Ngā patu pepeke o rotoKo te rehu (IRS) tētahi tikanga matua hei whakaiti i te horapa o te Trypanosoma cruzi, e puta ai te mate Chagas i te nuinga o Amerika ki te Tonga. Heoi, kāore e taea e te angitu o te IRS i te rohe o Grand Chaco, e kapi ana i a Bolivia, Argentina me Paraguay, te whakataetae ki ērā atu whenua o Southern Cone.
I aromatawaihia e tēnei rangahau ngā mahi tuku iho a te IRS me te whakahaere kounga o ngā patu pepeke i roto i tētahi hapori taketake o Chaco, Bolivia.
Te matū hoheārepa-cypermethrinI hopukina te (ai) ki runga i te pepa tātari i whakanohoia ki te mata o te pakitara o te pūwero, ā, i inehia i roto i ngā otinga tāke pūwero kua whakaritea mā te whakamahi i tētahi Kete Ine Ine Pepeke (IQK™) kua whakarerekētia kua whakamanahia mō ngā tikanga HPLC tauanga. I tātarihia ngā raraunga mā te whakamahi i tētahi tauira whakatauira pānga-whakaurunga rua-kino hei tirotiro i te whanaungatanga i waenga i te kukū o ngā pūwero i whakamahia ki te pepa tātari me te teitei o te pakitara pūwero, te kapi pūwero (te horahanga mata pūwero/te wā pūwero [m2/min]), me te ōwehenga tere pūwero i kitea/e tumanakohia ana. I aromatawaihia hoki ngā rerekētanga i waenga i te tutuki o ngā kaiwhakarato hauora me ngā kaipupuri whare ki ngā whakaritenga whare takoto kau a te IRS. I inehia te tere taunga o te alpha-cypermethrin i muri i te whakaranu ki ngā tāke pūwero kua whakaritea i roto i te taiwhanga.
I kitea ngā rerekētanga nui i roto i ngā kukū o te alpha-cypermethrin AI, me te 10.4% anake (50/480) o ngā tātari me te 8.8% (5/57) o ngā kāinga i tutuki i te kukū whainga o te 50 mg ± 20% AI/m2. Kāore ngā kukū i tohua i ngā kukū i kitea i roto i ngā otinga rehu. I muri i te whakaranu i te alpha-cypermethrin ai ki te otinga mata kua whakaritea o te tāke rehu, ka tere te tau, ā, ka hua ake he ngaronga rārangi o te alpha-cypermethrin ai ia meneti, me te ngaronga o te 49% i muri i te 15 meneti. 7.5% anake (6/80) o ngā whare i maimoatia i te tere rehu i tūtohutia e te WHO o te 19 m2/min (±10%), i te mea ko te 77.5% (62/80) o ngā whare i maimoatia i te tere iti iho i te mea i whakaarohia. Kāore te kukū toharite o te matū hohe i tukuna ki te kāinga i tino pā ki te kapinga rehu i kitea. Kāore te tutuki o te whānau i tino pā ki te kapinga rehu, ki te kukū toharite rānei o te cypermethrin i tukuna ki ngā kāinga.
Tērā pea ko te korenga o te tukunga pai rawa atu o te IRS nā ngā āhuatanga ā-tinana o ngā patu pepeke me te hiahia kia arotakehia ngā tikanga tuku patu pepeke, tae atu ki te whakangungu i ngā tīma IRS me te mātauranga tūmatanui hei whakatenatena i te tutuki i ngā whakaritenga. He taputapu nui a IQK™ e pai ana mō te mara e whakapai ake ana i te kounga o te IRS, ā, e āwhina ana i te whakangungu i ngā kaiwhakarato hauora me te whakatau kaupapa mō ngā kaiwhakahaere i roto i te whakahaere i ngā patu pepeke Chagas.
Ko te mate Chagas ka puta mai i te pangia e te pirinoa Trypanosoma cruzi (kinetoplastid: Trypanosomatidae), e puta ai ngā momo mate i roto i te tangata me ētahi atu kararehe. I roto i te tangata, ka puta te pangia tohumate tere i roto i ngā wiki ki ngā marama i muri i te pangia, ā, ka tohuhia e te kirika, te ngoikore, me te hepatosplenomegaly. E kiia ana ko te 20-30% o ngā pangia ka ahu whakamua ki te ahua mau tonu, ko te nuinga ko te cardiomyopathy, e tohuhia ana e ngā hapa o te pūnaha kawe, ngā arrhythmias o te ngakau, te ngoikore o te ventricle maui, ā, i te mutunga ko te ngoikore o te ngakau, me te iti ake o te wā, te mate gastrointestinal. Ka taea e ēnei āhuatanga te noho tonu mō ngā tekau tau, ā, he uaua ki te rongoā [1]. Kāore he kano kano.
I te tau 2017, i whakatau tatahia te taumahatanga o te mate Chagas i te ao katoa ki te 6.2 miriona tāngata, ā, i mate ai te 7900 me te 232,000 tau ora kua whakatikatikaina e te hauātanga (DALYs) mō ngā reanga katoa [2,3,4]. Ka horahia te Triatominus cruzi puta noa i Amerika Waenganui me Amerika ki te Tonga, me ētahi wāhanga o te tonga o Amerika ki te Raki, e Triatominus cruzi (Hemiptera: Reduviidae), e 30,000 (77%) o te tapeke o ngā kēhi hou i Amerika Latina i te tau 2010 [5]. Ko ētahi atu ara o te mate i ngā rohe kāore i te horapa whānuitia pērā i a Ūropi me te Hononga o Amerika ko te tuku toto whānau me te whakawhiti toto pangia. Hei tauira, i Pāniora, tata ki te 67,500 ngā kēhi mate i waenga i ngā manene o Amerika Latina [6], ā, ko te utu ā-tau mō te pūnaha hauora he US$9.3 miriona [7]. I waenganui i te tau 2004 me te tau 2007, 3.4% o ngā wāhine manene hapu o Amerika Latina i tirotirohia i tētahi hōhipera o Barcelona i kitea he Trypanosoma cruzi [8]. Nō reira, he mea nui ngā mahi ki te whakahaere i te horapa o ngā mate i roto i ngā whenua mate urutā hei whakaiti i te taumahatanga o te mate i roto i ngā whenua kāore he mate triatomine [9]. Ko ngā tikanga whakahaere o nāianei ko te rehu i roto i te whare (IRS) hei whakaiti i ngā taupori mate i roto me te taha o ngā kāinga, te tirotiro whaea hei tautuhi me te whakakore i te horapa whānau, te tirotiro i ngā pēke toto me ngā pēke whakawhitinga okana, me ngā kaupapa mātauranga [5,10,11,12].
I te Southern Cone o Amerika ki te Tonga, ko te kawe matua ko te pepeke triatomine mate. He momo endovore tēnei, he endovore hoki, ā, he whānui te whakaputa uri i roto i ngā kāinga me ngā whare kararehe. I roto i ngā whare kāore i te tino pai te hanga, he ngārara triatomine kei roto i ngā pakitara me ngā tuanui, ā, he tino kino te whakaekenga i roto i ngā whare [13, 14]. Ka whakatairanga te Southern Cone Initiative (INCOSUR) i ngā mahi ā-ao kua whakaritea hei whawhai i ngā mate kāinga i Tri. Whakamahia te IRS ki te kimi i ngā huakita mate me ētahi atu mate motuhake ki te wāhi [15, 16]. Nā tēnei i heke nui ai te maha o ngā mate Chagas, ā, i muri mai ka whakaūhia e te World Health Organization kua whakakorea te tukunga mai i te kawe i te pepeke i roto i ētahi whenua (Uruguay, Chile, ētahi wāhanga o Argentina me Brazil) [10, 15].
Ahakoa te angitu o INCOSUR, kei te noho tonu te kawe Trypanosoma cruzi i te rohe o Gran Chaco o te USA, he rauropi ngahere maroke ā-wā e horapa ana i te 1.3 miriona kiromita tapawha puta noa i ngā rohe o Bolivia, Argentina me Paraguay [10]. Ko ngā kainoho o te rohe kei roto i ngā rōpū tino rawakore, ā, e noho rawakore ana, he iti noa te urunga atu ki te hauora [17]. Ko te auau o te mate T. cruzi me te tuku kawe i roto i ēnei hapori kei roto i te teitei rawa atu o te ao [5,18,19,20] me te 26–72% o ngā kāinga kua pangia e te trypanosomatids. infestans [13, 21] me te 40–56% o ngā huakita Tri. pathogenic e pangia ana te Trypanosoma cruzi [22, 23]. Ko te nuinga (>93%) o ngā take katoa o te mate Chagas e kawe ana i te kawe i te rohe o Southern Cone kei Bolivia [5].
Ko te IRS anake te tikanga whānui e whakaaetia ana mō te whakaiti i te triacine i roto i te tangata i tēnei wā. Ko te infestans he rautaki kua whakamātauhia i roto i ngā tau kua hipa hei whakaiti i te taumahatanga o ētahi mate kawe tangata [24, 25]. Ko te nui o ngā whare i te kāinga o Tri. Ko te infestans (taupū mate) he tohu matua e whakamahia ana e ngā mana hauora hei whakatau i te whakatinanatanga o te IRS, ā, he mea nui, hei whakamārama i te maimoatanga o ngā tamariki kua pangia tonutia me te kore e pāngia anō [16,26,27,28,29]. Ko te whai huatanga o te IRS me te pumau o te tukunga o ngā kawe i roto i te rohe o Chaco e pāngia ana e ētahi āhuatanga: te kounga iti o te hanganga whare [19, 21], te whakatinanatanga IRS kāore i te tino pai me ngā tikanga aroturuki i te mate urutā [30], te koretake o te marea mō ngā whakaritenga a te IRS Te iti o te tutuki [31], te poto o te mahi toenga o ngā whakatakotoranga patupatu [32, 33] ā, kua iti ake te ātete me te/ranei te aro o ngā Tri. infestans ki ngā patupatu [22, 34].
He mea noa te whakamahi i ngā patu pepeke pyrethroid hangai i roto i te IRS nā te mea he mate kino ki ngā taupori ngoikore o ngā pepeke triatomine. I ngā kukū iti, kua whakamahia hoki ngā patu pepeke pyrethroid hei whakapataritari hei tango i ngā kawe i waho o ngā kapiti pakitara hei tirotiro [35]. He iti noa te rangahau mō te whakahaere kounga o ngā mahi a te IRS, engari i ētahi atu wāhi kua whakaatuhia he rerekētanga nui i roto i ngā kukū o ngā matū hohe patu pepeke (AI) e tukuna ana ki ngā kāinga, me ngā taumata e heke ana i raro i te awhe kukū whai hua [33,36,37,38]. Ko tētahi take mō te korenga o te rangahau whakahaere kounga ko te chromatography wai mahi-teitei (HPLC), te paerewa koura mō te ine i te kukū o ngā matū hohe i roto i ngā patu pepeke, he uaua te hangarau, he utu nui, ā, he maha ngā wā kāore e pai mō ngā āhuatanga whānui i roto i te hapori. Ko ngā whanaketanga hou i roto i te whakamātautau taiwhanga inaianei ka whakarato i ngā tikanga rerekē me te iti te utu mō te aromatawai i te tuku patu pepeke me ngā mahi a te IRS [39, 40].
I hangaia tēnei rangahau hei ine i ngā panonitanga o ngā kukū o ngā patu pepeke i ngā wā o ngā kaupapa IRS e aro ana ki te Tri. Phytophthora infestans o ngā rīwai i te rohe o Chaco, Bolivia. I inehia ngā kukū o ngā matū hohe o ngā patu pepeke i roto i ngā hanganga i whakaritea i roto i ngā tāke rehu me ngā tauira pepa tātari i kohia i roto i ngā rūma rehu. I aromatawaihia hoki ngā āhuatanga ka pā ki te tuku patu pepeke ki ngā kāinga. Hei whakatutuki i tēnei, i whakamahia e mātou he whakamātautau tae matū hei ine i te kukū o ngā pyrethroids i roto i ēnei tauira.
I whakahaerehia te rangahau ki Itanambicua, te kaunihera o Camili, te tari o Santa Cruz, Bolivia (20°1′5.94″ S; 63°30′41″ W) (Pikitia 1). Ko tēnei rohe he wāhanga o te rohe o Gran Chaco o te USA, ā, he ngahere maroke te āhua o te wā, he pāmahana 0–49 °C, he ua 500–1000 mm/tau [41]. Ko Itanambicua tētahi o ngā hapori Guaraní 19 o te tāone, e noho ana te 1,200 tāngata noho i roto i te 220 whare i hangaia i te pereki rā (adobe), i ngā taiepa tuku iho me ngā tabique (e mōhiotia ana i te rohe ko te tabique), i te rakau, i ngā ranunga rānei o ēnei rauemi. Ko ētahi atu whare me ngā hanganga e tata ana ki te whare ko ngā whare kararehe, ngā rūma rokiroki, ngā kīhini me ngā wharepaku, i hangaia mai i ngā rauemi rite. Ko te ōhanga o te rohe e ahu mai ana i te ahuwhenua oranga, ko te kānga me te pīnati te nuinga, tae atu ki ngā heihei iti, poaka, koati, parera me te ika, me ngā hua o te kāinga e hokona ana i te tāone mākete o Kamili (tata ki te 12 kiromita te tawhiti). He maha ngā whai wāhitanga mahi a te tāone o Kamili ki te taupori, ko te nuinga i roto i ngā rāngai hanga me ngā ratonga whare.
I roto i tēnei rangahau, ko te reiti pangia o te T. cruzi i waenga i ngā tamariki o Itanambiqua (2–15 tau) he 20% [20]. He rite tēnei ki te horapa o te pangia i waenga i ngā tamariki i pūrongohia i te hapori tata o Guarani, i kite hoki i te pikinga o te horapa i te pakeketanga, me te nuinga o ngā kainoho neke atu i te 30 tau te pakeke e pangia ana [19]. Ko te tukunga o te mate te huarahi matua o te pangia i roto i ēnei hapori, ko Tri te kawe matua. Ka uru atu ngā infestan ki ngā whare me ngā whare o waho [21, 22].
Kāore i taea e te mana hauora ā-rohe hou te whakarato pūrongo mō ngā mahi a te IRS i Itanambicua i mua i tēnei rangahau, heoi, e whakaatu mārama ana ngā pūrongo mai i ngā hapori tata he mahi tūpono noa iho ngā mahi a te IRS i roto i te kaunihera mai i te tau 2000, ā, i mahia te rehu whānui o te 20% beta cypermethrin; i te tau 2003, ā, i muri mai ka rehu nui ngā whare kua pangia e te huaketo mai i te tau 2005 ki te 2009 [22] me te rehu pūnaha mai i te tau 2009 ki te 2011 [19].
I roto i tēnei hapori, i whakahaerehia te IRS e ētahi tohunga hauora e toru kua whakangungua ki te hapori mā te whakamahi i te whakatakotoranga 20% o te alpha-cypermethrin suspension concentrate [SC] (Alphamost®, Hockley International Ltd., Manchester, UK). I hangaia te patu pepeke me te kukū tuku whāinga o te 50 mg ai/m2 e ai ki ngā whakaritenga o te Kaupapa Whakahaere Mate Chagas o te Tari Whakahaere o Santa Cruz (Servicio Departamental de Salud-SEDES). I whakamahia ngā patu pepeke mā te whakamahi i te rehu peke tuara Guarany® (Guarany Indústria e Comércio Ltda, Itu, São Paulo, Brazil) me te kaha whai hua o te 8.5 rita (waehere tāke: 0441.20), he pūwero rehu papatahi me te tere rere ingoa o te 757 ml/min, e whakaputa ana i te rerenga o te koki o te 80° i te pēhanga rango paerewa o te 280 kPa. I whakaranua hoki e ngā kaimahi akuaku ngā kēne aerosol me ngā whare rehu. I whakangungua ngā kaimahi e te tari hauora o te tāone o te rohe ki te whakarite me te tuku patu pepeke, me te rehu patu pepeke ki ngā pakitara o roto, o waho hoki o ngā whare. E tohutohuhia ana hoki rātou kia tangohia e ngā kainoho ngā taonga katoa i roto i te whare, tae atu ki ngā taonga (haunga ngā anga moenga), i te iti rawa 24 hāora i mua i te mahi a te IRS kia taea ai te uru katoa ki roto i te whare mō te rehu. Ko te whakatutukitanga o tēnei whakaritenga ka inehia e ai ki te whakaahuatanga i raro nei. E tohutohuhia ana hoki ngā kainoho kia tatari kia maroke rawa ngā pakitara kua peitahia i mua i te hokinga atu ki te whare, e ai ki te taunakitanga [42].
Hei ine i te kukū o te lambda-cypermethrin AI i tukuna ki ngā kāinga, i tāutahia e ngā kairangahau he pepa tātari (Whatman Nama 1; 55 mm te whānui) ki runga i ngā mata pakitara o ngā kāinga 57 i mua i te IRS. I uru atu ngā kāinga katoa i whiwhi IRS i taua wā (25/25 ngā kāinga i Noema 2016 me 32/32 ngā kāinga i Hanuere-Pēpuere 2017). Kei roto i ēnei ko ngā whare adobe 52 me ngā whare tabik 5. E waru ki te iwa ngā wahi pepa tātari i tāutahia ki ia whare, i wehea kia toru ngā teitei pakitara (0.2, 1.2 me te 2 m mai i te whenua), me ia pakitara e toru i tīpakohia ki te taha maui, mai i te tatau matua. I whakaratohia e tēnei e toru ngā tāruarua i ia teitei pakitara, e ai ki te taunakitanga mō te aroturuki i te tuku paitini whai hua [43]. I muri tonu i te paninga o te patupatu, ka kohia e ngā kairangahau te pepa tātari ka whakamaroke kia kore e pā ki te rā tika. Kia maroke, ka takaihia te pepa tātari ki te rīpene mārama hei tiaki me te pupuri i te patupatu ki runga i te mata kua pania, kātahi ka takaihia ki te pepa konumohe ka rongoatia ki te 7°C tae noa ki te whakamātautau. Mai i ngā pepa tātari 513 katoa i kohia, e 480 o roto i te 57 whare i wātea hei whakamātautau, arā, 8-9 pepa tātari mō ia kāinga. I roto i ngā tauira whakamātautau ko ngā pepa tātari 437 mai i te 52 whare adobe me te 43 pepa tātari mai i te 5 whare tabik. He rite te tauira ki te horapa o ngā momo whare noho i roto i te hapori (76.2% [138/181] adobe me te 11.6% [21/181] tabika) i tuhia i roto i ngā rangahau tatau-ki-te- tatau o tēnei rangahau. Ko te tātari pepa tātari mā te whakamahi i te Kete Ine Pepeke (IQK™) me tōna whakamana mā te whakamahi i te HPLC e whakaahuatia ana i roto i te Kōnae Tāpiri 1. Ko te kukū patu pepeke whāinga he 50 mg ai/m2, e āhei ai te manawanui ki te ± 20% (arā, 40–60 mg ai/m2).
I whakatauhia te kukū tauanga o te AI i roto i ngā ipu 29 i whakaritea e ngā kaimahi hauora. I tangohia e mātou he tauira 1–4 ngā tāke i whakaritea mō ia rā, me te toharite o te 1.5 (awhe: 1–4) ngā tāke i whakaritea mō ia rā mō te wā 18-rā. I whai te raupapa tauira i te raupapa tauira i whakamahia e ngā kaimahi hauora i Noema 2016 me Hanuere 2017. Te ahunga whakamua o ia rā mai i; Hanuere Pēpuere. I muri tonu i te whakaranu pai o te hanganga, ka kohia te 2 ml o te otinga mai i te mata o ngā mea kei roto. Kātahi ka konatunatua te tauira 2 mL ki te taiwhanga mā te vortexing mō te 5 meneti i mua i te kohikohinga o ngā tauira iti e rua 5.2 μL me te whakamātautau mā te whakamahi i te IQK™ e ai ki te whakaahuatanga (tirohia te Kōnae Tāpiri 1).
I inehia ngā tere whakatakotoranga o te matū hohe o te patu pepeke i roto i ngā tāke rehu e whā i tīpakohia motuhake hei tohu i ngā kukū matū hohe tīmatanga (kore) i roto i ngā awhe o runga, o raro, me ngā awhe ūnga. I muri i te whakaranu mō ngā meneti 15 karapīpiti, tangohia kia toru ngā tauira 5.2 µL mai i te paparanga mata o ia tauira vortex 2 mL i ia wā 1 meneti. Ko te kukū otinga ūnga i roto i te tāke he 1.2 mg ai/ml ± 20% (arā, 0.96–1.44 mg ai/ml), he rite ki te whakatutuki i te kukū ūnga i tukuna ki te pepa tātari, e ai ki te whakaahuatanga i runga ake nei.
Hei mārama ki te whanaungatanga i waenga i ngā mahi rehu patu pepeke me te tuku patu pepeke, i haere tahi tētahi kairangahau (RG) me ētahi kaimahi hauora e rua o te IRS i ngā wā tukunga o ia rā ki te 87 kāinga (ngā kāinga e 57 i tauirahia i runga ake nei me te 30 o ngā kāinga e 43 i rehuhia ki ngā patu pepeke). Maehe 2016). Tekau mā toru o ēnei kāinga e 43 i tangohia mai i te tātari: e ono ngā rangatira i whakakahore, ā, e whitu ngā kāinga i maimoatia wāhanga noa iho. I inehia te horahanga katoa o te mata hei rehu (mita tapawhā) i roto me waho o te whare, ā, i tuhia pukutia te wā katoa i pau i ngā kaimahi hauora ki te rehu (meneti). Ka whakamahia ēnei raraunga whakauru hei tatau i te tere rehu, e tautuhia ana ko te horahanga mata i rehuhia ia meneti (m2/min). Mai i ēnei raraunga, ka taea hoki te tatau i te ōwehenga rehu i kitea/e tumanakohia ana hei inenga whanaunga, me te tere rehu e tumanakohia ana e taunakitia ana ko te 19 m2/min ± 10% mō ngā whakatakotoranga taputapu rehu [44]. Mō te ōwehenga i kitea/e tumanakohia ana, ko te awhe manawanui ko te 1 ± 10% (0.8–1.2).
E ai ki te kōrero i runga ake nei, e 57 ngā whare i whakauruhia he pepa tātari ki ō rātou pakitara. Hei whakamātautau mēnā i pā te kitea o te pepa tātari ki te auau rehu a ngā kaimahi horoi, i whakaritea ngā auau rehu i roto i ēnei whare 57 ki ngā auau rehu i roto i te 30 ngā whare i rongoatia i te marama o Poutū-te-rangi 2016 kāore i whakauruhia he pepa tātari. I inehia ngā kukū o ngā patupatu i roto i ngā whare kua whakauruhia he pepa tātari anake.
I tuhia ngā tuhinga mō te whakatutukitanga o ngā kainoho o ngā kāinga e 55 ki ngā whakaritenga horoi kāinga o mua a te IRS, tae atu ki ngā kāinga e 30 i rehuhia i te marama o Poutū-te-rangi 2016 me ngā kāinga e 25 i rehuhia i te marama o Noema 2016. 0–2 (0 = kei te toe tonu ngā taonga katoa, te nuinga rānei o ngā taonga i roto i te whare; 1 = kua tangohia te nuinga o ngā taonga; 2 = kua kore rawa te whare e whakamahia). I rangahauhia te pānga o te whakatutukitanga o te rangatira ki ngā reiti rehu me ngā kukū o ngā patu pepeke moxa.
I tatauhia te mana tatauranga hei kite i ngā rerekētanga nui mai i ngā kukū e tumanakohia ana o te alpha-cypermethrin i whakamahia ki te pepa tātari, me te kite i ngā rerekētanga nui o ngā kukū patu pepeke me ngā tere rehu i waenga i ngā rōpū whare kua takiruahia. I tatauhia te mana tatauranga iti rawa (α = 0.05) mō te maha iti rawa o ngā whare i tauirahia mō tētahi rōpū kāwai (arā, te rahi tauira pumau) i whakatauhia i te tīmatanga. Hei whakarāpopototanga, ko te whakataurite i ngā kukū patu pepeke toharite i roto i te tauira kotahi puta noa i te 17 ngā rawa kua tīpakohia (kua whakarōpūtia hei rangatira kore-ture) he mana 98.5% hei kite i te rerekētanga 20% mai i te kukū whāinga toharite e tumanakohia ana o te 50 mg ai/m2, kei reira te rerekētanga (SD = 10) kua nui rawa te whakatau tata i runga i ngā kitenga i whakaputaina i hea atu [37, 38]. Te whakataurite i ngā kukū patu pepeke i roto i ngā kēne aerosol kua tīpakohia ki te kāinga mō te whai huatanga ōrite (n = 21) > 90%.
Ko te whakataurite i ngā tauira e rua o ngā kukū toharite o ngā patu pepeke i roto i ngā whare n = 10 me n = 12, ngā reiti rehu toharite rānei i roto i ngā whare n = 12 me n = 23, i hua ake ai he mana tatauranga o te 66.2% me te 86.2% mō te kimi. Ko ngā uara e tumanakohia ana mō te rerekētanga 20% ko te 50 mg ai/m2 me te 19 m2/min, ia. I runga i te āta whakaaro, i whakaarohia he nui ngā rerekētanga i roto i ia rōpū mō te reiti rehu (SD = 3.5) me te kukū patu pepeke (SD = 10). Ko te mana tatauranga he >90% mō ngā whakataurite ōrite o ngā reiti rehu i waenga i ngā whare he pepa tātari (n = 57) me ngā whare kāore he pepa tātari (n = 30). I mahia ngā tataunga mana katoa mā te whakamahi i te kaupapa SAMPASI i roto i te pūmanawa STATA v15.0 [45]).
I tirotirohia ngā pepa tātari i kohia mai i te whare mā te whakauru i ngā raraunga ki tētahi tauira pānga-whakaranu binomial kino maha-taurangi (kaupapa MENBREG i roto i te STATA v.15.0) me te taunga o ngā pakitara i roto i te whare (e toru ngā taumata) hei pānga matapōkere. Kukū irahiko Beta. -cypermethrin io I whakamahia ngā tauira hei whakamātautau i ngā huringa e pā ana ki te teitei o te pakitara nebulizer (e toru ngā taumata), te tere nebulization (m2/min), te rā tuku IRS, me te tūnga o te kaiwhakarato hauora (e rua ngā taumata). I whakamahia he tauira raina whānui (GLM) hei whakamātautau i te whanaungatanga i waenga i te kukū toharite o te alpha-cypermethrin i runga i te pepa tātari i tukuna ki ia kāinga me te kukū i roto i te otinga e rite ana i roto i te tāke rehu. I tirotirohia te whakatō o te kukū patupatu i roto i te otinga tāke rehu i roto i te wā i roto i te huarahi ōrite mā te whakauru i te uara tīmatanga (wā kore) hei taurite tauira, me te whakamātautau i te wā taunekeneke o te tāke ID × wā (rā). Ka tautuhia ngā tohu raraunga waho x mā te whakamahi i te ture rohe paerewa Tukey, ko x < Q1 – 1.5 × IQR x rānei > Q3 + 1.5 × IQR. E ai ki te tātaritanga tatauranga, kāore i whakaurua te auau rehu mō ngā whare e whitu me te kukū waenga o te patu pepeke AI mō te whare kotahi.
I whakaūtia te tika o te ine matū ai IQK™ o te kukū alpha-cypermethrin mā te whakatairite i ngā uara o ngā tauira pepa tātari 27 mai i ngā whare heihei e toru i whakamatautauria e IQK™ me HPLC (paerewa koura), ā, i whakaatuhia e ngā hua he hononga kaha (r = 0.93; p < 0.001) (Pikitia 2).
Te hononga o ngā kukū alpha-cypermethrin i roto i ngā tauira pepa tātari i kohia mai i ngā whare heihei i muri i te IRS, i inehia e HPLC me IQK™ (n = 27 pepa tātari mai i ngā whare heihei e toru)
I whakamātauria a IQK™ ki runga i ngā pepa tātari 480 i kohia mai i ngā whare manu 57. I runga i te pepa tātari, ko te ihirangi alpha-cypermethrin i waenga i te 0.19 ki te 105.0 mg ai/m2 (te toharite 17.6, IQR: 11.06-29.78). O ēnei, 10.4% anake (50/480) i roto i te awhe kukū whainga o te 40–60 mg ai/m2 (Pikitia 3). Ko te nuinga o ngā tauira (84.0% (403/480)) he 60 mg ai/m2. Ko te rerekētanga o te kukū waenga i whakatauhia mō ia kāinga mō ngā tātari whakamātautau 8-9 i kohia mō ia kāinga he nui te rahi, me te toharite o te 19.6 mg ai/m2 (IQR: 11.76-28.32, awhe: 0. 60-67.45). 8.8% anake (5/57) o ngā wāhi i whiwhi i ngā kukū patupatu e tumanakohia ana; 89.5% (51/57) i raro iho i ngā rohe o te awhe whāinga, ā, 1.8% (1/57) i runga ake i ngā rohe o te awhe whāinga (Pikitia 4).
Te tohatoha auau o ngā kukū alpha-cypermethrin i runga i ngā tātari i kohia mai i ngā kāinga i rongoatia ki te IRS (n = 57 ngā kāinga). Ko te rārangi poutū e tohu ana i te awhe kukū ūnga o te cypermethrin ai (50 mg ± 20% ai/m2).
Te kukū waenga o te beta-cypermethrin av i runga i te 8-9 pepa tātari mō ia kāinga, i kohia mai i ngā kāinga i tukatukahia e te IRS (n = 57 ngā kāinga). Ko te rārangi whakapae e tohu ana i te awhe kukū ūnga o te alpha-cypermethrin ai (50 mg ± 20% ai/m2). Ko ngā pae hapa e tohu ana i ngā rohe o raro me o runga o ngā uara waenga tata.
Ko ngā kukū waenga i tukuna ki ngā tātari me te teitei pakitara o te 0.2, 1.2 me te 2.0 m he 17.7 mg ai/m2 (IQR: 10.70–34.26), 17.3 mg a .i./m2 (IQR: 11.43–26.91) me te 17.6 mg ai/m2. ia (IQR: 10.85–31.37) (e whakaaturia ana i roto i te Kōnae Tāpiri 2). Hei whakahaere i te rā IRS, kāore i whakaatuhia e te tauira pānga whakauru he rerekētanga nui i roto i te kukū i waenga i ngā teitei pakitara (z < 1.83, p > 0.067) me ngā huringa nui i runga i te rā rehu (z = 1.84 p = 0.070). Kāore i rerekē te kukū waenga i tukuna ki ngā whare adobe e 5 i te kukū waenga i tukuna ki ngā whare adobe e 52 (z = 0.13; p = 0.89).
Ko ngā kukū AI i roto i ngā kēne aerosol Guarany® e 29 i whakaritea motuhaketia i mua i te whakamahinga o te IRS i rerekē mā te 12.1, mai i te 0.16 mg AI/mL ki te 1.9 mg AI/mL mō ia kēne (Pikitia 5). Ko te 6.9% anake (2/29) o ngā kēne aerosol kei roto ngā kukū AI i roto i te awhe horopeta whāinga o te 0.96–1.44 mg AI/ml, ā, ko te 3.5% (1/29) o ngā kēne aerosol kei roto ngā kukū AI >1.44 mg AI/ml.
I inehia ngā kukū toharite o te alpha-cypermethrin ai i roto i ngā whakatakotoranga rehu e 29. Ko te rārangi whakapae e tohu ana i te kukū AI e taunakitia ana mō ngā kēne aerosol (0.96–1.44 mg/ml) hei whakatutuki i te awhe kukū AI whainga o te 40–60 mg/m2 i roto i te whare heihei.
O ngā kēne aerosol 29 i tirotirohia, e 21 i rite ki te 21 whare. Ko te kukū waenga o te ai i tukuna ki te whare kāore i hono atu ki te kukū i roto i ngā tāke rehu takitahi i whakamahia hei rongoā i te whare (z = -0.94, p = 0.345), i kitea i roto i te hononga iti (rSp2 = -0.02) (Pikitia .6).
Te hononga i waenga i te kukū o te beta-cypermethrin AI i runga i ngā pepa tātari 8-9 i kohia mai i ngā whare i rongoatia ki te IRS me te kukū o te AI i roto i ngā otinga rehu kua whakaritea ki te kāinga i whakamahia hei rongoa i ia whare (n = 21)
I rerekē te kukū o te AI i roto i ngā wairewa mata o ngā pūwero e whā i kohia i muri tonu i te rūrūtanga (wā 0) mā te 3.3 (0.68–2.22 mg AI/ml) (Pikitia 7). Mō tētahi tāke, kei roto ngā uara i te awhe ūnga, mō tētahi tāke kei runga ake ngā uara i te ūnga, mō ētahi atu tāke e rua kei raro iho ngā uara i te ūnga; Kātahi ka heke nui ngā kukū o ngā patupatu i roto i ngā puna e whā i te wā o te whakamātautau whai muri i ngā meneti 15 (b = −0.018 ki te −0.084; z > 5.58; p < 0.001). I runga i ngā uara tīmatanga takitahi o te tāke, kāore i te hiranga te wā taunekeneke Tank ID x Time (meneti) (z = -1.52; p = 0.127). I roto i ngā puna e whā, ko te ngaronga toharite o te mg ai/ml patu ngarara he 3.3% ia meneti (95% CL 5.25, 1.71), ā, i eke ki te 49.0% (95% CL 25.69, 78.68) i muri i te 15 meneti (Pikitia 7).
I muri i te whakaranu pai i ngā otinga i roto i ngā tāke, i inehia te tere maturuturu o te alpha-cypermethrin i roto i ngā tāke rehu e whā, i ia meneti, mō te 15 meneti. E whakaaturia ana te rārangi e tohu ana i te taunga pai rawa atu ki ngā raraunga mō ia puna wai. Ko ngā kitenga (ngā pūwāhi) e tohu ana i te toharite o ngā tauira iti e toru.
Ko te rahinga pakitara toharite mō ia kāinga mō te maimoatanga IRS pea he 128 m2 (IQR: 99.0–210.0, whānuitanga: 49.1–480.0) ā, ko te wā toharite i pau i ngā kaimahi hauora he 12 meneti (IQR: 8.2–17.5, whānuitanga: 1.5–36.6). ) i rehuhia ia whare (n = 87). Ko te kapi rehu i kitea i roto i ēnei whare heihei i ahu mai i te 3.0 ki te 72.7 m2/min (waenga: 11.1; IQR: 7.90–18.00) (Pikitia 8). I tangohia ngā mea o waho, ā, i whakaritea ngā reiti rehu ki te awhe rehu i tūtohutia e te WHO, arā, 19 m2/min ± 10% (17.1–20.9 m2/min). 7.5% anake (6/80) o ngā kāinga i roto i tēnei awhe; 77.5% (62/80) i te awhe o raro, ā, 15.0% (12/80) i te awhe o runga. Kāore i kitea he whanaungatanga i waenga i te kukū toharite o te AI i tukuna ki ngā kāinga me te kapi rehu i kitea (z = -1.59, p = 0.111, n = 52 ngā kāinga).
Te tere o te rehu i kitea (minimum/m2) i roto i ngā whare heihei i rongoatia ki te IRS (n = 87). Ko te rārangi tohutoro e tohu ana i te awhe manawanui rehu e tumanakohia ana o te 19 m2/min (±10%) e taunakitia ana e ngā whakatakotoranga taputapu tāke rehu.
E 80% o ngā whare e 80 he ōwehenga kapi rehu i kitea/i tumanakohia kei waho i te awhe manawanui 1 ± 10%, me te 71.3% (57/80) o ngā whare he iti iho, 11.3% (9/80) he teitei ake, ā, 16 ngā whare i taka ki roto i te awhe manawanui i roto i te awhe. Kei te Kōnae Tāpiri 3 te tohatoha auau o ngā uara ōwehenga i kitea/i tumanakohia.
He rerekētanga nui te auau o te nebulization toharite i waenga i ngā kaimahi hauora e rua i mahi tonu i te IRS: 9.7 m2/min (IQR: 6.58–14.85, n = 68) ki te 15.5 m2/min (IQR: 13.07–21.17, n = 12). (z = 2.45, p = 0.014, n = 80) (e whakaaturia ana i roto i te Kōnae Tāpiri 4A) me te ōwehenga o te auau rehu i kitea/e tumanakohia ana (z = 2.58, p = 0.010) (e whakaaturia ana i roto i te Whakaaturanga Kōnae Tāpiri 4B).
Ki te kore ngā āhuatanga rerekē, kotahi anake te kaimahi hauora i rehu i ngā whare e 54 i whakauruhia ai te pepa tātari. Ko te reiti rehu toharite i roto i ēnei whare he 9.23 m2/min (IQR: 6.57–13.80) ki te whakarite ki te 15.4 m2/min (IQR: 10.40–18.67) i roto i ngā whare e 26 kāore he pepa tātari (z = -2.38, p = 0.017).
I rerekē te tutuki o ngā whānau ki te whakaritenga kia whakarērea ō rātou kāinga mō ngā tuku a te IRS: 30.9% (17/55) kāore i whakarērea katoatia ō rātou kāinga, ā, 27.3% (15/55) kāore i whakarērea katoatia ō rātou kāinga; i whakangaromia rawatia ō rātou kāinga.
Ko ngā taumata rehu i kitea i roto i ngā whare kore-noho (17.5 m2/min, IQR: 11.00–22.50) he nui ake i ngā whare āhua-noho (14.8 m2/min, IQR: 10.29–18.00) me ngā whare tino-noho (11.7 m2)./min, IQR: 7.86–15.36), engari kāore i tino nui te rerekētanga (z > -1.58; p > 0.114, n = 48) (e whakaaturia ana i roto i te Kōnae Tāpiri 5A). I puta ngā hua ōrite i te whakaaro ki ngā huringa e pā ana ki te aroaro, te ngaro rānei o te pepa tātari, kāore i kitea he taurangi nui i roto i te tauira.
I roto i ngā rōpū e toru, kāore i rerekē te roa o te wā e hiahiatia ana hei rehu i ngā whare i waenga i ngā whare (z < -1.90, p > 0.057), engari he rerekē te horahanga o te mata waenga: ko ngā whare takoto kau (104 m2 [IQR: 60.0–169, 0 m2) ]) he iti ake i ngā whare kore takoto kau (224 m2 [IQR: 174.0–284.0 m2]) me ngā whare āhua takoto kau (132 m2 [IQR: 108.0–384.0 m2]) (z > 2 .17; p < 0.031, n = 48). Ko ngā whare takoto kau he tata ki te haurua o te rahi (horahanga) o ngā whare kāore i takoto kau, kāore rānei i takoto kau.
Mō te iti o ngā kāinga (n = 25) me ngā raraunga tutuki ture me ngā raraunga patu pepeke AI, kāore he rerekētanga i roto i ngā kukū AI toharite i tukuna ki ngā kāinga i waenga i ēnei kāwai tutuki ture (z < 0.93, p > 0.351), e ai ki te Kōnae Tāpiri 5B. I puta ngā hua ōrite i te wā i tirotirohia ai te aroaro/te ngaro o te pepa tātari me te kitenga i te kapi rehu (n = 22).
Ka arotakehia e tēnei rangahau ngā mahi me ngā tikanga a te IRS i roto i tētahi hapori taiwhenua noa i te rohe o Gran Chaco o Bolivia, he rohe kua roa nei te horapa o te mate urutā [20]. He rerekē te kukū o te alpha-cypermethrin ai i tukuna i te wā o te IRS i waenga i ngā whare, i waenga i ngā tātari takitahi i roto i te whare, me waenga i ngā tāke rehu takitahi kua whakaritea hei whakatutuki i te kukū kotahi o te 50 mg ai/m2. Ko te 8.8% anake o ngā kāinga (10.4% o ngā tātari) he kukū kei roto i te awhe whāinga o te 40–60 mg ai/m2, ko te nuinga (89.5% me te 84% ia) he kukū kei raro iho i te rohe iti e whakaaetia ana.
Ko tētahi āhuatanga pea mō te kore e tino pai te tukunga o te alpha-cypermethrin ki te kāinga ko te koretake o te whakaranu o ngā patupatu me ngā taumata taupatupatu o te wairewa i whakaritea i roto i ngā tāke rehu [38, 46]. I roto i te rangahau o nāianei, i whakaū ngā kitenga a ngā kairangahau i ngā kaimahi hauora i whai rātou i ngā tohutao whakarite patupatu, ā, i whakangungua rātou e SEDES ki te whakaoho kaha i te wairewa i muri i te whakaranu i roto i te tāke rehu. Heoi, i whakaatuhia e te tātaritanga o ngā ihirangi o te puna he rerekē te kukū o te AI mā te 12 tauwehe, me te 6.9% anake (2/29) o ngā wairewa puna whakamātautau kei roto i te awhe ūnga; Mō ētahi atu rangahau, i inehia ngā wairewa i runga i te mata o te tāke rehu i roto i ngā āhuatanga taiwhanga. E whakaatu ana tēnei i te hekenga rārangi o te alpha-cypermethrin ai o te 3.3% ia meneti i muri i te whakaranu me te ngaronga tāpiri o te ai o te 49% i muri i te 15 meneti (95% CL 25.7, 78.7). Ehara i te mea onge ngā tere whakatōtō teitei nā te kohikohinga o ngā whakatārewatanga patu pepeke i hangaia i te wā i whakaranua ai ngā hanganga paura mākū (WP) (hei tauira, DDT [37, 47]), ā, e whakaatu ana tēnei rangahau i tēnei mō ngā hanganga pyrethroid SA. He whānuitia te whakamahinga o ngā kukū whakatōtō i roto i te IRS, ā, pērā i ngā whakaritenga patu pepeke katoa, ko tō rātou pumau ā-tinana e whakawhirinaki ana ki ngā āhuatanga maha, inā koa te rahi o te matūriki o te matū hohe me ētahi atu matūriki. Ka pāngia pea te whakatōtō e te pakeketanga whānui o te wai e whakamahia ana hei whakarite i te paru, he āhuatanga uaua ki te whakahaere i te mara. Hei tauira, i tēnei wāhi rangahau, he iti noa te urunga wai ki ngā awa o te rohe e whakaatu ana i ngā rerekētanga o te rere me ngā matūriki oneone e iri ana i te wā. Kei te rangahauhia ngā tikanga mō te aroturuki i te pumau ā-tinana o ngā hanganga SA [48]. Heoi, kua whakamahia angitu ngā rongoā kiriuhi hei whakaiti i ngā mate o te whare i roto i ngā huakita Tri. pathogenic i ētahi atu wāhi o Amerika Latina [49].
Kua pūrongohia hoki ngā whakatakotoranga patu pepeke kāore i te rawaka i roto i ētahi atu kaupapa whakahaere pepeke. Hei tauira, i roto i te kaupapa whakahaere leishmaniasis visceral i Inia, 29% noa iho o ngā rōpū rehu 51 i aroturuki i ngā otinga DDT kua whakaritea me te whakaranu tika, ā, kāore i whakakīia ngā tāke rehu e ai ki te taunakitanga [50]. I whakaatuhia he ia rite i roto i te aromatawai o ngā kāinga i Bangladesh: 42–43% noa iho o ngā tīma wehenga IRS i whakarite i ngā patu pepeke me ngā ipu kua whakakīia e ai ki te tikanga, i roto i tētahi rohe iti ko te whika he 7.7% noa iho [46].
Kāore hoki i te ahurei ngā panonitanga i kitea i roto i te kukū o te AI i tukuna ki te kāinga. I Inia, 7.3% anake (41 o te 560) o ngā kāinga i rongoatia i whiwhi i te kukū ūnga o te DDT, me ngā rerekētanga i roto me waenga i ngā kāinga he rite tonu te nui [37]. I Nepōra, i mimiti te pepa tātari i te toharite o te 1.74 mg ai/m2 (awhe: 0.0–17.5 mg/m2), he 7% noa iho tēnei o te kukū ūnga (25 mg ai/m2) [38]. I whakaatuhia e te tātari HPLC o te pepa tātari he rerekētanga nui i roto i ngā kukū deltamethrin ai i runga i ngā pakitara o ngā whare i Chaco, Paraguay: mai i te 12.8–51.2 mg ai/m2 ki te 4.6–61.0 mg ai/m2 i runga i ngā tuanui [33]. I Tupiza, Bolivia, i pūrongo te Kaupapa Whakahaere Chagas i te tukunga o te deltamethrin ki ngā kāinga e rima i ngā kukū o te 0.0–59.6 mg/m2, i inehia e te HPLC [36].
Wā tuku: Paenga-whāwhā-16-2024