ʻO ka nui o ka maʻi malaria ma waena o nā keiki mai 6 mahina a 10 mau makahiki he 2.7 no 100 mau mahina kanaka ma ka ʻāpana IRS a he 6.8 no 100 mau mahina kanaka ma ka ʻāpana kaohi. Eia nō naʻe, ʻaʻohe ʻokoʻa koʻikoʻi o ka maʻi malaria ma waena o nā wahi ʻelua i nā mahina mua ʻelua (Iulai-ʻAukake) a ma hope o ke kau ua (Dekemaba-Pepeluali) (e nānā i ke Kiʻi 4).
Nā piʻo ola ʻo Kaplan-Meier no nā keiki 1 a 10 mau makahiki ma ka wahi aʻo ma hope o 8 mau mahina o ka nānā ʻana
Ua hoʻohālikelike kēia haʻawina i ka laha ʻana o ka maʻi malaria a me ka hanana ma nā ʻāpana ʻelua me ka hoʻohana ʻana i nā hoʻolālā kaohi malaria i hoʻohui ʻia e loiloi i ka hopena hou aʻe o ka IRS. Ua hōʻiliʻili ʻia nā ʻikepili ma nā ʻāpana ʻelua ma o ʻelua mau anamanaʻo cross-sectional a me kahi anamanaʻo hihia passive 9 mahina ma nā keʻena olakino. Ua hōʻike nā hopena mai nā anamanaʻo cross-sectional i ka hoʻomaka a me ka hopena o ke kau hoʻoili malaria ua emi nui ka parasitaemia malaria ma ka ʻāpana IRS (LLTID + IRS) ma mua o ka ʻāpana kaohi (LLTIN wale nō). ʻOiai ua like nā ʻāpana ʻelua ma ke ʻano o ka epidemiology malaria a me nā hana komo, hiki ke wehewehe ʻia kēia ʻokoʻa e ka waiwai i hoʻohui ʻia o IRS ma ka ʻāpana IRS. ʻO ka ʻoiaʻiʻo, ua ʻike ʻia nā ʻupena insecticidal lōʻihi a me ka IRS e hōʻemi nui i ke kaumaha malaria ke hoʻohana wale ʻia. No laila, ua wānana nā haʻawina he nui [7, 21, 23, 24, 25] e hopena kā lākou hui pū ʻana i ka emi nui ʻana o ke kaumaha malaria ma mua o kekahi. ʻOiai ʻo IRS, piʻi ka parasitaemia Plasmodium mai ka hoʻomaka a hiki i ka hopena o ke kau ua ma nā wahi me ka hoʻoili malaria kau, a manaʻo ʻia kēia ʻano e piʻi i ka hopena o ke kau ua. Eia nō naʻe, ʻoi aku ka haʻahaʻa o ka piʻi ʻana o ka ʻāpana IRS (53.0%) ma mua o ka ʻāpana kaohi (220.0%). ʻEiwa mau makahiki o nā hoʻolaha IRS i hoʻomau ʻia me ke kānalua ʻole ua kōkua i ka hōʻemi ʻana a i ʻole ke kāohi ʻana i nā piko o ka laha ʻana o ka maʻi ma nā wahi IRS. Eia kekahi, ʻaʻohe ʻokoʻa o ka helu gametophyte ma waena o nā wahi ʻelua i ka hoʻomaka. I ka hopena o ke kau ua, ʻoi aku ka kiʻekiʻe ma kahi kaohi (11.5%) ma mua o ka wahi IRS (3.2%). Hoʻākāka iki kēia ʻike i ka haʻahaʻa loa o ka parasitemia malaria ma ka ʻāpana IRS, ʻoiai ʻo ka helu gametocyte kahi kumu kūpono o ka maʻi makika e alakaʻi ana i ka laha malaria.
Hōʻike nā hopena o ka loiloi regression logistic i ka pilikia maoli e pili ana me ka maʻi malaria ma ka wahi kaohi a hōʻike i ka manaʻo nui ʻia o ka pilina ma waena o ke kuni a me ka parasitemia a he mea hoʻohuihui ka anemia.
E like me ka parasitaemia, ʻoi aku ka haʻahaʻa o ka nui o ka malaria i waena o nā keiki 0-10 mau makahiki ma ka IRS ma mua o nā wahi kaohi. Ua ʻike ʻia nā piko hoʻoili kuʻuna ma nā wahi ʻelua, akā ua haʻahaʻa loa lākou ma ka IRS ma mua o ka wahi kaohi (Kiʻi 3). ʻO ka ʻoiaʻiʻo, ʻoiai e mau ana nā pesticides no kahi o 3 mau makahiki ma LLINs, mau lākou a hiki i 6 mau mahina ma ka IRS. No laila, hana ʻia nā hoʻolaha IRS i kēlā me kēia makahiki e uhi i nā piko hoʻoili. E like me ka mea i hōʻike ʻia e nā piʻo ola ʻo Kaplan-Meier (Kiʻi 4), ʻoi aku ka liʻiliʻi o nā hihia lapaʻau o ka malaria i nā keiki e noho ana ma nā wahi IRS ma mua o nā mea ma nā wahi kaohi. He kūlike kēia me nā haʻawina ʻē aʻe i hōʻike i ka emi nui ʻana o ka nui o ka malaria i ka wā e hui pū ʻia ai ka IRS i hoʻonui ʻia me nā hana ʻē aʻe. Eia nō naʻe, ʻo ka lōʻihi palena o ka pale ʻana mai nā hopena koena o ka IRS e hōʻike ana he pono e hoʻomaikaʻi ʻia kēia hoʻolālā ma ka hoʻohana ʻana i nā insecticides lōʻihi a i ʻole ka hoʻonui ʻana i ka pinepine o ka noi makahiki.
ʻO nā ʻokoʻa o ka laha ʻana o ka anemia ma waena o ka IRS a me nā wahi kaohi, ma waena o nā hui makahiki like ʻole a ma waena o nā mea komo me ke kuni a me ka ʻole o ke kuni e lawelawe paha ma ke ʻano he hōʻailona maikaʻi ʻole o ka hoʻolālā i hoʻohana ʻia.
Ua hōʻike kēia haʻawina e hiki i ka pirimiphos-methyl IRS ke hōʻemi nui i ka laha a me ka nui o ka maʻi malaria i nā keiki ma lalo o 10 mau makahiki ma ka ʻāina ʻo Koulikoro i kūʻē i ka pyrethroid, a ʻoi aku ka nui o ka loaʻa ʻana o ka malaria i nā keiki e noho ana ma nā wahi IRS a noho lōʻihi ʻaʻole i loaʻa ka malaria ma ia wahi. Ua hōʻike nā haʻawina he lāʻau pepehi kanaka kūpono ka pirimiphos-methyl no ka kaohi ʻana i ka malaria ma nā wahi i maʻamau ai ke kūʻē ʻana i ka pyrethroid.
Ka manawa hoʻouna: Dec-09-2024