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 kaohi namu like ʻole a lākou i 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 pono 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 pono ka ʻike o ka malaria me ka pae hoʻonaʻauao kiʻekiʻe (OR = 2.04; 95% CI: 1.35, 3.10). Ua pili pono ka hoʻohana ʻana i nā hui i loko o ka hale 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 pūnaewele 10 e pili ana iā Aboud Boa Vincent (323,729.62 E, 651,821.62 N), Aboud Kuassikro (326,413.09 E, 651,573.06 N), Aboud Mandek (326,413.09 E, 606,413.09 E, 606,413.09 E, 606,413.09 E, 606,413.09) Abude 652372.90N), Amengbeu (348477.76N), 664971.70N, Damojiang (374,039.75 E, 661,579.59 N), Gesigie 1 (363,140.15 E, 634,256.15 E, 634,256. 642, 062.37 N), ʻOfa (350 924.31 E, 654 607.17 N), ʻOfonbo (338 578.5) 1 E, 657 302.17 N) a me ʻOji (longitude 363,990.74 hikina, latitude 648,587.44 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 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 Appendix 1].
Ua hoʻopaʻa inoa ʻia nā pesticides i ʻōlelo ʻia e nā mahiʻai e ko lākou mau 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 ʻia ma o ka ʻōmole spray). 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 koko ka mea kanu i ulu nui ʻia i nā ʻohana i noiʻi ʻia; 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). Ua loaʻa i ka hapa nui o ka poʻe pane 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 i ka liʻiliʻi o 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 e pili pono ana me ko lākou kūlana socioeconomic (hoʻāʻo pololei a Fisher, p < 0.0001). ʻO ka ʻoiaʻiʻo, ʻo nā quintiles kūlana socioeconomic kiʻekiʻe e noho aliʻi ʻia e nā mahiʻai i ʻoi aku ka naʻauao, a ʻo ka ʻaoʻao ʻē aʻe, ʻo nā quintiles kūlana socioeconomic haʻahaʻa loa i haku ʻia me nā 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 me ke kūlana socioeconomic haʻahaʻa, makemake nā mahiʻai i nā lāʻau lapaʻau lāʻau 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 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 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 pīpī 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 nā huahana he mea 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 ʻē aʻe o ke kāohi ʻana i nā makika, 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 makika, a i ʻole ka hoʻohana wale ʻana i nā pepa e pale aku ai i nā makika.
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 ka pinepine o ka hoʻohana ʻana i nā mea pepehi pepeke i loko o ka home a me nā manaʻo o 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 3-3 mau manawa i ka pule. 4 mau manawa (90.34%). Ma waho aʻe o ke alapine, ua pili pono ka nui o nā pesticides i hoʻohana ʻia me nā manaʻo o nā mahiʻai no ke kūʻē ʻana i nā pesticide (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 i ka awelika o 30,000. ʻAʻole kūkākūkā ʻia nā mea e like me ka nalowale o ka huahana a me ka halihali.
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). ): 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 nui ʻana i 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 ʻo ka pae o ka hoʻonaʻauao kiʻekiʻe he mea wānana i ka ʻike maikaʻi ʻana i ka malaria. Hōʻoia kēia ʻike 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 manaʻoʻiʻo nā mea pane ʻo ka pīpī ʻana i ka nui o ka insecticide ke ala maikaʻi loa e pale aku ai i nā makika mai ka hoʻomohala ʻana i ke kūʻē, kahi 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 e hoʻokau mua nā mahiʻai 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 hoʻolako 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 nā pani pesticide e uhaki i nā kaulahao o ke kūʻē ʻana i ka insecticide a e hoʻomaopopo pono ʻaʻole manaʻo ka pani ʻana he hoʻololi i ka hōʻailona huahana (no ka mea, he like ka hui hana o nā hōʻailona like ʻole), akā, he 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 ke ʻano honua i hoʻomohala ʻia ai a ʻaʻole paha e hōʻike like i ka ʻoiaʻiʻo o kēia wā o nā mea waiwai moʻomeheu kikoʻī, 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 i ʻole ko lākou manaʻo no 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 noiʻi. Hiki ke ʻimi ʻia nā kiko ʻelua i nā noiʻi e hiki mai ana.
Ka manawa hoʻouna: Aug-13-2024