohana ana i nā pesticides ma ko lākou mau home (0.93%) a me nā mea kanu (16.67%).
ʻO ka helu kiʻekiʻe loa o nā huahana insecticidal (sprays or coils) i koi ʻia i kēlā me kēia hale he 3, a ua hoʻopili maikaʻi ʻia ka SES me ka helu o nā huahana i hoʻohana ʻia (ka hoʻāʻo pololei a Fisher p <0.0001, akā naʻe i kekahi mau mea i loaʻa nā huahana like);nā mea hana ma lalo o nā inoa kālepa like ʻole.Hōʻike ka papa 2 i ka pinepine o ka hoʻohana ʻana i nā 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 ʻia ma ka hale (48.74%) a me ka mahiʻai (54.74%) i nā ʻōpala insecticide.Hana ʻia nā huahana mai kēlā me kēia pesticide a i hui pū ʻia me nā pesticides ʻē aʻe.ʻO ka hui pū ʻana o nā insecticides hale he carbamates, organophosphates a me pyrethroids, aʻo nā neonicotinoids a me nā pyrethroids ka mea maʻamau i waena o nā insecticides mahiʻai (Appendix 5).Hōʻike ka Figure 2 i ka māhele o nā ʻohana like ʻole o nā pesticides i hoʻohana ʻia e ka poʻe mahiʻai, ua helu ʻia ia mau mea āpau ma ke ʻano he Papa II (pilikia haʻahaʻa) a i ʻole Papa III (pilikia liʻiliʻi) e like me ka World Health Organization classification of pesticides [44].I kekahi manawa, ua ʻike ʻia ua hoʻohana ka ʻāina i ka insecticide deltamethrin, i manaʻo ʻia no nā kumu mahiʻai.
Ma nā ʻōlelo o nā mea hana, propoxur a me deltamethrin nā huahana maʻamau i hoʻohana ʻia ma ka home a ma ke kula, kēlā me kēia.Aia ka waihona 5 hou i ka ʻike kikoʻī e pili ana i nā huahana kemika i hoʻohana ʻia e ka poʻe mahiʻai ma ka home a me kā lākou mea kanu.
Ua ʻōlelo ka poʻe mahiʻai i nā ʻano hana ʻē aʻe e hoʻomalu ai i ka makika, e like me ka pā lau (pêpê ma ka ʻōlelo Abbey kūloko), puhi i nā lau, hoʻomaʻemaʻe ʻāina, wehe i ka wai kū, hoʻohana i nā namu, a i ʻole ka hoʻohana ʻana i nā lau e pale aku i nā makika.
Nā mea pili i ka ʻike o ka poʻe mahiʻai no ka maʻi maʻi a me ka hoʻoheheʻe ʻana i ka lāʻau insecticide i loko (ka loiloi loiloi regression).
Ua hōʻike ka ʻikepili i kahi hui nui ma waena o ka hoʻohana ʻana i ka insecticide hale a me ʻelima mau wānana: pae hoʻonaʻauao, SES, ʻike i nā makika ma ke kumu nui o ka maʻi maʻi, ka hoʻohana ʻana i ka ITN, a me ka hoʻohana ʻana i ka lāʻau insecticide agrochemical.Hōʻike ka Kiʻi 3 i nā OR ʻokoʻa no kēlā me kēia hoʻololi wānana.I ka hui ʻia ʻana e ke kauhale, ua hōʻike nā mea wānana a pau i kahi pilina maikaʻi me ka hoʻohana ʻana i nā ʻōpala insecticide i loko o nā hale (koe ka ʻike o nā kumu nui o ka maʻi maʻi, i hoʻopili ʻia me ka hoʻohana ʻana i ka insecticide (OR = 0.07, 95% CI: 0.03, 0.13). )) (Kiʻi 3).Ma waena o kēia mau wānana maikaʻi, ʻo kahi mea hoihoi ka hoʻohana ʻana i nā pesticides i ka mahiʻai.ʻO ka poʻe 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, ʻoi aku ka liʻiliʻi o nā ʻohana me nā pae kiʻekiʻe o ka ʻike e pili ana i ka maʻi malaria i ka hoʻohana ʻana i nā pesticides ma ka home.Ua ʻike paha ka poʻe me nā pae kiʻekiʻe o ka hoʻonaʻauao ʻo ka makika ke kumu nui o ka maʻi maʻi (OR = 2.04; 95% CI: 1.35, 3.10), akā ʻaʻohe hui helu me SES kiʻekiʻe (OR = 1.51; 95% CI. : 0.93, 2.46).
Wahi a ke poʻo o ka ʻohana, ʻo ka piʻi nui ʻana o ka namu i ka wā ua a ʻo ka pō ka manawa o ka nahu pinepine ʻana o ka makika (85.79%).I ka nīnau ʻia ʻana o ka poʻe mahiʻai e pili ana i ko lākou ʻike ʻana i ka hopena o ke kāpīpī ʻana i nā pepeke ma luna o nā heluna namu lawe malaria, 86.59% i hōʻoia i ka ulu ʻana o nā makika i ke kūʻē ʻana i nā lāʻau insecticides.ʻO ka hiki ʻole ke hoʻohana i nā huahana kemika kūpono ma muli o ko lākou loaʻa ʻole ʻana i manaʻo ʻia ke kumu nui o ka pono ʻole a i ʻole ka hoʻohana hewa ʻana i nā huahana, i manaʻo ʻia he mau kumu hoʻoholo ʻē aʻe.ʻO ka mea nui, ua pili ka hope me ke kūlana hoʻonaʻauao haʻahaʻa (p <0.01), ʻoiai ke hoʻomalu nei no SES (p <0.0001).ʻO 12.41% wale nō o ka poʻe pane i manaʻo i ke kū ʻana i ka makika ʻo ia kekahi o nā kumu kūpono o ke kūʻē ʻana i nā pepeke.
Loaʻa ka pilina maikaʻi ma waena o ka pinepine o ka hoʻohana ʻana i ka lāʻau insecticide ma ka home a me ka ʻike ʻana i ke kūʻē ʻana o ka makika i nā lāʻau lāʻau (p <0.0001): ʻo nā hōʻike e pili ana i ke kūʻē ʻana o ka makika i nā insecticides ua hoʻokumu ʻia ma ka hoʻohana ʻana i nā insecticides ma ka home e nā mahiʻai 3-4 mau manawa a pule (90.34%) .Ma waho aʻe o ka pinepine, ua hoʻopili maikaʻi ʻia ka nui o nā pesticides i hoʻohana ʻia me ka manaʻo o ka poʻe mahiʻai no ke kūʻē ʻana i nā pesticide (p <0.0001).
Ua nānā kēia haʻawina i ka manaʻo o ka poʻe mahiʻai e pili ana i ka maʻi malaria a me ka hoʻohana ʻana i nā pesticide.Hōʻike kā mākou mau hualoaʻa he kuleana koʻikoʻi ka hoʻonaʻauao a me ke kūlana socioeconomic i nā hana maʻamau a me ka ʻike e pili ana i ka maʻi malaria.ʻOiai ua hele ka hapa nui o nā poʻo hale i ke kula haʻahaʻa, e like me nā wahi ʻē aʻe, he mea nui ka hapa o ka poʻe mahiʻai ʻole i aʻo ʻia [35, 45].Hiki ke wehewehe ʻia kēia ʻano ma muli o ka hoʻomaka ʻana o ka poʻe mahiʻai i ka hoʻonaʻauao, ʻo ka hapa nui o lākou e haʻalele i ke kula e kākoʻo i ko lākou ʻohana ma o nā hana mahiʻai [26].Akā, hōʻike kēia hanana i ka pilina ma waena o ke kūlana socioeconomic a me ka hoʻonaʻauao he mea koʻikoʻi e wehewehe i ka pilina ma waena o ke kūlana socioeconomic a me ka hiki ke hana i ka ʻike.
Ma nā wahi he nui o ka malaria-endemic, ua kamaʻāina nā mea komo i nā kumu a me nā hōʻailona o ka maʻi malaria [33,46,47,48,49].Ua ʻae ʻia ka maʻalahi o nā keiki i ka maʻi malaria [31, 34].Hiki ke pili kēia ʻike i ka maʻalahi o nā keiki a me ka paʻakikī o nā hōʻailona malaria [50, 51].
Ua hōʻike ka poʻe i komo i ka hoʻolilo ʻana i ka awelika o $30,000, ʻaʻole me ka lawe ʻana a me nā mea ʻē aʻe.
ʻO ka hoʻohālikelike ʻana i ke kūlana socioeconomic o ka poʻe mahiʻai e hōʻike ana i ka poʻe mahiʻai me ke kūlana socioeconomic haʻahaʻa e hoʻolilo i ke kālā ma mua o ka poʻe mahiʻai waiwai loa.Ma muli paha o ka ʻike ʻana o nā ʻohana me ke kūlana socioeconomic haʻahaʻa he ʻoi aku ke kiʻekiʻe o nā kumukūʻai (ma muli o ko lākou kaumaha nui i ke kālā o ka hale holoʻokoʻa) a i ʻole ma muli o nā pōmaikaʻi pili o ka ʻoihana aupuni a me ka ʻoihana pilikino (e like me ka hihia me nā ʻohana ʻoi aku ka waiwai).): Ma muli o ka loaʻa ʻana o ka ʻinikua olakino, ʻoi aku ka haʻahaʻa o ke kālā no ka mālama ʻana i ka maʻi maʻi (e pili ana i ka nui o nā kumukūʻai) ma mua o nā koina no nā ʻohana i pōmaikaʻi ʻole mai ka ʻinikua [52].ʻO ka ʻoiaʻiʻo, ua hōʻike ʻia ua hoʻohana nui nā ʻohana waiwai i nā lāʻau lapaʻau biomedical i hoʻohālikelike ʻia me nā ʻohana ʻilihune.
ʻOiai ʻo ka hapa nui o ka poʻe mahiʻai e noʻonoʻo nei ʻo ka makika ke kumu nui o ka maʻi maʻi, he mea liʻiliʻi wale nō ka hoʻohana ʻana i nā pesticides (ma o ka pulupulu a me ka fumigation) i ko lākou mau home, e like me nā ʻike ma Cameroon a me Equatorial Guinea [48, 53].ʻO ka nele o ka hopohopo no nā makika i hoʻohālikelike ʻia me nā mea kanu ma muli o ka waiwai waiwai o nā mea kanu.No ka hoʻemi ʻana i nā kumukūʻai, ʻoi aku ka maikaʻi o nā ala haʻahaʻa e like me ke puhi ʻana i nā lau ma ka home a i ʻole ke kipaku wale ʻana i nā makika me ka lima.ʻO ka mea ʻona paha kekahi kumu: ʻo ke ʻala o kekahi mau huahana kemika a me ka ʻeha ma hope o ka hoʻohana ʻana i mea e pale ai kekahi mau mea hoʻohana i kā lākou hoʻohana [54].ʻO ke kiʻekiʻe o ka hoʻohana ʻana i nā lāʻau lapaʻau i loko o nā hale (85.20% o nā hale i hōʻike ʻia e hoʻohana ana ia mau mea) kōkua pū kekahi i ka hoʻohana haʻahaʻa ʻana i nā lāʻau inika e kūʻē i nā makika.ʻO ka loaʻa ʻana o nā ʻupena moe i mālama ʻia i ka insecticide i loko o ka hale e pili pū ana me ka hele ʻana o nā keiki ma lalo o 1 makahiki o ka makahiki, ma muli paha o ke kākoʻo o ke keʻena antenatal no nā wahine hāpai e loaʻa ana i nā ʻupena moe i mālama ʻia i ka insecticide i ka wā o nā kūkākūkā antenatal [6].
ʻO Pyrethroids ka mea nui i hoʻohana ʻia i loko o nā ʻupena moe i mālama ʻia i ka insecticide [55] a hoʻohana ʻia e ka poʻe mahiʻai e hoʻomalu i nā pests a me nā makika, e hāpai ana i nā hopohopo e pili ana i ka piʻi ʻana o ke kūʻē insecticide [55, 56, 57,58,59].Hiki paha i kēia hiʻohiʻona ke wehewehe i ka emi ʻana o ka naʻau o nā makika i nā lāʻau insecticides i ʻike ʻia e ka poʻe mahiʻai.
ʻAʻole pili ke kūlana socioeconomic kiʻekiʻe me ka ʻike maikaʻi o ka maʻi maʻi a me nā makika ke kumu.Ma ka hoʻohālikelike ʻana i nā mea i ʻike mua ʻia e Ouattara a me nā hoa hana ma 2011, ʻoi aku ka maikaʻi o ka poʻe waiwai e ʻike i nā kumu o ka maʻi maʻi maʻi no ka mea ua maʻalahi lākou i ka ʻike ma o ka televise a me ka lekiō [35].Hōʻike kā mākou hōʻike i ka pae o ka hoʻonaʻauao kiʻekiʻe e wānana i ka ʻike maikaʻi ʻana i ka maʻi maʻi.Ua hōʻoia kēia ʻike ʻana he mea nui ka hoʻonaʻauao ʻana i ka ʻike o ka poʻe mahiʻai e pili ana i ka maʻi maʻi maʻi.ʻO ke kumu i emi ai ka hopena o ke kūlana socioeconomic, ʻo ia ke kaʻana pinepine ʻana o nā kauhale i ke kīwī a me ka lekiō.Eia nō naʻe, pono e noʻonoʻo ʻia ke kūlana socioeconomic i ka wā e noi ai i ka ʻike e pili ana i nā hoʻolālā pale ʻana i ka maʻi malaria.
ʻO ke kūlana socioeconomic kiʻekiʻe a me ka pae hoʻonaʻauao kiʻekiʻe ua pili maikaʻi me ka hoʻohana ʻana i ka pesticide hale (ka pāpaʻi a i ʻole ka ʻōpala).ʻO ka mea kupanaha, ʻo ka hiki o ka poʻe mahiʻai ke ʻike i nā makika ke kumu nui o ka maʻi maʻi i hoʻopilikia maikaʻi ʻole i ke kumu hoʻohālike.Hoʻopili maikaʻi ʻia kēia wānana me ka hoʻohana ʻana i ka pesticide ke hui pū ʻia ma waena o ka heluna kanaka holoʻokoʻa, akā pili maikaʻi ʻole me ka hoʻohana ʻana i ka pesticide ke hui ʻia e ke kauhale.Hōʻike kēia hopena i ke koʻikoʻi o ka mana o ka cannibalism i ke ʻano kanaka a me ka pono e hoʻokomo i nā hopena maʻamau i ka nānā ʻana.Hōʻike kā mākou haʻawina no ka manawa mua e ʻoi aku ka nui o ka poʻe mahiʻai me ka ʻike i ka hoʻohana ʻana i nā pesticides i ka mahiʻai ma mua o nā poʻe ʻē aʻe e hoʻohana i nā pesticide sprays a me nā coils e like me nā hoʻolālā kūloko e pale ai i ka maʻi malaria.
Ke hoʻolohe nei i nā haʻawina mua e pili ana i ka mana o ke kūlana socioeconomic ma nā manaʻo o ka poʻe mahiʻai e pili ana i nā pesticides [16, 60, 61, 62, 63], ua hōʻike nā hale waiwai i ka loli kiʻekiʻe a me ka pinepine o ka hoʻohana ʻana i ka pesticide.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, e kūlike me nā hopohopo i hōʻike ʻia ma nā wahi ʻē aʻe [64].No laila, ʻo nā huahana kūloko i hoʻohana ʻia e ka poʻe mahiʻai he ʻano kemika like ʻole ma lalo o nā inoa ʻoihana like ʻole, ʻo ia hoʻi, pono ka poʻe mahiʻai e hoʻokumu i ka ʻike loea o ka huahana a me kāna mau mea hana.Pono e hoʻolohe 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].
No ka loaʻa ʻana o ka hopena maikaʻi i ka hoʻohana ʻana i ka pesticide ma nā kaiāulu kuaʻāina, pono nā kulekele a me nā hana i ka hoʻomaikaʻi ʻana i nā hoʻolālā kamaʻilio, me ka noʻonoʻo ʻana i nā pae hoʻonaʻauao a me nā ʻano hana i loko o ka pōʻaiapili o 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 lākou e hiki ai) a me ka maikaʻi o ka huahana.Ke loaʻa ka maikaʻi ma ke kumukūʻai kūpono, ke manaʻo nei e piʻi nui ka koi no ka loli ʻana i ke kūʻai ʻana i nā huahana maikaʻi.E hoʻonaʻauao i ka poʻe mahiʻai e pili ana i ka hoʻololi ʻana i nā pesticide e uhaʻi i nā kaulahao o ke kūʻē ʻana i nā iniseti, e hoʻomaopopo ana ʻaʻole ke ʻano o ka hoʻololi ʻana i ka hoʻololi ʻana i ka hōʻailona huahana;(no ka mea, loaʻa i nā mana like ʻole ka pūhui hana like), akā he ʻokoʻa i nā mea hana.Hiki ke kākoʻo ʻia kēia hoʻonaʻauao e ka hōʻailona huahana ʻoi aku ka maikaʻi ma o nā hiʻohiʻona maʻalahi.
Ma muli o ka hoʻohana nui ʻia ʻana o nā pesticides e ka poʻe mahiʻai kuaʻāina ma ka ʻāina ʻo Abbotville, ʻo ka hoʻomaopopo ʻana i nā āpau ʻike a me nā ʻano o ka poʻe mahiʻai e pili ana i ka hoʻohana ʻana i ka pesticide i ke kaiapuni he mea ia e pono ai no ka hoʻomohala ʻana i nā papahana ʻike holomua.Ke hōʻoia nei kā mākou noiʻi ʻana he mea nui ka hoʻonaʻauao i ka hoʻohana pono ʻana i nā pesticides a me ka ʻike e pili ana i ka malaria.Ua manaʻo ʻia ke kūlana socioeconomic ʻohana he mea hana nui e noʻonoʻo ai.Ma waho aʻe o ke kūlana socioeconomic a me ka pae hoʻonaʻauao o ke poʻo o ka ʻohana, ʻo nā kumu ʻē aʻe e like me ka ʻike e pili ana i ka maʻi maʻi, ka hoʻohana ʻana i nā lāʻau lapaʻau no ka hoʻopaʻa ʻana i nā pests, a me ka ʻike ʻana i ke kūʻē ʻana o ka makika i nā mea kanu lāʻau i ka manaʻo o ka poʻe mahiʻai e pili ana i ka hoʻohana ʻana i nā iniseti.
Hiki ke hoʻomanaʻo ʻia nā ʻano hana e pili ana i ka pane e like me nā nīnau nīnau a me ka makemake o ka nohona.He mea maʻalahi ka hoʻohana ʻana i nā hiʻohiʻona o ka home e loiloi i ke kūlana socioeconomic, ʻoiai ʻo kēia mau ana he kikoʻī paha i ka manawa a me ka pōʻaiapili ʻāina i kūkulu ʻia ai a ʻaʻole like paha ke hōʻike like ʻana i ka ʻoiaʻiʻo maoli o nā mea kikoʻī o ka waiwai moʻomeheu. .ʻOiaʻiʻo, aia paha nā loli nui i ka noho ʻana o ka home i nā ʻāpana kuhikuhi ʻaʻole pono e alakaʻi i ka hōʻemi ʻana i ka ʻilihune waiwai.
ʻAʻole hoʻomanaʻo kekahi poʻe mahiʻai i nā inoa o nā huahana pesticide, no laila hiki ke hoʻohaʻahaʻa ʻia ka nui o nā pesticides e hoʻohana ai ka poʻe mahiʻai.ʻAʻole i noʻonoʻo kā mākou haʻawina i ka manaʻo o ka poʻe mahiʻai e pili ana i ka pulupulu pesticide a me ko lākou manaʻo i ka hopena o kā lākou hana i ko lākou olakino a me ke kaiapuni.ʻAʻole hoʻi i hoʻokomo ʻia nā mea kūʻai aku i ka haʻawina.Hiki ke ʻimi ʻia nā mea ʻelua i nā haʻawina e hiki mai ana.
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Ka manawa hoʻouna: Apr-28-2024