Ko te Visceral leishmaniasis (VL), e mōhiotia ana ko te kala-azar i te whenua iti o Īnia, he mate pirinoa i puta mai i te protozoan Leishmania e mau ana te haki, ā, ka mate pea mēnā kāore e rongoatia wawetia. Ko te namu onepu Phlebotomus argentipes anake te kaikawe kua whakaūtia o te VL i te Tonga-mā-rāwhiti o Āhia, e whakahaeretia ana mā te rehu toenga o roto (IRS), he patu ngarara hangai. Nā te whakamahinga o te DDT i roto i ngā kaupapa whakahaere VL kua hua ake te whanaketanga o te ātete i roto i ngā namu onepu, nō reira kua whakakapia te DDT e te patu ngarara alpha-cypermethrin. Heoi, he rite tonu te mahi a te alpha-cypermethrin ki te DDT, nō reira ka piki ake te mōrearea o te ātete i roto i ngā namu onepu i raro i te ahotea i puta mai i te pānga maha ki tēnei patu ngarara. I roto i tēnei rangahau, i aromatawaihia e mātou te ngoikore o ngā waeroa mohoao me ā rātou uri F1 mā te whakamahi i te whakamātautau koiora pounamu CDC.
I kohia e mātou ngā waeroa mai i ngā kāinga tekau i te rohe o Muzaffarpur o Bihar, Īnia. E waru ngā kāinga i whakamahi tonu i ngā waeroa kaha.te sipermetīriniMō te rehu i roto i te whare, kotahi te kāinga i mutu te whakamahi i te cypermethrin kaha-nui mō te rehu i roto i te whare, ā, kotahi te kāinga kāore i whakamahi i te cypermethrin kaha-nui mō te rehu i roto i te whare. Ko ngā waeroa i kohia i tukuna ki te horopeta tātaritanga kua tautuhia i mua mō te wā kua tautuhia (3 μg/ml mō te 40 meneti), ā, ko te reiti hinga me te matenga i tuhia 24 hāora i muri i te pānga.
Ko ngā reiti whakamate o ngā waeroa mohoao i waenga i te 91.19% ki te 99.47%, ā, ko ngā reiti whakamate o ō rātou whakatupuranga F1 i waenga i te 91.70% ki te 98.89%. E rua tekau mā whā hāora i muri i te pānga, ko te mate o ngā waeroa mohoao i waenga i te 89.34% ki te 98.93%, ā, ko ngā reiti whakamate o tō rātou whakatupuranga F1 i waenga i te 90.16% ki te 98.33%.
E whakaatu ana ngā hua o tēnei rangahau ka puta pea he ātete i roto i te P. argentipes, e tohu ana i te hiahia kia aroturukitia tonutia me te mataara kia mau tonu ai te mana whakahaere ina oti te whakakore.
Ko te Visceral leishmaniasis (VL), e mōhiotia ana ko te kala-azar i te whenua iti o Īnia, he mate pirinoa i puta mai i te protozoan Leishmania kua whai haki, ā, ka horapa mā te ngau a ngā namu onepu wahine kua pangia (Diptera: Myrmecophaga). Ko ngā namu onepu anake te kaikawe kua whakaūtia o te VL i te Tonga-mā-rāwhiti o Āhia. Kua tata a Īnia ki te whakatutuki i te whāinga o te whakakore i te VL. Heoi, kia mau tonu ai te iti o te mate i muri i te whakakorenga, he mea nui kia whakaitihia te taupori kaikawe hei ārai i te horapa pea.
Ko te whakahaere i ngā namu i te Tonga-mā-rāwhiti o Āhia ka tutuki mā te rehu toenga o roto (IRS) mā te whakamahi i ngā patu pepeke hangai. Nā te whanonga okiokinga huna o ngā waewae hiriwa e pai ai te whakahaere i ngā patu pepeke mā te rehu toenga o roto [1]. Ko te rehu toenga o roto o te dichlorodiphenyltrichloroethane (DDT) i raro i te Kaupapa Whakahaere Malaria ā-Motu i Inia kua nui ngā pānga ki te whakahaere i ngā taupori namu me te whakaiti nui i ngā take VL [2]. Nā tēnei whakahaere kore i whakamaheretia o te VL i akiaki te Kaupapa Whakakore VL Inia ki te whakamahi i te rehu toenga o roto hei tikanga matua mō te whakahaere i ngā waewae hiriwa. I te tau 2005, i hainatia e ngā kāwanatanga o Inia, o Bangladesh, me Nepōra tētahi whakaaetanga me te whāinga kia whakakorea te VL i te tau 2015 [3]. Ko ngā mahi whakakore, e uru ana ki te whakakotahitanga o te whakahaere whāngai me te tātaritanga tere me te maimoatanga o ngā take tangata, i whai kia uru ki te wāhanga whakakotahi i te tau 2015, he whāinga i whakahoutia i muri mai ki te tau 2017 me te tau 2020.[4] Ko te mahere hou o te ao hei whakakore i ngā mate pārūrū kua warewarehia ko te whakakorenga o te VL i te tau 2030.[5]
I te taenga atu o Īnia ki te wāhanga whai muri i te whakakorenga o te BCVD, he mea nui kia kaua e puta he ātete nui ki te beta-cypermethrin. Ko te take o te ātete he rite tonu te tikanga mahi a te DDT me te cypermethrin, arā, ka aro atu rāua ki te pūmua VGSC[21]. Nō reira, ka piki ake pea te mōrearea o te whanaketanga ātete i roto i ngā namu onepu nā te ahotea i puta mai i te whakamahinga auau ki te cypermethrin tino kaha. Nō reira, he mea nui kia aroturukihia, kia tautuhia hoki ngā taupori namu onepu pea e ātete ana ki tēnei patu ngarara. I roto i tēnei horopaki, ko te whāinga o tēnei rangahau he aroturuki i te āhua ngoikore o ngā namu onepu mohoao mā te whakamahi i ngā horopeta tātaritanga me ngā roanga whakamahinga i whakatauhia e Chaubey et al. [20] i ako i ngā P. argentipes mai i ngā kāinga rerekē i te rohe o Muzaffarpur o Bihar, Īnia, i whakamahi tonu i ngā pūnaha rehu o roto i rongoatia ki te cypermethrin (ngā kāinga IPS tonu). I whakaritea te tūnga ngoikore o ngā P. argentipes mohoao mai i ngā kāinga kua mutu te whakamahi i ngā pūnaha rehu o roto i rongoatia ki te cypermethrin (ngā kāinga IPS o mua) me ērā kāore anō kia whakamahi i ngā pūnaha rehu o roto i rongoatia ki te cypermethrin (ngā kāinga ehara i te IPS) mā te whakamahi i te whakamātautau koiora pounamu CDC.
Tekau ngā kāinga i tīpakohia mō te rangahau (Pikitia 1; Ripanga 1), e waru o ēnei kua pāngia e te rehu tonu o ngā pyrethroid hangai i roto i te whare (hypermethrin; kua tohua hei kāinga hypermethrin tonu) ā, he mate pāwera (neke atu i te kotahi te kēhi) i roto i ngā tau e 3 kua hipa. O ngā kāinga e rua e toe ana i roto i te rangahau, kotahi te kāinga kāore i whakamahi i te rehu o te beta-cypermethrin i roto i te whare (kāinga rehu kore-roto) i tīpakohia hei kāinga whakahaere, ā, ko tētahi atu kāinga i rehu wā-poto i roto i te beta-cypermethrin (kāinga rehu wā-poto/kāinga rehu o roto o mua) i tīpakohia hei kāinga whakahaere. Ko te kōwhiringa o ēnei kāinga i ahu mai i te mahi tahi me te Tari Hauora me te Rōpū Rehu o roto me te whakamana i te Mahere Mahi Iti Rehu o roto i te Rohe o Muzaffarpur.
He mahere whenua o te rohe o Muzaffarpur e whakaatu ana i ngā wāhi o ngā kāinga i whakaurua ki te rangahau (1–10). Ngā wāhi rangahau: 1, Manifulkaha; 2, Ramdas Majhauli; 3, Madhubani; 4, Anandpur Haruni; 5, Pandey; 6, Hirapur; 7, Madhopur Hazari; 8, Hamidpur; 9, Noonfara; 10, Simara. I whakaritea te mahere mā te whakamahi i te pūmanawa QGIS (putanga 3.30.3) me te Open Assessment Shapefile.
I whakaritea ngā pounamu mō ngā whakamātautau whakaaturanga kia rite ki ngā tikanga a Chaubey et al. [20] me Denlinger et al. [22]. I roto i te poto, i whakaritea ngā pounamu karāhe 500 mL i te rā kotahi i mua i te whakamātautau, ā, i pania te pakitara o roto o ngā pounamu ki te patupatu i tohua (ko te horopeta tātaritanga o te α-cypermethrin he 3 μg/mL) mā te pani i te otinga acetone o te patupatu (2.0 mL) ki raro, ki ngā pakitara me te taupoki o ngā pounamu. Kātahi ka whakamaroketia ia pounamu ki runga i te roera miihini mō te 30 meneti. I roto i tēnei wā, wetekina mārire te taupoki kia mimiti te acetone. I muri i te 30 meneti o te whakamaroke, tangohia te taupoki ka hurihia te pounamu kia mimiti katoa te acetone. Kātahi ka waiho kia tuwhera ngā pounamu kia maroke i te pō. Mō ia whakamātautau tāruarua, kotahi te pounamu, i whakamahia hei mana whakahaere, i pania ki te 2.0 mL o te acetone. I whakamahia anō ngā pounamu katoa puta noa i ngā whakamātautau i muri i te horoinga tika kia rite ki te tikanga i whakaahuahia e Denlinger et al. me te World Health Organization [22, 23].
I te rā i muri i te whakarite i te patu pepeke, i tangohia mai i ngā whare herehere ngā waeroa 30–40 (ngā waeroa uwha e matekai ana), ā, i pupuhi mārire ki roto i ia oko. Tata ki te rite te maha o ngā namu i whakamahia mō ia pounamu kua pania ki te patu pepeke, tae atu ki te mana whakahaere. Whakahokia tēnei kia rima ki te ono ngā wā i ia kāinga. I muri i te 40 meneti o te pānga ki te patu pepeke, ka tuhia te maha o ngā namu i patua. I hopukina ngā namu katoa ki te mīhini mimiti, ka whakanohoia ki roto i ngā ipu pepa iti kua hipokina ki te mata angiangi, ā, ka whakanohoia ki roto i tētahi incubator motuhake i raro i ngā āhuatanga haumākū me te pāmahana rite tonu me te pūtake kai rite tonu (ngā pōro miro kua rumakina ki te 30% te wai huka) ki ngā koroni kāore i rongoatia. I tuhia te mate i muri i te 24 hāora i muri i te pānga ki te patu pepeke. I wehea ngā waeroa katoa, ā, i tirotirohia hei whakaū i te tuakiri momo. I mahia te tukanga kotahi ki ngā namu uri F1. I tuhia ngā reiti patu me te mate i muri i te 24 hāora i muri i te pānga. Mena he iti iho i te 5% te mate i roto i ngā pounamu whakahaere, kāore i whakatikatikaina te mate i roto i ngā tauira. Mena he ≥ 5% te mate i roto i te pounamu whakahaere, ā, he ≤ 20%, ka whakatikatikaina te mate i roto i ngā pounamu whakamātautau o taua tauira mā te whakamahi i te tātai a Abbott. Mena he nui ake te mate i roto i te rōpū whakahaere i te 20%, ka makahia te rōpū whakamātautau katoa [24, 25, 26].
Te mate toharite o ngā waeroa P. argentipes i hopukina i te ngahere. Ko ngā pae hapa e tohu ana i ngā hapa paerewa o te toharite. Ko te hononga o ngā rārangi whakapae whero e rua ki te kauwhata (90% me te 98% te mate, ia) e tohu ana i te matapihi mate ka puta pea te ātete.[25]
Te mate toharite o ngā uri F1 o ngā P. argentipes i hopukina i te ngahere. Ko ngā pae hapa e tohu ana i ngā hapa paerewa o te toharite. Ko ngā kōpiko e whakawhitihia ana e ngā rārangi whakapae whero e rua (90% me te 98% te mate, ia) e tohu ana i te whānuitanga o te mate ka puta ake pea te ātete [25].
I kitea he tino pāngia ngā waeroa i te kāinga mana whakahaere/kāore i te IRS (Manifulkaha) e ngā patu pepeke. Ko te mate toharite (±SE) o ngā waeroa i hopukina i te ngahere i roto i ngā haora 24 i muri i te hinganga me te pānga he 99.47 ± 0.52% me te 98.93 ± 0.65%, ia, ā, ko te mate toharite o ngā uri F1 he 98.89 ± 1.11% me te 98.33 ± 1.11%, ia (Ripanga 2, 3).
E whakaatu ana ngā hua o tēnei rangahau ka taea e ngā namu onepu waewae-hiriwa te whakawhanake i te ātete ki te pyrethroid (SP) α-cypermethrin hangai i roto i ngā kāinga i whakamahia ai te pyrethroid (SP) α-cypermethrin i ngā wā katoa. He rerekē, ko ngā namu onepu waewae-hiriwa i kohia mai i ngā kāinga kāore i hipokina e te kaupapa IRS/mana whakahaere i kitea he tino pāngia. He mea nui te aroturuki i te pāngia o ngā taupori namu onepu mohoao hei aroturuki i te whai huatanga o ngā patu pepeke i whakamahia, nā te mea ka āwhina pea ēnei mōhiohio ki te whakahaere i te ātete ki ngā patu pepeke. Kua pūrongohia ngā taumata teitei o te ātete DDT i roto i ngā namu onepu mai i ngā rohe taketake o Bihar nā te pēhanga kōwhiringa hītori mai i te IRS e whakamahi ana i tēnei patu pepeke [1].
I kitea e mātou he tino pāngia ngā P. argentipes e ngā pyrethroids, ā, i whakaatuhia e ngā whakamātautau mara i Inia, Bangladesh me Nepal he nui te whai huatanga o te IRS ki ngā pepeke ina whakamahia ngātahi me te cypermethrin, te deltamethrin rānei [19, 26, 27, 28, 29]. Nō nā tata nei, i kōrero a Roy et al. [18] kua whanake te ātete o ngā P. argentipes ki ngā pyrethroids i Nepal. I whakaatuhia e tā mātou rangahau pāngia ngā namu onepu waewae hiriwa i kohia mai i ngā kāinga kāore i te pāngia e te IRS he tino pāngia, engari ko ngā namu i kohia mai i ngā kāinga IRS wā-poto/mua me ngā kāinga IRS tonu (ko te mate i waenga i te 90% ki te 97% engari ko ngā namu onepu mai i Anandpur-Haruni i 89.34% te mate i te 24 hāora i muri i te pānga) he ātete pea ki te cypermethrin tino whai hua [25]. Ko tētahi take pea mō te whanaketanga o tēnei ātete ko te pēhanga e puta mai ana i te rehu ā-roto (IRS) me ngā kaupapa rehu ā-rohe e hangai ana ki ngā take, he tikanga paerewa mō te whakahaere i ngā pakarutanga kala-azar i ngā rohe/poraka/kāinga e mate urutā ana (Tukanga Whakahaere Paerewa mō te Rangahau me te Whakahaere i te Pakarutanga [30]. Ko ngā hua o tēnei rangahau e whakarato ana i ngā tohu wawe mō te whanaketanga o te pēhanga whiriwhiri ki te cypermethrin tino whai hua. Engari, kāore ngā raraunga whakaraeraetanga o mua mō tēnei rohe, i whiwhihia mā te whakamahi i te whakamātautau koiora pounamu CDC, e wātea ana hei whakataurite; kua aroturukihia e ngā rangahau o mua katoa te whakaraeraetanga o P. argentipes mā te whakamahi i te pepa kua whakakiia ki te patu pepeke a te WHO. Ko ngā horopeta tātaritanga o ngā patu pepeke i roto i ngā rīpene whakamātautau a te WHO ko ngā kukū tautuhi kua tūtohutia mō ngā patu pepeke hei whakamahi ki ngā kawe malaria (Anopheles gambiae), ā, kāore i te mārama te whakamahinga whakahaere o ēnei kukū ki ngā namu onepu nā te mea he iti ake te rere o ngā namu onepu i ngā namu, ā, he roa ake te wā e pa ana ki te papa i roto i te whakamātautau koiora [23].
Kua whakamahia ngā piretiro hangai i ngā rohe whenua VL o Nepal mai i te tau 1992, me te whakamahi tahi me ngā SP alpha-cypermethrin me te lambda-cyhalothrin hei whakahaere i ngā namu onepu [31], ā, kua whakamahia hoki te deltamethrin i Bangladesh mai i te tau 2012 [32]. Kua kitea te ātete āhuahanga i roto i ngā taupori namu onepu hiriwa waewae mohoao i ngā rohe kua roa te whakamahinga o ngā piretiro hangai [18, 33, 34]. Kua kitea he whakarerekētanga kore-taurite (L1014F) i roto i ngā taupori namu onepu Inia mohoao, ā, kua honoa ki te ātete ki te DDT, e kī ana ko te ātete piretiro ka puta i te taumata ngota, i te mea ko te DDT me te piretiro (alpha-cypermethrin) e aro ana ki te ira kotahi i roto i te pūnaha io pepeke [17, 34]. Nō reira, he mea nui te aromatawai pūnaha o te ngoikore o te cypermethrin me te aroturuki i te ātete namu i ngā wā whakakorenga me ngā wā muri i te whakakorenga.
Ko tētahi herenga pea o tēnei rangahau ko tā mātou whakamahi i te whakamātautau koiora ipu CDC hei ine i te ngoikore, engari ko ngā whakataurite katoa i whakamahi i ngā hua mai i ngā rangahau o mua mā te whakamahi i te kete whakamātautau koiora WHO. Tērā pea kāore ngā hua mai i ngā whakamātautau koiora e rua e ōrite tika ana nā te mea ka ine te whakamātautau koiora ipu CDC i te knockdown i te mutunga o te wā tātaritanga, engari ko te whakamātautau koiora kete WHO ka ine i te mate i te 24, 72 rānei hāora i muri i te whakaaturanga (ko te mea whakamutunga mō ngā matū mahi puhoi) [35]. Ko tētahi atu herenga pea ko te maha o ngā kāinga IRS i roto i tēnei rangahau ki te whakataurite ki tētahi kāinga ehara i te IRS me tētahi kāinga ehara i te IRS/IRS o mua. Kāore e taea e mātou te kī ko te taumata ngoikore o te kawe namu i kitea i roto i ngā kāinga takitahi i roto i tētahi rohe he tohu mō te taumata ngoikore i roto i ētahi atu kāinga me ngā rohe i Bihar. I te mea ka uru atu a Īnia ki te wāhanga muri i te whakakorenga o te huaketo leukemia, he mea nui kia ārai i te whanaketanga nui o te ātete. Me aroturuki tere i te ātete i roto i ngā taupori namu onepu mai i ngā rohe rerekē, poraka me ngā rohe whenua. He mea tīmatanga noa iho ngā raraunga i whakaaturia i roto i tēnei rangahau, ā, me manatoko mā te whakataurite ki ngā kukū tautuhi i whakaputaina e te World Health Organization [35] kia whiwhi ai i tētahi whakaaro motuhake ake mō te āhua o te ngoikore o P. argentipes i ēnei wāhi i mua i te whakarerekē i ngā kaupapa whakahaere kawe hei pupuri i te iti o ngā taupori namu onepu me te tautoko i te whakakorenga o te huaketo leukemia.
Tērā pea ka tīmata te waeroa P. argentipes, te kaikawe o te huaketo leukosis, ki te whakaatu i ngā tohu tōmua o te ātete ki te cypermethrin tino whai hua. Me aroturuki tonu i te ātete ki ngā pepeke patu i roto i ngā taupori mohoao o P. argentipes hei pupuri i te pānga mate urutā o ngā wawaotanga whakahaere pepeke. Me huri ngā pepeke patu me ngā momo mahi rerekē, me/ranei te aromatawai me te rēhitatanga o ngā pepeke patu hou, ā, e taunakihia ana hei whakahaere i te ātete ki ngā pepeke patu me te tautoko i te whakakorenga o te huaketo leukosis i Inia.
Wā tuku: 17-Pepuere-2025