Ke hoʻolaha ʻia nei nā ʻupena moe e loaʻa ana ka pyrethroid clofenpyr (CFP) a me ka pyrethroid piperonyl butoxide (PBO) ma nā ʻāina endemic e hoʻomaikaʻi i ka kaohi ʻana i ka malaria i hoʻouna ʻia e nā makika pale pyrethroid. He proinsecticide ka CFP e pono ai ka hoʻāla ʻia e ka makika cytochrome P450 monooxygenase (P450), a hoʻonui ka PBO i ka pono o nā pyrethroids ma ke kāohi ʻana i ka hana o kēia mau enzymes i loko o nā makika pale pyrethroid. No laila, ʻo ka kāohi ʻana o ka P450 e PBO e hōʻemi paha i ka pono o nā ʻupena pyrethroid-CFP ke hoʻohana ʻia ma ka home like me nā ʻupena pyrethroid-PBO.
Ua hana ʻia ʻelua mau hoʻokolohua hoʻokolohua no ka loiloi ʻana i ʻelua ʻano like ʻole o ka pyrethroid-CFP ITN (Interceptor® G2, PermaNet® Dual) wale nō a me ka hui pū ʻana me ka pyrethroid-PBO ITN (DuraNet® Plus, PermaNet® 3.0). Nā hopena entomological o ka hoʻohana ʻana i nā heluna Vector kū'ē Pyrethroid ma ka hema o Benin. Ma nā haʻawina ʻelua, ua hoʻāʻo ʻia nā ʻano mesh āpau i nā lāʻau mesh hoʻokahi a me ka pālua. Ua hana pū ʻia nā Bioassays e loiloi i ke kū'ē ʻana o nā lāʻau lapaʻau o nā heluna vector i loko o ka hale a e aʻo i ka pilina ma waena o CFP a me PBO.
Ua ʻike ka heluna vector i ka CFP akā ua hōʻike i nā pae kiʻekiʻe o ke kūʻē ʻana i nā pyrethroids, akā ua lanakila ʻia kēia kūʻē e ka hoʻolaha mua ʻana iā PBO. Ua hoʻemi nui ʻia ka make ʻana o nā vector i loko o nā hale liʻiliʻi me ka hoʻohana ʻana i ka hui pū ʻana o nā ʻupena pyrethroid-CFP a me nā ʻupena pyrethroid-PBO i hoʻohālikelike ʻia me nā hale liʻiliʻi e hoʻohana ana i ʻelua mau ʻupena pyrethroid-CFP (74% no Interceptor® G2 vs. 85%, PermaNet® Dual 57% vs. 83%), p < 0.001). Ua hoʻemi ka hoʻolaha mua ʻana iā PBO i ka ʻawahia o CFP i nā bioassays ʻōmole, e hōʻike ana he hopena paha kēia ma muli o ka antagonism ma waena o CFP a me PBO. ʻOi aku ka kiʻekiʻe o ka make ʻana o nā vector i loko o nā hale liʻiliʻi me ka hoʻohana ʻana i nā hui pū ʻana o nā ʻupena i loaʻa nā ʻupena pyrethroid-CFP i hoʻohālikelike ʻia me nā hale liʻiliʻi me ka ʻole o nā ʻupena pyrethroid-CFP, a i ka wā i hoʻohana wale ʻia ai nā ʻupena pyrethroid-CFP ma ke ʻano he ʻelua mau ʻupena. Ke hoʻohana pū ʻia, ʻoi aku ka nui o ka make (83-85%).
Ua hōʻike kēia haʻawina ua hoʻemi ʻia ka pono o nā ʻupena pyrethroid-CFP i ka wā i hoʻohana ʻia ai me ka pyrethroid-PBO ITN i hoʻohālikelike ʻia me ka hoʻohana wale ʻana, ʻoiai ʻoi aku ka kiʻekiʻe o ka pono o nā hui ʻupena me nā ʻupena pyrethroid-CFP. Hōʻike kēia mau hopena e hoʻonui ka hoʻonohonoho ʻana i ka hoʻolaha ʻana o nā pūnaewele pyrethroid-CFP ma mua o nā ʻano pūnaewele ʻē aʻe i nā hopena kaohi vector i nā kūlana like.
ʻO nā ʻupena moe i mālama ʻia me nā mea pepehi pepeke (ITN) i loaʻa nā mea pepehi pepeke pyrethroid ua lilo i kumu nui o ka kaohi ʻana i ka malaria i nā makahiki he iwakālua i hala. Mai ka makahiki 2004, ua hoʻolako ʻia ma kahi o 2.5 biliona mau ʻupena moe i mālama ʻia me nā mea pepehi pepeke i ʻApelika sub-Saharan [1], e hopena ana i ka piʻi ʻana o ka hapa o ka heluna kanaka e hiamoe ana ma lalo o nā ʻupena moe i mālama ʻia me nā mea pepehi pepeke mai 4% a i 47% [2]. He mea koʻikoʻi ka hopena o kēia hoʻokō ʻana. Ua manaʻo ʻia ua pale ʻia ma kahi o 2 biliona mau hihia malaria a me 6.2 miliona mau make ma ka honua holoʻokoʻa ma waena o 2000 a me 2021, me nā loiloi hoʻohālike e hōʻike ana he mau mea hoʻokele nui kēia pono nā ʻupena i mālama ʻia me nā mea pepehi pepeke [2, 3]. Eia nō naʻe, hiki mai kēia mau holomua me ke kumukūʻai: ka wikiwiki o ka ulu ʻana o ke kūʻē ʻana o ka pyrethroid i nā heluna kanaka vector malaria. ʻOiai hiki i nā ʻupena moe i mālama ʻia me nā mea pepehi pepeke pyrethroid ke hāʻawi i ka pale pilikino e kūʻē i ka malaria ma nā wahi kahi e hōʻike ai nā vectors i ke kūʻē ʻana o ka pyrethroid [4], ua wānana nā haʻawina hoʻohālike ma nā pae kiʻekiʻe o ke kūʻē ʻana, e hōʻemi nā ʻupena moe i mālama ʻia me nā mea pepehi pepeke i ka hopena epidemiological [5]. . No laila, ʻo ke kū'ē ʻana i ka pyrethroid kekahi o nā hoʻoweliweli koʻikoʻi i ka holomua mau loa i ka kaohi ʻana i ka malaria.
I nā makahiki i hala iho nei, ua hoʻomohala ʻia kahi hanauna hou o nā ʻupena moe i mālama ʻia me ka insecticide, kahi e hoʻohui pū ai i nā pyrethroids me kahi kemika ʻelua, e hoʻomaikaʻi i ka kaohi ʻana i ka malaria i hoʻouna ʻia e nā makika pale pyrethroid. ʻO ka papa hou mua o ITN aia ka synergist piperonyl butoxide (PBO), ka mea e hoʻoikaika i nā pyrethroids ma ka hoʻopau ʻana i nā enzymes detoxifying e pili ana me ke kūʻē ʻana i ka pyrethroid, ʻoiai ka pono o nā cytochrome P450 monooxygenases (P450s) [6]. ʻO nā ʻupena moe i mālama ʻia me ka fluprone (CFP), kahi azole insecticide me kahi ʻano hana hou e kuhikuhi ana i ka hanu ʻana o ke kelepona, ua loaʻa hou nei. Ma hope o ka hōʻike ʻana o ka hopena entomological i hoʻomaikaʻi ʻia i nā hoʻokolohua hoʻāʻo hut [7, 8], ua hana ʻia kahi moʻo o nā hoʻokolohua hoʻomalu randomized cluster (cRCT) e loiloi i nā pono olakino lehulehu o kēia mau ʻupena i hoʻohālikelike ʻia me nā ʻupena i mālama ʻia me ka insecticide e hoʻohana ana i nā pyrethroids wale nō a hāʻawi i nā hōʻike e pono ai e hoʻomaopopo i nā ʻōlelo aʻoaʻo kulekele mai ka World Health Organization (WHO) [9]. Ma muli o nā hōʻike o ka hopena epidemiological i hoʻomaikaʻi ʻia mai nā CRCT ma Uganda [11] a me Tanzania [12], ua ʻae ka WHO i nā ʻupena moe i mālama ʻia me ka insecticide pyrethroid-PBO [10]. Ua paʻi hou ʻia ka pyrethroid-CFP ITN ma hope o nā RCT like ma Benin [13] a me Tanzania [14] i hōʻike ʻia ua hōʻemi ka prototype ITN (Interceptor® G2) i ka nui o ka maʻi malaria o nā kamaliʻi ma 46% a me 44%, kēlā me kēia. 10]. ].
Ma hope o nā hana hou a ka Global Fund a me nā mea hāʻawi malaria nui ʻē aʻe e hoʻoponopono i ke kūʻē ʻana i ka insecticide ma ka wikiwiki ʻana i ka hoʻolauna ʻana i nā ʻupena moe hou [15], ke hoʻohana mua ʻia nei nā ʻupena moe pyrethroid-PBO a me pyrethroid-CFP ma nā wahi endemic. Hoʻololi i nā insecticides kuʻuna. nā ʻupena moe i mālama ʻia e hoʻohana wale ana i nā pyrethroids. Ma waena o 2019 a me 2022, ua piʻi ka hapa o nā ʻupena makika PBO pyrethroid i hoʻolako ʻia i sub-Saharan Africa mai 8% a 51% [1], ʻoiai nā ʻupena makika PBO pyrethroid, me nā ʻupena makika CFP pyrethroid, manaʻo ʻia nā ʻupena makika "hana pālua" e helu no 56% o nā hoʻouna. E komo i ka mākeke ʻApelika ma 2025 [16]. I ka hoʻomau ʻana o ka hōʻike o ka pono o nā ʻupena makika pyrethroid-PBO a me pyrethroid-CFP, manaʻo ʻia e loaʻa nui kēia mau ʻupena i nā makahiki e hiki mai ana. No laila, ke ulu nei ka pono e hoʻopiha i nā hakahaka ʻike e pili ana i ka hoʻohana pono ʻana i nā ʻupena moe i mālama ʻia me nā pepeke pepeke o ka hanauna hou e hoʻokō ai i ka hopena nui loa ke hoʻonui ʻia no ka hoʻohana piha ʻana.
Ma muli o ka hoʻolaha like ʻana o nā ʻupena makika pyrethroid CFP a me nā ʻupena makika pyrethroid PBO, hoʻokahi nīnau noiʻi hana a ka National Malaria Control Program (NMCP): E hoʻemi ʻia anei kona pono - PBO ITN? ʻO ke kumu o kēia hopohopo, ʻo ia ka hana a PBO ma ke kāohi ʻana i nā enzymes makika P450 [6], ʻoiai ʻo CFP he proinsecticide e pono ai ka hoʻāla ʻana ma o P450s [17]. No laila, ua manaʻo ʻia i ka wā e hoʻohana ʻia ai ka pyrethroid-CFP ITN a me ka pyrethroid-CFP ITN ma ka home hoʻokahi, hiki i ka hopena inhibitory o PBO ma P450 ke hoʻemi i ka pono o ka pyrethroid-CFP ITN. Ua hōʻike ʻia kekahi mau haʻawina hoʻokolohua e hōʻemi ana ka pre-exposure iā PBO i ka toxicity acute o CFP i nā vectors makika i nā bioassays hōʻike pololei [18,19,20,21,22]. Eia nō naʻe, i ka wā e hana ai i nā haʻawina ma waena o nā pūnaewele like ʻole ma ke kahua, e ʻoi aku ka paʻakikī o nā pilina ma waena o kēia mau kemika. Ua nānā nā haʻawina i paʻi ʻole ʻia i nā hopena o ka hoʻohana ʻana i nā ʻano ʻupena i mālama ʻia me ka insecticide like ʻole. No laila, ʻo nā haʻawina kahua e loiloi ana i ka hopena o ka hoʻohana ʻana i ka hui pū ʻana o ka pyrethroid-CFP i mālama ʻia me ka insecticide a me nā ʻupena moe pyrethroid-PBO i loko o ka hale hoʻokahi e kōkua i ka hoʻoholo ʻana inā he pilikia hana ka antagonism ma waena o kēia mau ʻano ʻupena a kōkua i ka hoʻoholo ʻana i ka hoʻolālā hoʻolaha maikaʻi loa. no kona mau wahi i hoʻolaha like ʻia.
Ka manawa hoʻouna: Sep-21-2023