Ke hoʻolaha ʻia nei nā ʻupena moe i loko o ka pyrethroid clofenpyr (CFP) a me ka pyrethroid piperonyl butoxide (PBO) i nā ʻāina hopena e hoʻomaikaʻi i ka hoʻomalu ʻana i ka maʻi maʻi i lawe ʻia e nā makika pale pyrethroid-resistant.ʻO ka CFP he proinsecticide e koi ana i ka hoʻoulu 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 enzyme i nā makika pale pyrethroid.No laila, hiki i ka P450 inhibition e PBO ke hoʻemi i ka pono o nā ʻupena pyrethroid-CFP ke hoʻohana ʻia ma ka home like me nā ʻupena pyrethroid-PBO.
Ua mālama ʻia ʻelua mau hoʻokolohua cockpit hoʻokolohua e loiloi i ʻelua mau ʻano pyrethroid-CFP ITN (Interceptor® G2, PermaNet® Dual) wale nō a hui pū me pyrethroid-PBO ITN (DuraNet® Plus, PermaNet® 3.0).Nā hopena Entomological o ka hoʻohana ʻana i ka Pyrethroid resistance Vector populations ma ka hema Benin.I loko o nā haʻawina ʻelua, ua hoʻāʻo ʻia nā ʻano mesh āpau i ka hoʻomaʻamaʻa ʻana i hoʻokahi a me ʻelua.Ua mālama ʻia nā bioassays e loiloi i ke kūʻē ʻana i ka lāʻau o nā heluna vector i loko o ka hale a noʻonoʻo i ka pilina ma waena o CFP a me PBO.
Ua maʻalahi ka heluna kanaka vector i ka CFP akā ua hōʻike i nā kiʻekiʻe kiʻekiʻe o ke kū'ē i nā pyrethroids, akā ua lanakila kēia kū'ē ma o ka hoʻolaha mua ʻana iā PBO.Ua hoʻemi nui ʻia ka make ʻana o Vector i nā hale me ka hoʻohana ʻana i nā ʻupena pyrethroid-CFP a me nā ʻupena pyrethroid-PBO i hoʻohālikelike ʻia me nā ʻupena e hoʻohana ana i ʻelua mau ʻupena pyrethroid-CFP (74% no Interceptor® G2 vs. 85%, PermaNet® Dual 57% vs. 83 % ), p < 0.001).ʻO ka hōʻike mua ʻana iā PBO i hōʻemi i ka ʻawaʻawa o CFP i loko o nā bioassays hue, me ka manaʻo e pili ana kēia hopena ma muli o ka antagonism ma waena o CFP a me PBO.ʻOi aku ka kiʻekiʻe o ka make ʻana o Vector ma nā hale me ka hoʻohana ʻana i nā ʻupena i loaʻa nā ʻupena pyrethroid-CFP i hoʻohālikelike ʻia me nā hale me ka ʻupena ʻole pyrethroid-CFP, a i ka wā i hoʻohana ʻia ai nā ʻupena pyrethroid-CFP ma ke ʻano he ʻelua ʻupena.Ke hoʻohana pū ʻia, ʻoi aku ka nui o ka make (83-85%).
Ua hōʻike ʻia kēia haʻawina ua hoʻemi ʻia ka maikaʻi o nā mesh pyrethroid-CFP ke hoʻohana pū ʻia me ka pyrethroid-PBO ITN i hoʻohālikelike ʻia me ka hoʻohana wale ʻana, akā ʻoi aku ka kiʻekiʻe o ka pono o nā hui mesh i loaʻa nā meshes pyrethroid-CFP.Hōʻike kēia mau hualoaʻa i ka hoʻokaʻawale ʻana o nā pūnaewele pyrethroid-CFP ma luna o nā ʻano pūnaewele ʻē aʻe e hoʻonui i nā hopena mana vector i nā kūlana like.
Ua lilo nā ʻupena moe i mālama ʻia i ka lāʻau insecticide (ITNs) i loaʻa nā insecticides pyrethroid i mea nui o ka hoʻomalu malaria i nā makahiki ʻelua i hala.Mai ka makahiki 2004, ma kahi o 2.5 biliona mau ʻupena moe i mālama ʻia i ka insecticide i hoʻolako ʻia i ka sub-Saharan Africa [1], ka hopena o ka hoʻonui ʻana o ka heluna o ka heluna kanaka e hiamoe ana ma lalo o nā ʻupena moe i mālama ʻia i ka insecticide mai 4% a 47% [2].He mea nui ka hopena o kēia hoʻokō.Ua manaʻo ʻia aia ma kahi o 2 biliona mau maʻi malaria a me 6.2 miliona mau make i pale ʻia ma ka honua holoʻokoʻa ma waena o 2000 a me 2021, me nā loiloi hoʻohālike e hōʻike ana ʻo nā ʻupena lāʻau insecticide ka mea hoʻokele nui o kēia pono [2, 3].Eia nō naʻe, hiki mai kēia mau holomua ma ke kumukūʻai: ka hoʻonui wikiwiki ʻana o ke kūʻē pyrethroid i nā heluna malaria vector.ʻOiai ʻo nā ʻupena moe i mālama ʻia e ka pyrethroid insecticide hiki ke hāʻawi i ka palekana o kēlā me kēia kanaka mai ka maʻi maʻi ma nā wahi kahi e hōʻike ai nā vectors i ka pale pyrethroid [4], wānana nā haʻawina hoʻohālike i nā pae kiʻekiʻe o ke kūʻē ʻana, e hōʻemi nā ʻupena moe i mālama ʻia i ka insecticide [5]..No laila, ʻo ke kūpaʻa pyrethroid kekahi o nā mea hoʻoweliweli koʻikoʻi i ka holomua hoʻomau i ka mālama ʻana i ka malaria.
I nā makahiki i hala iho nei, ua hoʻomohala ʻia kahi hanauna hou o nā ʻupena moe i mālama ʻia i ka insecticide, e hui pū ana i nā pyrethroids me kahi kemika ʻelua, e hoʻomaikaʻi i ka hoʻomalu ʻana i ka maʻi maʻi i lawe ʻia e nā makika pale pyrethroid.Aia ka papa hou mua o ITN i ka synergist piperonyl butoxide (PBO), ka mea e potentiates pyrethroids ma ka neutralizing detoxifying enzymes e pili ana me ka pyrethroid resistance, ʻoi aku ka maikaʻi o ka cytochrome P450 monooxygenases (P450s) [6].Ua loaʻa hou nā Bednets i mālama ʻia me ka fluprone (CFP), he insecticide azole me kahi ʻano hana hou e pili ana i ka hanu ʻana o ke kelepona.Ma hope o ka hōʻike ʻana i ka hopena entomological i hoʻomaikaʻi ʻia i nā hoʻokolohua pailota hale [7, 8], ua alakaʻi ʻia kahi ʻano o ka cluster randomized controlled trials (cRCT) e loiloi i nā pono olakino olakino o kēia mau ʻupena i hoʻohālikelike ʻia me nā ʻupena i mālama ʻia i ka insecticide me ka hoʻohana ʻana i nā pyrethroids wale nō a hāʻawi i ka nā hōʻike e pono ai e hoʻomaopopo i nā manaʻo kulekele mai ka World Health Organization (WHO) [9].Ma muli o nā hōʻike o ka hoʻomaikaʻi ʻana i ka hopena epidemiological mai CRCTs ma Uganda [11] a me Tanzania [12], ua kākoʻo ka WHO i ka pyrethroid-PBO insecticide-treated bednets [10].Ua paʻi hou ʻia ka pyrethroid-CFP ITN ma hope o nā RCT like ma Benin [13] a me Tanzania [14] i hōʻike i ka prototype ITN (Interceptor® G2) i hōʻemi i ka maʻi o ka maʻi maʻi kamaliʻi e 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 o ka hoʻolalelale ʻana i ka hoʻokomo ʻana i nā bednets hou [15], ua hoʻohana ʻia nā ʻupena moe pyrethroid-PBO a me pyrethroid-CFP ma nā wahi endemic.Hoʻololi i nā insecticides kahiko.nā ʻupena moe e hoʻohana wale i nā pyrethroids.Ma waena o 2019 a me 2022, ua hoʻonui ʻia ka hapa o nā ʻupena namu PBO pyrethroid i hāʻawi ʻia i sub-Saharan Africa mai 8% a i 51% [1], ʻoiai ʻo PBO pyrethroid namu ʻupena, me ka CFP pyrethroid mosquito nets, ua manaʻo ʻia ka "hana ʻelua" i ka makika. helu no 56% o nā hoʻouna.E komo i ka mākeke ʻApelika e 2025[16].Ma ke ʻano he hōʻike o ka maikaʻi o nā ʻupena namu pyrethroid-PBO a me pyrethroid-CFP e hoʻomau nei ka ulu ʻana, manaʻo ʻia e lilo kēia mau ʻupena i mea ākea i nā makahiki e hiki mai ana.No laila, ke ulu nei ka pono e hoʻopiha i nā ʻike āpau e pili ana i ka hoʻohana maikaʻi ʻana i nā ʻupena moe i mālama ʻia i nā pepeke hou e loaʻa ai ka hopena kiʻekiʻe ke hoʻonui ʻia no ka hoʻohana piha ʻana.
Hāʻawi ʻia i ka hoʻonui like ʻana o ka pyrethroid CFP a me ka pyrethroid PBO ʻupena makika, aia ka National Malaria Control Program (NMCP) i hoʻokahi nīnau noiʻi hana: E hoʻemi ʻia ka pono - PBO ITN?ʻO ke kumu o kēia hopohopo ʻo ia ka hana ʻana o PBO ma ke kāohi ʻana i nā enzymes P450 namu [6], ʻoiai ʻo CFP kahi proinsecticide e koi ai i ka hoʻāla ʻana ma o P450s [17].No laila, manaʻo ʻia ke hoʻohana ʻia ka pyrethroid-CFP ITN a me ka pyrethroid-CFP ITN i ka home hoʻokahi, hiki i ka hopena hoʻohiolo o PBO ma P450 ke hoʻemi i ka pono o ka pyrethroid-CFP ITN.Ua hōʻike ʻia kekahi mau noiʻi hoʻokolohua ʻo ka pre-exposure i ka PBO e hōʻemi i ka ʻawaʻawa nui o CFP i nā vectors namu i nā bioassays hōʻike pololei [18,19,20,21,22].Eia nō naʻe, i ka wā e hana ana i nā haʻawina ma waena o nā ʻupena like ʻole i ke kula, ʻoi aku ka paʻakikī o ka pilina ma waena o kēia mau kemika.Ua nānā nā haʻawina ʻaʻole i paʻi ʻia i ka hopena o ka hoʻohana pū ʻana i nā ʻano ʻupena lāʻau lapaʻau insecticide.No laila, ʻo nā haʻawina kula e loiloi ana i ka hopena o ka hoʻohana ʻana i ka hui pū ʻana o ka pyrethroid-CFP a me nā ʻupena moe pyrethroid-PBO i loko o ka hale hoʻokahi e kōkua i ka hoʻoholo ʻana inā pilikia paha ka hakakā ma waena o kēia mau ʻano ʻupena a kōkua i ka hoʻoholo ʻana i ka hoʻolālā hoʻolālā maikaʻi loa. .no kona mau mahele like ole.
Ka manawa hoʻouna: Sep-21-2023