Ko te reiti whānui o te mate malaria i waenga i ngā tamariki mai i te 6 marama ki te 10 tau te pakeke he 2.7 mō ia 100 tangata-marama i te rohe o te IRS, ā, 6.8 mō ia 100 tangata-marama i te rohe whakahaere. Heoi, kāore he rerekētanga nui o te mate malaria i waenga i ngā wāhi e rua i ngā marama tuatahi e rua (Hōngongoi–Ākuhata) me muri i te wā ua (Tīhema–Pēpuere) (tirohia te Pikitia 4).
Ngā ānau oranga o Kaplan-Meier mō ngā tamariki 1 ki te 10 tau te pakeke i te rohe rangahau i muri i te 8 marama o te aroturukitanga
I whakaritea e tēnei rangahau te horapa me te auau o te malaria i roto i ngā rohe e rua mā te whakamahi i ngā rautaki whakahaere malaria whakauru hei aromatawai i te pānga tāpiri o te IRS. I kohia ngā raraunga i roto i ngā rohe e rua mā roto i ngā rangahau whakawhiti-wāhanga e rua me te rangahau kimi take 9-marama i ngā whare hauora. I whakaatuhia e ngā hua mai i ngā rangahau whakawhiti-wāhanga i te tīmatanga me te mutunga o te wā tuku malaria he iti ake te parataemia malaria i roto i te rohe IRS (LLTID+IRS) i te rohe whakahaere (LLTIN anake). I te mea he rite ngā rohe e rua i runga i te mate urutā malaria me ngā wawaotanga, ka taea te whakamārama i tēnei rerekētanga mā te uara tāpiri o te IRS i roto i te rohe IRS. Inaa, e mōhiotia ana ko ngā kupenga patu pepeke roa me te IRS ka whakaiti nui i te taumahatanga malaria ina whakamahia takitahi. Nō reira, he maha ngā rangahau [7, 21, 23, 24, 25] e tohu ana ka hua ake he whakaiti nui ake i te taumahatanga malaria i roto i tā rāua whakakotahitanga i a rāua anake. Ahakoa te IRS, ka piki ake te parataemia Plasmodium mai i te tīmatanga ki te mutunga o te wā ua i ngā rohe e tuku ana te malaria ā-wā, ā, e matapaetia ana ka eke tēnei ia ki te tihi i te mutunga o te wā ua. Heoi, ko te pikinga i roto i te rohe IRS (53.0%) he iti iho i tērā i roto i te rohe whakahaere (220.0%). E iwa tau o ngā kaupapa IRS karapīpiti i āwhina i te whakaiti, i te pehi rānei i ngā tihi o te horapa o te huaketo i roto i ngā rohe IRS. Heoi anō, kāore he rerekētanga i roto i te taupū gametophyte i waenga i ngā rohe e rua i te tīmatanga. I te mutunga o te wā ua, he nui ake i roto i te wāhi whakahaere (11.5%) i te wāhi IRS (3.2%). E whakamārama ana tēnei kitenga i te iti rawa o te horapa o ngā parasitemia malaria i roto i te rohe IRS, nā te mea ko te taupū gametocyte te pūtake pea o te mate namu e arahi ana ki te horapa o te malaria.
E whakaatu ana ngā hua o te tātari whakatauranga logistic i te mōrearea tūturu e pā ana ki te mate malaria i te rohe mana, ā, e whakaatu ana hoki he nui rawa te whakatau tata i te hononga i waenga i te kirika me te pirinoa, ā, he āhuatanga whakapoauau te anemia.
Pērā i te pararutiki, he iti ake te auau o te malaria i waenga i ngā tamariki 0–10 tau te pakeke i roto i te IRS i ngā rohe whakahaere. I kitea ngā tihi tuku iho i ngā rohe e rua, engari he iti ake i roto i te IRS i ngā rohe whakahaere (Pikitia 3). Inaa, ahakoa e toru tau te roa o ngā patupatu i roto i ngā LLIN, e ono marama te roa o te ora i roto i te IRS. Nō reira, ka whakahaerehia ngā kaupapa IRS i ia tau hei kapi i ngā tihi tuku. E ai ki ngā ānau ora o Kaplan–Meier (Pikitia 4), he iti ake ngā keehi haumanu o te malaria i roto i ngā tamariki e noho ana i ngā rohe IRS i ērā i roto i ngā rohe whakahaere. He rite tēnei ki ētahi atu rangahau kua pūrongo i ngā whakahekenga nui o te auau malaria i te wā e whakakotahihia ana te IRS whānui me ētahi atu wawaotanga. Heoi, ko te roanga iti o te tiaki mai i ngā pānga toenga o te IRS e kī ana me whakapai ake pea tēnei rautaki mā te whakamahi i ngā patupatu roa ake te ora, te whakanui ake rānei i te auau o te tono ā-tau.
Ko ngā rerekētanga o te horapa o te anemia i waenga i ngā rohe IRS me ngā rohe mana whakahaere, i waenga i ngā rōpū reanga rerekē me waenga i ngā kaiuru me te hunga kāore he kirika he tohu pai pea mō te rautaki i whakamahia.
E whakaatu ana tēnei rangahau ka taea e te pirimiphos-methyl IRS te whakaiti nui i te horapa me te auau o te malaria i roto i ngā tamariki kei raro iho i te 10 tau te pakeke i te rohe o Koulikoro e ātete ana ki te pyrethroid, ā, ko ngā tamariki e noho ana i ngā rohe o IRS he nui ake te tūponotanga ka pāngia e te malaria, ā, ka noho roa atu rātou kāore e pāngia e te malaria i roto i te rohe. Kua whakaatuhia e ngā rangahau he pai te pirimiphos-methyl hei patu pepeke mō te whakahaere malaria i ngā rohe e kitea whānuitia ana te ātete ki te pyrethroid.
Wā tuku: Hakihea-09-2024