A na-akwalite ụgbụ akwa nwere pyrethroid clofenpyr (CFP) na pyrethroid piperonyl butoxide (PBO) n'obodo ndị a na-ahụkarị iji melite njikwa ịba nke anwụnta na-eguzogide pyrethroid na-ebufe. CFP bụ ọgwụ mgbochi nje nke chọrọ ka anwụnta cytochrome P450 monooxygenase (P450) rụọ ọrụ, PBO na-emekwa ka pyrethroids dịkwuo irè site n'igbochi ọrụ nke enzymes ndị a na anwụnta na-eguzogide pyrethroid. Ya mere, mgbochi P450 site na PBO nwere ike ibelata irè nke ụgbụ pyrethroid-CFP mgbe ejiri ya n'otu ụlọ dị ka ụgbụ pyrethroid-PBO.
E mere nnwale abụọ nke cockpit iji nyochaa ụdị abụọ dị iche iche nke pyrethroid-CFP ITN (Interceptor® G2, PermaNet® Dual) naanị ya na njikọta ya na pyrethroid-PBO ITN (DuraNet® Plus, PermaNet® 3.0). Mmetụta dị n'ime ihe nke ojiji. Nguzogide Pyrethroid. Ndị Vector na ndịda Benin. N'ọmụmụ ihe abụọ ahụ, a nwalere ụdị mesh niile na ọgwụgwọ otu na nke abụọ. E mekwara nyocha bio iji chọpụta iguzogide ọgwụ nke ndị vector n'ime ụlọ ahụ ma mụọ mmekọrịta dị n'etiti CFP na PBO.
Ndị vektọ ahụ nwere mmetụta dị ukwuu na CFP mana ha gosipụtara oke iguzogide pyrethroids, mana e meriri nguzogide a site na ikpughe tupu PBO. Ọnwụ vektọ belatara nke ukwuu n'ụlọ ntu site na iji njikọta nke ụgbụ pyrethroid-CFP na ụgbụ pyrethroid-PBO ma e jiri ya tụnyere ụlọ ntu ndị na-eji ụgbụ pyrethroid-CFP abụọ (74% maka Interceptor® G2 vs. 85%, PermaNet® Dual 57% vs. 83% ), p < 0.001). Mkpughe tupu PBO belatara nsí nke CFP na bioassays karama, na-atụ aro na mmetụta a nwere ike ịbụ n'ihi mmegide dị n'etiti CFP na PBO. Ọnwụ vektọ dị elu n'ụlọ ntu site na ijikọta ụgbụ nwere ụgbụ pyrethroid-CFP ma e jiri ya tụnyere ụlọ ntu na-enweghị ụgbụ pyrethroid-CFP, na mgbe ejiri ụgbụ pyrethroid-CFP naanị dị ka ụgbụ abụọ. Mgbe ejiri ya ọnụ, ọnwụ kachasị elu (83-85%).
Nnyocha a gosiri na arụmọrụ nke pyrethroid-CFP meshes belatara mgbe ejiri ya na pyrethroid-PBO ITN ma e jiri ya tụnyere ojiji naanị ya, ebe arụmọrụ nke njikọta mesh nwere pyrethroid-CFP meshes dị elu. Nsonaazụ ndị a na-egosi na itinye nkesa nke netwọk pyrethroid-CFP n'ọnọdụ kachasị elu karịa ụdị netwọk ndị ọzọ ga-eme ka mmetụta njikwa vektọ dịkwuo elu n'ọnọdụ ndị yiri ya.
Ọgwụ mgbochi ọrịa ịba (ITNs) nke nwere ọgwụ nje pyrethroid abụrụla isi ihe na-achịkwa ịba n'ime afọ iri abụọ gara aga. Kemgbe 2004, e nyela ihe dị ka ijeri 2.5 nke ụgbụ mgbochi ọrịa ahụhụ na mpaghara ndịda Sahara Africa [1], nke butere mmụba nke ọnụọgụgụ ndị mmadụ na-ehi ụra n'okpuru ụgbụ mgbochi ọrịa ahụhụ site na 4% ruo 47% [2]. Mmetụta nke mmejuputa a dị oke mkpa. A na-eme atụmatụ na ihe dị ka ijeri 2 nke ọrịa ịba na ọnwụ nde 6.2 ka egbochiri n'ụwa niile n'etiti 2000 na 2021, yana nyocha ihe nlereanya na-egosi na ụgbụ mgbochi ọrịa bụ isi ihe kpatara uru a [2, 3]. Agbanyeghị, ọganihu ndị a na-abịa na ọnụ ahịa: mmụba ngwa ngwa nke iguzogide pyrethroid na ọnụ ọgụgụ ndị na-alụso ọrịa ịba ọgụ. Ọ bụ ezie na ụgbụ mgbochi ọrịa pyrethroid nke a na-agwọ ọgwụ nje nwere ike inye nchebe nkeonwe megide ịba n'ebe ndị na-alụso ọrịa ọgụ na-egosipụta iguzogide pyrethroid [4], ọmụmụ ihe nlereanya na-ebu amụma na na ọkwa dị elu nke iguzogide, ụgbụ mgbochi ọrịa ahụhụ ga-ebelata mmetụta ọrịa na-efe efe [5]. Ya mere, iguzogide pyrethroid bụ otu n'ime ihe iyi egwu kachasị ukwuu na ọganihu na-adịgide adịgide na njikwa ịba.
N'ime afọ ole na ole gara aga, e mepụtala ọgbọ ọhụrụ nke ụgbụ akwa e ji ọgwụ ahụhụ gwọọ, nke na-ejikọta pyrethroids na kemịkalụ nke abụọ, iji melite njikwa ịba nke anwụnta na-eguzogide pyrethroid na-ebute. Klas ọhụrụ mbụ nke ITN nwere synergist piperonyl butoxide (PBO), nke na-eme ka pyrethroids dị ike site na igbochi enzymes detoxifying jikọtara ya na iguzogide pyrethroid, karịsịa irè nke cytochrome P450 monooxygenases (P450s) [6]. A na-enwetakwa Bednets ejiri fluprone (CFP) gwọọ, ọgwụ ahụhụ azole nwere usoro ọhụrụ nke ime ihe na-elekwasị anya na iku ume sel, n'oge na-adịbeghị anya. Mgbe egosipụtachara mmetụta entomological ka mma na nnwale nnwale hut [7, 8], e mere usoro nnwale cluster randomized controlled (cRCT) iji nyochaa uru ahụike ọha na eze nke ụgbụ ndị a ma e jiri ya tụnyere ụgbụ e ji ọgwụ ahụhụ gwọọ site na iji pyrethroids naanị ma nye ihe akaebe dị mkpa iji nye ndụmọdụ amụma sitere na Òtù Ahụike Ụwa (WHO) [9]. Dabere na ihe akaebe nke mmụba nke mmetụta ọrịa na-efe efe site na CRCTs na Uganda [11] na Tanzania [12], WHO kwadoro pyrethroid-PBO bednets nke a gwọrọ ọgwụ ahụhụ [10]. E bipụtakwara pyrethroid-CFP ITN n'oge na-adịbeghị anya mgbe e mechara nyocha RCT ndị yiri ya na Benin [13] na Tanzania [14] gosiri na ihe nlereanya ITN (Interceptor® G2) belatara ọnụọgụgụ nke ịba ụmụaka site na 46% na 44%, n'otu n'otu. 10]. ].
Mgbe mbọ ọhụrụ nke Global Fund na ndị ọzọ na-enye aka na ịba iji lụso ọgụ megide ọgwụ ahụhụ site n'ime ka e tinye ụgbụ ọhụrụ ngwa ngwa [15], a na-eji ụgbụ pyrethroid-PBO na pyrethroid-CFP eme ihe n'ebe ndị mmadụ na-anaghị ahụ ya. Na-anọchi ọgwụ ahụhụ ọdịnala. ụgbụ akwa a gwọrọ agwọ nke na-eji naanị pyrethroids. N'agbata 2019 na 2022, oke nke ụgbụ anwụnta PBO pyrethroid nke e nyere na ndịda Sahara Africa mụbara site na 8% ruo 51% [1], ebe ụgbụ anwụnta PBO pyrethroid, gụnyere ụgbụ anwụnta CFP pyrethroid, a na-atụ anya na ụgbụ anwụnta "dual action" ga-abụ 56% nke mbupu. Banye n'ahịa Afrịka ka ọ na-erule 2025[16]. Dịka ihe akaebe nke irè nke ụgbụ anwụnta pyrethroid-PBO na pyrethroid-CFP na-aga n'ihu na-eto, a na-atụ anya na ụgbụ ndị a ga-adịkwu n'ọtụtụ afọ ndị na-abịa. Ya mere, ọ dị mkpa ka e mejupụta oghere ozi gbasara ojiji kacha mma nke ụgbụ ọgwụ e ji ọgwụ ahụhụ gwọọ iji nweta mmetụta kachasị elu mgbe e mere ka ọ rụọ ọrụ nke ọma.
Ebe ọ bụ na nje bacteria pyrethroid CFP na pyrethroid PBO anwụnta na-agbasa n'otu oge, Mmemme Njikwa Ọrịa Malaria nke Mba (NMCP) nwere otu ajụjụ nyocha ọrụ: À ga-ebelata irè ya - PBO ITN? Ihe kpatara nchegbu a bụ na PBO na-arụ ọrụ site na igbochi enzymes P450 anwụnta [6], ebe CFP bụ ọgwụ nje nke chọrọ ka e mee ka ọ rụọ ọrụ site na P450s [17]. Ya mere, a na-eche na mgbe ejiri pyrethroid-CFP ITN na pyrethroid-CFP ITN n'otu ụlọ, mmetụta mgbochi nke PBO na P450 nwere ike ibelata irè nke pyrethroid-CFP ITN. Ọtụtụ ọmụmụ ụlọ nyocha egosila na ikpughe na PBO tupu ebelata nsí nke CFP nye vektọ anwụnta na nyocha bioimmune kpọmkwem [18,19,20,21,22]. Agbanyeghị, mgbe a na-eme ọmụmụ ihe n'etiti netwọk dị iche iche n'ọhịa ahụ, mmekọrịta dị n'etiti kemịkalụ ndị a ga-adị mgbagwoju anya karị. Ọmụmụ ihe ndị a na-ebipụtabeghị enyochala mmetụta nke iji ụdị ụgbụ dị iche iche ejiri ọgwụ ahụhụ mee ọnụ. Ya mere, ọmụmụ ihe ubi na-enyocha mmetụta nke iji ngwakọta nke ụgbụ pyrethroid-CFP na pyrethroid-PBO e ji ọgwụ ahụhụ gwọọ n'otu ezinụlọ ga-enyere aka ikpebi ma esemokwu dị n'etiti ụdị ụgbụ ndị a nwere ike ibute nsogbu ọrụ ma nyere aka ịchọpụta atụmatụ kachasị mma maka mpaghara ndị kesara ya n'otu aka ahụ.
Oge ozi: Sep-21-2023