He mahi nui tā ngā patupatu i roto i te ahuwhenua taiwhenua, engari ko te nui rawa, ko te whakamahinga hē rānei, ka pā kino ki ngā kaupapa here whakahaere i ngā mate urutā; I whakahaerehia tēnei rangahau i waenga i ngā hapori ahuwhenua i te tonga o Côte d'Ivoire hei whakatau ko ēhea ngā patupatu e whakamahia ana e ngā kaimahi pāmu o te rohe, me pēhea hoki tēnei e pā ai ki ngā tirohanga a ngā kaimahi pāmu ki te mate urutā. Mā te mārama ki te whakamahinga o ngā patupatu ka āwhina i te whakawhanake i ngā kaupapa mōhiotanga mō te whakahaere namu me te whakamahinga o ngā patupatu.
I whakahaerehia te rangahau i waenga i ngā whare 1,399 i roto i ngā kāinga 10. I rangahauhia ngā kaimahi pāmu mō ō rātou mātauranga, ngā mahi ahuwhenua (hei tauira, te whakaputa hua, te whakamahi i ngā patu pepeke), ngā tirohanga ki te malaria, me ngā rautaki whakahaere namu rerekē i whakamahia e rātou. Ka aromatawaihia te tūnga ōhanga-ōhanga (SES) o ia whare i runga i ētahi rawa o te whare kua whakaritea. Ka tatauhia ngā whanaungatanga tatauranga i waenga i ngā taurangi rerekē, e whakaatu ana i ngā āhuatanga mōrearea nui.
He hononga nui te taumata mātauranga o ngā kaimahi pāmu ki tō rātou tūnga ōhanga-ōhanga (p < 0.0001). Ko te nuinga o ngā whare (88.82%) i whakapono ko ngā waeroa te tino take o te malaria, ā, he hononga pai te mōhiotanga ki te malaria ki te taumata mātauranga teitei (OR = 2.04; 95% CI: 1.35, 3.10). He hononga kaha te whakamahinga o ngā matū i roto i te whare ki te tūnga ōhanga-ōhanga o te whare, te taumata mātauranga, te whakamahinga o ngā kupenga moenga i rongoatia ki ngā patu pepeke me ngā patu pepeke ahuwhenua (p < 0.0001). Kua kitea kei te whakamahi ngā kaimahi pāmu i ngā patu pepeke pyrethroid i roto i te whare, ā, kei te whakamahi i ēnei patu pepeke hei tiaki i ngā hua.
E whakaatu ana tā mātou rangahau ko te taumata mātauranga tonu te mea nui e awe ana i te mōhiotanga o ngā kaimahi pāmu ki te whakamahinga o ngā patu pepeke me te whakahaere i te malaria. Ka tūtohu mātou kia whakaarohia te whakapai ake i te whakawhitiwhiti kōrero e aro ana ki te whakatutukitanga mātauranga, tae atu ki te tūnga ōhanga-ōhanga, te wātea, me te urunga atu ki ngā hua matū whakahaeretia i te wā e whakawhanake ana i te whakahaere patu pepeke me ngā wawaotanga whakahaere mate kawe-ira mō ngā hapori o te rohe.
Ko te ahuwhenua te pūtake ohanga matua mō te maha o ngā whenua o Āwherika ki te Hauāuru. I te tau 2018 me te tau 2019, ko Côte d'Ivoire te kaihanga koko me ngā nati kāhew nui rawa atu o te ao, ā, ko te tuatoru o ngā kaihanga kawhe nui rawa atu i Āwherika [1], me ngā ratonga me ngā hua ahuwhenua e 22% o te hua ā-rohe (GDP) [2]. I te mea ko rātou ngā kaipupuri o te nuinga o ngā whenua ahuwhenua, ko ngā kaipupuri whenua iti i ngā taiwhenua ngā tino kaiāwhina ki te whanaketanga ōhanga o te rāngai [3]. He nui te pūmanawa ahuwhenua o te whenua, me te 17 miriona heketea o ngā whenua ahuwhenua me ngā rerekētanga o te wā e pai ana ki te kanorau o ngā hua me te whakatipu kawhe, koko, nati kāhew, rapa, miro, uwhi, nikau, manioka, raihi me ngā huawhenua [2]. Ka whai wāhi te ahuwhenua kaha ki te horapa o ngā pepeke, ko te nuinga mā te whakanui ake i te whakamahinga o ngā patu pepeke hei whakahaere i ngā pepeke [4], inā koa i waenga i ngā kaimahi whenua, hei tiaki i ngā hua me te whakanui ake i ngā hua hua [5], me te whakahaere i ngā waeroa [6]. Heoi, ko te whakamahinga hē o ngā patu pepeke tētahi o ngā tino take o te ātete ki ngā patu pepeke i roto i ngā kawe mate, inā koa i ngā wāhi ahuwhenua kei reira ngā waeroa me ngā riha hua ka pāngia e te pēhanga kōwhiringa mai i ngā patu pepeke kotahi [7,8,9,10]. Ka taea e te whakamahinga o ngā patu pepeke te whakararu i te parahanga ka pā ki ngā rautaki whakahaere patu pepeke me te taiao, nō reira me aro atu [11, 12, 13, 14, 15].
Kua rangahaua te whakamahinga o ngā patupatu e ngā kaimahi pāmu i ngā wā o mua [5, 16]. Kua whakaatuhia te taumata mātauranga hei mea matua mō te whakamahinga tika o ngā patupatu [17, 18], ahakoa he maha ngā wā ka pāngia te whakamahinga o ngā patupatu e ngā kaimahi pāmu e ngā wheako wheako, ngā taunakitanga rānei a ngā kaihokohoko [5, 19, 20]. Ko ngā herenga pūtea tētahi o ngā arai tino noa e whakawhāiti ana i te urunga atu ki ngā patupatu, ngā patupatu rānei, e ārahi ana i ngā kaimahi pāmu ki te hoko hua ture kore, kua tawhito rānei, he iti ake te utu i ngā hua ture [21, 22]. Ka kitea anō ngā au rite i ētahi atu whenua o Āwherika ki te Hauāuru, ko te iti o te moni whiwhi te take mō te hoko me te whakamahi i ngā patupatu kāore i te tika [23, 24].
I Côte d'Ivoire, he whānuitia te whakamahinga o ngā patu pepeke ki ngā hua whenua [25, 26], e pā ana ki ngā mahi ahuwhenua me ngā taupori kawe malaria [27, 28, 29, 30]. Kua whakaatuhia e ngā rangahau i ngā wāhi e horapa ana te malaria he hononga i waenga i te tūnga ōhanga-ōhanga me ngā tirohanga ki te malaria me ngā mōrearea mate, me te whakamahinga o ngā kupenga moenga i rongoatia ki ngā patu pepeke (ITN) [31,32,33,34,35,36,37]. Ahakoa ēnei rangahau, ka whakararuhia ngā mahi ki te whakawhanake i ngā kaupapa here whakahaere namu motuhake e te kore o ngā mōhiohio e pā ana ki te whakamahinga patu pepeke i ngā wāhi tuawhenua me ngā āhuatanga e whai wāhi ana ki te whakamahinga tika o ngā patu pepeke. I tirotirohia e tēnei rangahau ngā whakapono malaria me ngā rautaki whakahaere namu i waenga i ngā whare ahuwhenua i Abeauville, te tonga o Côte d'Ivoire.
I whakahaerehia te rangahau i roto i ngā kāinga tekau i te tari o Abeauville i te tonga o Côte d'Ivoire (Pikitia 1). E 292,109 ngā tāngata o te Porowini o Agbowell, he rohe 3,850 kiromita tapawha te rahi, ā, koia te porowini tino taupori i te rohe o Anyebi-Tiasa [38]. He āhuarangi pārūrū tōna, e rua ngā wā ua (Paenga-whāwhā ki Hūrae me Oketopa ki Noema) [39, 40]. Ko te ahuwhenua te mahi matua o te rohe, ā, e whakahaerehia ana e ngā kaimahi pāmu iti me ngā kamupene ahuwhenua nui. Ko enei waahi 10 ko 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, 634.256.56.5), Love 642, 062.37 N), Ofa (350 924.31 E, 654 607.17 N), Ofonbo (338 578.5) 1 E, 657 302.17 N) me Oji (te roa 363,990.74 rawhiti, te whānui 648,587.44 raki).
I whakahaerehia te rangahau i waenga i te marama o Ākuhata 2018 me Maehe 2019 me te whai wāhi mai o ngā whare pāmu. Ko te tapeke o ngā kainoho o ia kāinga i tangohia mai i te tari ratonga ā-rohe, ā, 1,500 ngā tāngata i tīpakohia matapōkeretia mai i tēnei rārangi. Ko ngā kaiuru i tohua mai i waenga i te 6% me te 16% o te taupori o te kāinga. Ko ngā whare i whakaurua ki te rangahau ko ngā whare pāmu i whakaae ki te whai wāhi. I whakahaerehia he rangahau tuatahi i waenga i te 20 ngā pāmu hei aromatawai mēnā me tuhi anō ētahi pātai. Kātahi ka whakaotihia ngā pātai e ngā kaikohi raraunga whakangungua me te utu i ia kāinga, ā, kotahi te iti rawa i tohua mai i te kāinga tonu. Nā tēnei kōwhiringa i whakarite kia kotahi te kaikohi raraunga o ia kāinga e mōhio ana ki te taiao me te kōrero i te reo o te rohe. I roto i ia kāinga, i whakahaerehia he uiui kanohi ki te kanohi me te upoko o te whare (te matua tāne, te whaea rānei) me te kore rānei te upoko o te whare, tētahi atu pakeke neke atu i te 18 tau te pakeke. E 36 ngā pātai i roto i te pātai, i wehea kia toru ngā wāhanga: (1) Te āhua o te whare noho, te āhua o te taupori me te āhua o te ōhanga-pāpori (2) Ngā mahi ahuwhenua me te whakamahinga o ngā patu pepeke (3) Te mōhiotanga ki te malaria me te whakamahinga o ngā patu pepeke hei whakahaere i ngā namu [tirohia te Tāpiritanga 1].
Ko ngā patupatu i whakahuatia e ngā kaimahi pāmu i whakakōwaeatia mā ō rātou ingoa arumoni, ā, i whakarōpūtia mā ngā kai hohe me ngā rōpū matū mā te whakamahi i te Ivory Coast Phytosanitary Index [41]. I aromatawaihia te tūnga ōhanga-ōhanga o ia whare mā te tatau i tētahi taupū rawa [42]. I hurihia ngā rawa o te whare ki ngā taurangi takirua [43]. Ko ngā whakatauranga tauwehenga kino e pā ana ki te tūnga ōhanga-ōhanga iti (SES), ko ngā whakatauranga tauwehenga pai e pā ana ki te SES teitei ake. Ka whakarapopototia ngā kaute rawa hei whakaputa i tētahi kaute katoa mō ia whare [35]. I runga i te kaute katoa, i wehea ngā whare ki ngā quintiles e rima o te tūnga ōhanga-ōhanga, mai i te hunga rawakore ki te hunga whai rawa [tirohia te Kōnae Tāpiri 4].
Hei whakatau mēnā he rerekē te taurangi i runga i te tūnga ōhanga-ōhanga, te kāinga, te taumata mātauranga rānei o ngā upoko whare, ka taea te whakamahi i te whakamātautau chi-square, te whakamātautau tika rānei a Fisher, i ngā wā e tika ana. I whakauruhia ngā tauira whakatauira arorau ki ngā taurangi matapae e whai ake nei: taumata mātauranga, tūnga ōhanga-ōhanga (kua hurihia katoa hei taurangi takirua), kāinga (kua whakaurua hei taurangi kāwai), taumata teitei o te mōhiotanga mō te malaria me te whakamahinga patupatu i roto i te ahuwhenua, me te whakamahinga patupatu i roto i te whare (putanga mā te pounamu rehu). te koiri rānei); taumata mātauranga, tūnga ōhanga-ōhanga me te kāinga, ā, i hua ake ai te mōhiotanga nui ki te malaria. I whakahaerehia he tauira whakatauira whakauru arorau mā te whakamahi i te mōkihi R lme4 (mahi Glmer). I whakahaerehia ngā tātaritanga tatauranga i roto i te R 4.1.3 (https://www.r-project.org) me Stata 16.0 (StataCorp, College Station, TX).
O ngā uiuinga 1,500 i whakahaerehia, 101 i tangohia mai i te tātaritanga nā te mea kāore i oti te pātai. Ko te ōwehenga teitei rawa atu o ngā whare i rangahautia i Grande Maury (18.87%), ā, ko te iti rawa i Ouanghi (2.29%). Ko ngā whare 1,399 i rangahautia i whakaurua ki te tātaritanga e tohu ana i te taupori o te 9,023 tāngata. E ai ki te Ripanga 1, 91.71% o ngā upoko whare he tāne, ā, 8.29% he wahine.
Tata ki te 8.86% o ngā upoko whare i ahu mai i ngā whenua tata pērā i a Benin, Mali, Burkina Faso me Ghana. Ko ngā iwi tino kitea ko Abi (60.26%), Malinke (10.01%), Krobu (5.29%) me Baulai (4.72%). E ai ki te tauira o ngā kaimahi pāmu, ko te ahuwhenua anake te puna moni whiwhi mō te nuinga o ngā kaimahi pāmu (89.35%), ko te koko te tipu tino whakatipuria i roto i ngā whare i rangahautia; ka whakatipuria hoki ngā huawhenua, ngā hua kai, te raihi, te rapa me te pānati ki runga i tētahi wāhi whenua iti noa iho. Ko ngā upoko whare e toe ana he kaipakihi, he kaitoi me he kaihao ika (Ripanga 1). Kei roto i te Kōnae Tāpiri he whakarāpopototanga o ngā āhuatanga o te whare mā ia kāinga [tirohia te Kōnae Tāpiri 3].
Kāore i rerekē te kāwai mātauranga i runga i te ira tangata (p = 0.4672). Ko te nuinga o ngā kaiwhakautu i kuraina tuatahi (40.80%), ā, i muri mai ko te kura tuarua (33.41%) me te kore pānui me te tuhituhi (17.97%). E 4.64% anake i uru ki te whare wānanga (Ripanga 1). O ngā wāhine 116 i uiuitia, neke atu i te 75% i kuraina tuatahi, ā, ko te toenga kāore i haere ki te kura. He rerekē te taumata mātauranga o ngā kaimahi pāmu puta noa i ngā kāinga (whakamātautau tika a Fisher, p < 0.0001), ā, he hononga pai te taumata mātauranga o ngā upoko whare ki tō rātou tūnga ōhanga-ā-pāpori (whakamātautau tika a Fisher, p < 0.0001). Inaa, ko ngā quintiles tūnga ōhanga-ā-pāpori teitei ake ko ngā kaimahi pāmu mātau ake, ā, ko ngā quintiles tūnga ōhanga-ā-pāpori iti rawa ko ngā kaimahi pāmu kore pānui me te tuhituhi; I runga i ngā rawa katoa, ka wehea ngā whare tauira ki ngā quintiles whai rawa e rima: mai i te hunga rawakore (Q1) ki te hunga whai rawa (Q5) [tirohia te Kōnae Tāpiri 4].
He rerekētanga nui kei roto i te tūnga marena o ngā upoko o ngā whare o ngā momo whai rawa rerekē (p < 0.0001): 83.62% he takitahi te wahine, 16.38% he maha ngā wahine (tae atu ki te 3 ngā hoa rangatira). Kāore i kitea he rerekētanga nui i waenga i te momo whai rawa me te maha o ngā hoa rangatira.
Ko te nuinga o ngā kaiwhakautu (88.82%) i whakapono ko ngā waeroa tētahi o ngā tino take o te malaria. 1.65% anake i whakautu kāore rātou i te mōhio he aha te take o te malaria. Ko ētahi atu take kua tautuhia ko te inu wai paru, te pānga ki te rā, te kai koretake me te ngenge (Ripanga 2). I te taumata kāinga i Grande Maury, ko te nuinga o ngā whare i whakaaro ko te inu wai paru te tino take o te malaria (te rerekētanga tatauranga i waenga i ngā kāinga, p < 0.0001). Ko ngā tohu matua e rua o te malaria ko te pāmahana tinana teitei (78.38%) me te kōwhai o ngā kanohi (72.07%). I kōrero anō hoki ngā kaimahi pāmu mō te ruaki, te anemia me te kiri mā (tirohia te Ripanga 2 i raro nei).
I roto i ngā rautaki ārai i te malaria, i kōrero ngā kaiwhakautu mō te whakamahinga o ngā rongoā tuku iho; heoi, i te wā e mate ana, i whakaarohia ngā maimoatanga malaria hauora me ngā maimoatanga malaria tuku iho he kōwhiringa whai hua (80.01%), me ngā manakohanga e pā ana ki te tūnga ōhanga-ōhanga. He hononga nui (p < 0.0001). ): Ko ngā kaipāmu he tūnga ōhanga-ōhanga teitei ake i pai ake, ā, ka taea te utu i ngā maimoatanga hauora me te tūnga ōhanga-ōhanga iti ake, ko ngā kaipāmu i pai ake ki ngā maimoatanga otaota tuku iho; Tata ki te haurua o ngā whare e whakapau moni ana i te toharite neke atu i te 30,000 XOF ia tau mō te maimoatanga malaria (he hononga kino ki te SES; p < 0.0001). I runga i ngā whakatau tata utu tika i pūrongohia e te tangata ake, ko ngā whare he iti rawa te tūnga ōhanga-ōhanga he nui ake te tūponotanga ki te whakapau moni XOF 30,000 (tata ki te US$50) ki te maimoatanga malaria i ngā whare he teitei te tūnga ōhanga-ōhanga. Hei tāpiri, i whakapono te nuinga o ngā kaiwhakautu he ngawari ake te pāngia o ngā tamariki (49.11%) ki te malaria i ngā pakeke (6.55%) (Ripanga 2), ā, he nui ake te kitea o tēnei tirohanga i roto i ngā whare i te quintile rawakore (p < 0.01).
Mō ngā ngau namu, ko te nuinga o ngā kaiuru (85.20%) i kī mai i whakamahia e rātou ngā kupenga moenga i rongoatia ki ngā patu pepeke, ā, ko te nuinga i riro mai i a rātou i te wā o te tohatoha ā-motu o te tau 2017. I kīia ko ngā pakeke me ngā tamariki i moe i raro i ngā kupenga namu i rongoatia ki ngā patu pepeke i roto i te 90.99% o ngā whare. Ko te auau o te whakamahinga o ngā kupenga moenga i rongoatia ki ngā patu pepeke i roto i te whare neke atu i te 70% i ngā kāinga katoa engari ko te kāinga o Gessigye, ko te 40% anake o ngā whare i kī mai i whakamahi i ngā kupenga moenga i rongoatia ki ngā patu pepeke. Ko te toharite o ngā kupenga moenga i rongoatia ki ngā patu pepeke kei roto i te whare he hononga nui, he hononga pai hoki ki te rahi o te whare (te tauwehenga hononga a Pearson r = 0.41, p < 0.0001). I whakaatuhia hoki e ā mātou hua he nui ake te tūponotanga o ngā whare he tamariki kei raro iho i te 1 tau te pakeke ki te whakamahi i ngā kupenga moenga i rongoatia ki ngā patu pepeke i te kāinga, ki te whakataurite ki ngā whare kāore he tamariki, ki ngā tamariki pakeke rānei (ōwehenga ōwehenga (OR) = 2.08, 95% CI : 1.25–3.47).
Haunga te whakamahi i ngā kupenga moenga i rongoatia ki ngā pepeke, i pātaihia hoki ngā kaimahi pāmu mō ētahi atu tikanga whakahaere namu i roto i ō rātou kāinga, me ngā hua ahuwhenua e whakamahia ana hei whakahaere i ngā pepeke hua. E 36.24% anake o ngā kaiuru i kōrero mō te rehu i ngā pepeke ki roto i ō rātou kāinga (he hononga nui, he hononga pai hoki ki te SES p < 0.0001). Ko ngā matū i kōrerotia i ahu mai i ngā waitohu arumoni e iwa, ā, i tukuna te nuinga ki ngā mākete ā-rohe me ētahi kaihokohoko i roto i te ahua o ngā koiri whakamomona (16.10%) me ngā rehu pepeke (83.90%). I piki ake te kaha o ngā kaimahi pāmu ki te whakahua i ngā ingoa o ngā pepeke i rehuhia ki ō rātou whare me te taumata mātauranga (12.43%; p < 0.05). I te tuatahi, i hokona ngā hua matū ahuwhenua i whakamahia i roto i ngā ipu, ā, i whakaranua ki roto i ngā rehu i mua i te whakamahinga, ko te ōwehenga nui rawa atu i whakaritea mō ngā hua whenua (78.84%) (Ripanga 2). Ko te kāinga o Amangbeu te ōwehenga iti rawa o ngā kaimahi pāmu e whakamahi ana i ngā pepeke ki roto i ō rātou kāinga (0.93%) me ngā hua whenua (16.67%).
Ko te maha rawa o ngā hua patu pepeke (rehu, koiri rānei) i kīia mō ia whare he 3, ā, he hononga pai te SES ki te maha o ngā hua i whakamahia (whakamātautau tika a Fisher p < 0.0001, heoi i ētahi wā i kitea he rite tonu te mea kei roto i ngā hua); ngā kai hohe i raro i ngā ingoa hokohoko rerekē. E whakaatu ana te Ripanga 2 i te auau o te whakamahinga patu pepeke ia wiki i waenga i ngā kaimahi pāmu e ai ki ō rātou tūnga ōhanga-ōhanga.
Ko ngā piretiro te whānau matū tino kitea i roto i ngā rehu patu pepeke o te whare (48.74%) me te ahuwhenua (54.74%). Ka hangaia ngā hua mai i ia patu pepeke, i te whakakotahitanga rānei me ētahi atu patu pepeke. Ko ngā huinga noa o ngā patu pepeke o te whare ko ngā carbamates, ngā organophosphates me ngā piretiro, ko ngā neonicotinoids me ngā piretiro he mea noa i roto i ngā patu pepeke ahuwhenua (Tāpiritanga 5). E whakaatu ana te Pikitia 2 i te ōwehenga o ngā whānau rerekē o ngā patu pepeke e whakamahia ana e ngā kaimahi pāmu, e whakarōpūtia ana katoa hei Akomanga II (morearea ngawari) Akomanga III rānei (morearea iti) e ai ki te whakarōpūtanga patu pepeke a te Whakahaere Hauora o te Ao [44]. I tētahi wā, i kitea kei te whakamahia e te whenua te patu pepeke deltamethrin, he mea hanga mō ngā kaupapa ahuwhenua.
Mō ngā matū hohe, ko te propoxur me te deltamethrin ngā hua e whakamahia whānuitia ana i te kāinga me te mara. Kei roto i te kōnae tāpiri 5 ngā kōrero taipitopito mō ngā hua matū e whakamahia ana e ngā kaiahuwhenua i te kāinga me ā rātou hua.
I whakahuatia e ngā kaipāmu ētahi atu tikanga mō te whakahaere namu, tae atu ki ngā pā rau (pêpê i te reo o te rohe o Abbey), te tahu rau, te horoi i te rohe, te tango i te wai e tū ana, te whakamahi i ngā rongoā ārai namu, te whakamahi noa rānei i ngā pepa hei pei i ngā namu.
Ngā āhuatanga e pā ana ki te mōhiotanga o ngā kaimahi pāmu ki te malaria me te rehu patu pepeke o roto (tātari whakatauira logistics).
I whakaatuhia e ngā raraunga he hononga nui i waenga i te whakamahinga o ngā patu pepeke o te whare me ngā tohu e rima: te taumata mātauranga, te SES, te mōhiotanga ki ngā waeroa hei take nui o te malaria, te whakamahinga ITN, me te whakamahinga patu pepeke ahuwhenua. E whakaatu ana te Pikitia 3 i ngā OR rerekē mō ia taurangi tohu. I te whakarōpūtanga mā te kāinga, i whakaatuhia e ngā tohu katoa he hononga pai ki te whakamahinga o ngā rehu patu pepeke i roto i ngā whare (haunga te mōhiotanga ki ngā take matua o te malaria, he hononga whakahurihuri ki te whakamahinga patu pepeke (OR = 0.07, 95% CI: 0.03, 0.13). )) (Pikitia 3). I roto i ēnei tohu pai, ko tētahi mea whakamere ko te whakamahinga o ngā patu pepeke i roto i te ahuwhenua. Ko ngā kaipāmu i whakamahi i ngā patu pepeke ki ngā hua he 188% te nui ake o te tūponotanga ki te whakamahi i ngā patu pepeke i te kāinga (95% CI: 1.12, 8.26). Heoi, ko ngā whare he nui ake te mōhiotanga mō te tuku i te malaria he iti ake te tūponotanga ki te whakamahi i ngā patu pepeke i roto i te kāinga. Ko te hunga whai mātauranga teitei ake, he nui ake te tūponotanga ki te mōhio ko ngā waeroa te tino take o te malaria (OR = 2.04; 95% CI: 1.35, 3.10), engari kāore he hononga tatauranga ki te SES teitei (OR = 1.51; 95% CI: 0.93, 2.46).
E ai ki te upoko o te whare, ka piki te taupori namu i te wā ua, ā, ko te pō te wā e tino ngaua ai ngā namu (85.79%). I te pātaitanga ki ngā kaimahi pāmu mō ō rātou tirohanga ki te pānga o te rehu patu pepeke ki ngā taupori namu e kawe ana i te malaria, 86.59% i whakaū kei te whanake te ātete o ngā namu ki ngā patu pepeke. Ko te kore e taea te whakamahi i ngā hua matū e tika ana nā te kore e wātea ana te take matua mō te kore whai hua, te whakamahi hē rānei i ngā hua, e kiia ana ko ētahi atu āhuatanga whakatau. Ina koa, ko te mea whakamutunga i hono atu ki te iti o te mana mātauranga (p < 0.01), ahakoa i te whakahaere i te SES (p < 0.0001). Ko te 12.41% anake o ngā kaiwhakautu i whakaaro ko te ātete namu tētahi o ngā take pea o te ātete patu pepeke.
I kitea he hononga pai i waenga i te auau o te whakamahinga o ngā patu pepeke i roto i te kāinga me ngā tirohanga mō te ātete o ngā namu ki ngā patu pepeke (p < 0.0001): ko ngā pūrongo mō te ātete o ngā namu ki ngā patu pepeke i ahu mai i te whakamahinga o ngā patu pepeke i te kāinga 3–3 ngā wā i te wiki. 4 ngā wā (90.34%). Haunga te auau, he hononga pai anō hoki te nui o ngā patu pepeke i whakamahia ki ngā tirohanga a ngā kaimahi pāmu mō te ātete ki ngā patu pepeke (p < 0.0001).
I arotahi tēnei rangahau ki ngā tirohanga a ngā kaimahi pāmu mō te malaria me te whakamahinga o ngā patu pepeke. E whakaatu ana ā mātou hua he mea nui te mātauranga me te tūnga ōhanga-ōhanga ki ngā whanonga me te mōhiotanga mō te malaria. Ahakoa i haere te nuinga o ngā upoko o te whare ki te kura tuatahi, pērā i ngā wāhi kē atu, he nui te ōwehenga o ngā kaimahi pāmu kāore i te mātauranga [35, 45]. Ka taea te whakamārama i tēnei āhuatanga mā te mea ahakoa he maha ngā kaimahi pāmu ka tīmata ki te whiwhi mātauranga, me whakarērea e te nuinga o rātou te kura hei tautoko i ō rātou whānau mā roto i ngā mahi ahuwhenua [26]. Engari, e whakaatu ana tēnei āhuatanga he mea nui te whanaungatanga i waenga i te tūnga ōhanga-ōhanga me te mātauranga hei whakamārama i te whanaungatanga i waenga i te tūnga ōhanga-ōhanga me te kaha ki te mahi i runga i ngā mōhiohio.
I roto i te maha o ngā rohe e horapa ana te malaria, e mōhio ana ngā kaiuru ki ngā take me ngā tohu o te malaria [33,46,47,48,49]. E whakaaetia whānuitia ana he ngāwari te pāngia o ngā tamariki e te malaria [31, 34]. Tērā pea e pā ana tēnei mōhiotanga ki te ngāwari o ngā tamariki me te kaha o ngā tohu o te malaria [50, 51].
I kī mai ngā kaiuru i whakapau moni rātou i te toharite o te 30,000. Kāore i te kōrerohia ngā āhuatanga pēnei i te ngaronga o te hua me te kawe waka.
Mā te whakataurite i te tūnga ōhanga-ā-pāpori o ngā kaimahi pāmu e whakaatu ana he nui ake te moni e pau ana i ngā kaimahi pāmu iti rawa te tūnga ōhanga-ā-pāpori i ngā kaimahi pāmu whai rawa. Tērā pea nā te mea e kite ana ngā whare iti rawa te tūnga ōhanga-ā-pāpori he nui ake ngā utu (nā te taumaha nui ake i roto i ngā pūtea katoa o te whare) nā te mea rānei he nui ake ngā painga e pā ana ki te mahi a te iwi me te rāngai tūmataiti (pērā i ngā whare whai rawa). ): Nā te wātea o te inihua hauora, ko te pūtea mō te maimoatanga malaria (e pā ana ki ngā utu katoa) tera pea he iti iho i ngā utu mō ngā whare kāore e whai hua mai i te inihua [52]. Inaa, i pūrongohia ko ngā whare whai rawa te nuinga o te wā i whakamahi i ngā maimoatanga hauora ki te whakataurite ki ngā whare rawakore.
Ahakoa e whakaaro ana te nuinga o ngā kaimahi pāmu ko ngā waeroa te tino take o te malaria, he tokoiti noa iho e whakamahi ana i ngā patu pepeke (mā te rehu me te whakapūkara) i roto i ō rātou kāinga, he rite ki ngā kitenga i Cameroon me Equatorial Guinea [48, 53]. Ko te kore o te āwangawanga mō ngā waeroa ki ngā pepeke hua whenua nā te uara ōhanga o ngā hua whenua. Hei whakawhāiti i ngā utu, ko ngā tikanga iti te utu pērā i te tahu rau i te kāinga, te pana noa rānei i ngā waeroa mā te ringaringa te mea e pai ake ana. Ko te paitini e kitea ana he take anō pea: ko te haunga o ētahi hua matū me te kore whakamarie i muri i te whakamahinga ka ārai i ētahi kaiwhakamahi i te whakamahi [54]. Ko te nui o te whakamahinga o ngā patu pepeke i roto i ngā whare (85.20% o ngā whare i kī kei te whakamahi) ka whai wāhi atu ki te iti o te whakamahinga o ngā patu pepeke ki ngā waeroa. Ko te noho o ngā kupenga moenga kua rongoatia ki ngā patu pepeke i roto i te whare he hononga kaha hoki ki te noho o ngā tamariki kei raro iho i te 1 tau te pakeke, nā te tautoko pea a te whare hauora mō ngā wāhine hapu e whiwhi ana i ngā kupenga moenga kua rongoatia ki ngā patu pepeke i te wā o ngā kōrero ki te whānautanga [6].
Ko ngā piretiroi ngā patu pepeke matua e whakamahia ana i roto i ngā kupenga moenga kua rongoatia ki ngā patu pepeke [55] ā, e whakamahia ana e ngā kaimahi pāmu hei whakahaere i ngā pepeke me ngā waeroa, e ara ake ana ngā āwangawanga mō te pikinga ake o te ātete ki ngā patu pepeke [55, 56, 57,58,59]. Tērā pea ka whakamāramahia e tēnei āhuatanga te hekenga o te aro o ngā waeroa ki ngā patu pepeke i kitea e ngā kaimahi pāmu.
Kāore i te hono te tūnga ōhanga-ōhanga teitei ki te mōhiotanga nui ake ki te malaria me ngā waeroa hei take. He rerekē ki ngā kitenga o mua a Ouattara mā i te tau 2011, ko te hunga whai rawa he pai ake te tautuhi i ngā take o te malaria nā te mea he ngāwari ki a rātou te uru atu ki ngā mōhiohio mā te pouaka whakaata me te reo irirangi [35]. E whakaatu ana tā mātou tātaritanga ko te taumata mātauranga teitei he tohu mō te māramatanga pai ake ki te malaria. E whakaū ana tēnei kitenga ko te mātauranga tonu te wāhanga matua o te mōhiotanga o ngā kaimahi pāmu mō te malaria. Ko te take he iti ake te pānga o te tūnga ōhanga-ōhanga he maha ngā wā ka whakamahia te pouaka whakaata me te reo irirangi i ngā kāinga. Heoi, me whai whakaaro ki te tūnga ōhanga-ōhanga ina whakamahia te mōhiotanga mō ngā rautaki ārai malaria ā-whare.
He hononga pai te tūnga ōhanga-ā-pāpori teitei me te taumata mātauranga teitei ki te whakamahinga o ngā patupatu i roto i te whare (rehu, rehu rānei). He mea whakamiharo, ko te kaha o ngā kaimahi pāmu ki te tautuhi i ngā waeroa hei tino take o te malaria i pā kino ki te tauira. He hononga pai tēnei matapae ki te whakamahinga patupatu i te wā i whakarōpūhia ai puta noa i te taupori katoa, engari he hononga kino ki te whakamahinga patupatu i te wā i whakarōpūhia ai e te kāinga. E whakaatu ana tēnei hua i te hiranga o te awe o te kai tangata ki ngā whanonga tangata me te hiahia ki te whakauru i ngā pānga matapōkere ki roto i te tātari. E whakaatu ana tā mātou rangahau mō te wā tuatahi ko ngā kaimahi pāmu whai wheako ki te whakamahi patupatu i roto i te ahuwhenua he nui ake te tūponotanga ki te whakamahi i ngā rehu patupatu me ngā koiri patupatu hei rautaki ā-roto ki te whakahaere i te malaria i ētahi atu.
E ai ki ngā rangahau o mua mō te awe o te tūnga ōhanga-ōhanga ki ngā waiaro o ngā kaimahi pāmu ki ngā patupatu [16, 60, 61, 62, 63], i kōrero ngā whare whai rawa he nui ake te rerekētanga me te auau o te whakamahinga patupatu. I whakapono ngā kaiwhakautu ko te rehu i te nui o te patupatu te huarahi pai ki te karo i te whanaketanga o te ātete o ngā waeroa, he rite tonu ki ngā āwangawanga i whakapuakina i hea atu [64]. Nō reira, he rite tonu te hanganga matū o ngā hua o te whare e whakamahia ana e ngā kaimahi pāmu i raro i ngā ingoa arumoni rerekē, ko te tikanga me whakatairanga ngā kaimahi pāmu i te mōhiotanga hangarau o te hua me ōna kai hohe. Me aro hoki ki te mōhiotanga o ngā kaihokohoko, nā te mea ko rātou tētahi o ngā tohutoro matua mō ngā kaihoko patupatu [17, 24, 65, 66, 67].
Hei whai pānga pai ki te whakamahinga o ngā patu pepeke i ngā hapori taiwhenua, me arotahi ngā kaupapa here me ngā wawaotanga ki te whakapai ake i ngā rautaki whakawhitiwhiti kōrero, me te whai whakaaro ki ngā taumata mātauranga me ngā mahi whanonga i roto i te horopaki o te urutau ahurea me te taiao, tae atu ki te whakarato i ngā patu pepeke haumaru. Ka hoko te tangata i runga i te utu (te nui e taea e rātou te utu) me te kounga o te hua. Kia wātea te kounga i te utu e taea ana, e tumanakohia ana ka piki ake te hiahia mō te huringa whanonga i roto i te hoko hua pai; Whakaakohia ngā kaimahi pāmu mō ngā whakakapinga patu pepeke hei wawahi i ngā mekameka o te ātete ki ngā patu pepeke, me te whakamārama ko te whakakapinga ehara i te mea he huringa i roto i te waitohu hua (nā te mea he rite tonu te matū hohe o ngā waitohu rerekē), engari he rerekētanga i roto i ngā kai hohe. Ka taea hoki te tautoko i tēnei mātauranga mā te tapanga hua pai ake mā roto i ngā whakaaturanga māmā, mārama.
I te mea he whānuitia te whakamahinga o ngā patupatu e ngā kaimahi whenua o te Porowini o Abbotville, ko te mārama ki ngā āputa mātauranga me ngā waiaro o ngā kaimahi whenua ki te whakamahinga o ngā patupatu i roto i te taiao te mea nui hei whakawhanake i ngā kaupapa whakamōhio angitu. E whakaū ana tā mātou rangahau he mea nui tonu te mātauranga ki te whakamahinga tika o ngā patupatu me te mōhiotanga mō te malaria. I whakaarohia hoki te tūnga ōhanga-ōhanga o te whānau hei taputapu nui hei whakaaroaro. Haunga te tūnga ōhanga-ōhanga me te taumata mātauranga o te upoko o te whare, ko ētahi atu mea pēnei i te mōhiotanga mō te malaria, te whakamahinga o ngā patupatu hei whakahaere i ngā pepeke, me ngā tirohanga mō te ātete o ngā namu ki ngā patupatu ka pā ki ngā waiaro o ngā kaimahi whenua ki te whakamahinga o ngā patupatu.
Ko ngā tikanga e whakawhirinaki ana ki te kaiwhakautu pēnei i ngā pātai ka taea te whakamahara me te whakahāwea i te hiahia pāpori. He tino māmā te whakamahi i ngā āhuatanga o te whare hei aromatawai i te tūnga ōhanga-ōhanga, ahakoa he mea motuhake ēnei ine ki te wā me te horopaki matawhenua i whakawhanakehia ai, ā, kāore pea e whakaata ōrite i te ao tūturu o ngā taonga ahurea motuhake, ka uaua ai te whakataurite i waenga i ngā rangahau. Ina hoki, tera pea he huringa nui kei roto i te mana o te whare ki ngā wāhanga taupū e kore e arahi ki te whakaiti i te rawakore rauemi.
Kāore ētahi o ngā kaimahi pāmu e maumahara ki ngā ingoa o ngā hua patu pepeke, nō reira, tera pea ka iti iho te nui o ngā patu pepeke e whakamahia ana e ngā kaimahi pāmu, ka nui rawa rānei te whakatau tata. Kāore i whakaarohia e tā mātou rangahau ngā waiaro o ngā kaimahi pāmu ki te rehu patu pepeke, me ō rātou tirohanga ki ngā hua o ā rātou mahi ki tō rātou hauora me te taiao. Kāore hoki i whakaurua ngā kaihokohoko ki roto i te rangahau. Ka taea te tūhura i ngā āhuatanga e rua i roto i ngā rangahau a meake nei.
Wā tuku: 13 o Ākuhata 2024