Cov txaj txaj uas muaj cov pyrethroid clofenpyr (CFP) thiab pyrethroid piperonyl butoxide (PBO) tau raug txhawb nqa nyob rau hauv cov teb chaws muaj kab mob los txhim kho kev tswj tus kab mob malaria kis los ntawm pyrethroid-resistant yoov tshaj cum. CFP yog ib qho tshuaj tua kab mob uas yuav tsum tau ua kom los ntawm yoov tshaj cum cytochrome P450 monooxygenase (P450), thiab PBO txhim kho cov txiaj ntsig ntawm pyrethroids los ntawm inhibiting qhov kev txiav txim ntawm cov enzymes hauv pyrethroid-resistant yoov tshaj cum. Yog li, P450 inhibition los ntawm PBO tuaj yeem txo cov txiaj ntsig ntawm pyrethroid-CFP nets thaum siv hauv tib lub tsev li pyrethroid-PBO nets.
Ob qhov kev sim ntsuas qhov ntsuas cua tau ua los ntsuas ob hom sib txawv ntawm pyrethroid-CFP ITN (Interceptor® G2, PermaNet® Dual) ib leeg thiab ua ke nrog pyrethroid-PBO ITN (DuraNet® Plus, PermaNet® 3.0). Entomological cuam tshuam ntawm kev siv Pyrethroid tsis kam Vector cov pej xeem nyob rau sab qab teb Benin. Hauv ob qho kev tshawb fawb, txhua hom mesh tau sim hauv kev kho ib leeg thiab ob chav mesh. Bioassays kuj tau ua los ntsuas tshuaj tiv thaiv ntawm cov neeg nyob hauv lub tsev pheeb suab thiab los kawm txog kev cuam tshuam ntawm CFP thiab PBO.
Cov pej xeem vector tau nkag siab zoo rau CFP tab sis pom muaj qib siab ntawm kev tiv thaiv pyrethroids, tab sis qhov kev tawm tsam no tau kov yeej los ntawm kev cuam tshuam ua ntej rau PBO. Vector tuag tau txo qis hauv cov tsev pheeb suab uas siv cov pyrethroid-CFP nets thiab pyrethroid-PBO nets piv rau cov tsev pheeb suab uas siv ob pyrethroid-CFP nets (74% rau Interceptor® G2 vs. 85%, PermaNet® Dual 57% vs. 83% p <0.001). Pre-exposure rau PBO txo cov toxicity ntawm CFP nyob rau hauv lub raj mis bioassays, qhia tias cov nyhuv no tej zaum yuav yog vim ib feem ntawm antagonism ntawm CFP thiab PBO. Vector tuag ntau dua hauv cov tsev pheeb suab uas siv cov nets uas muaj pyrethroid-CFP nets piv rau cov tsev pheeb suab uas tsis muaj pyrethroid-CFP nets, thiab thaum pyrethroid-CFP nets tau siv ib leeg ua ob lub vas. Thaum siv ua ke, kev tuag yog siab tshaj (83-85%).
Txoj kev tshawb no tau pom tias qhov ua tau zoo ntawm pyrethroid-CFP meshes tau txo qis thaum siv nrog pyrethroid-PBO ITN piv rau kev siv ib leeg, qhov kev ua tau zoo ntawm cov mesh ua ke uas muaj pyrethroid-CFP meshes siab dua. Cov txiaj ntsig no qhia tau hais tias qhov tseem ceeb tshaj plaws ntawm kev faib cov pyrethroid-CFP tes hauj lwm tshaj lwm hom kev tes hauj lwm yuav ua rau kom muaj kev tswj xyuas vector zoo tshaj plaws hauv cov xwm txheej zoo sib xws.
Insecticide-treated bed nets (ITNs) uas muaj cov tshuaj tua kab pyrethroid tau dhau los ua qhov tseem ceeb ntawm kev tswj tus kabmob malaria hauv ob xyoo dhau los. Txij li xyoo 2004, kwv yees li 2.5 billion tus tshuaj tua kab-kho txaj nets tau muab rau sub-Saharan Africa [1], ua rau muaj kev nce ntxiv ntawm cov pejxeem pw hauv cov tshuaj tua kab-kho txaj nets los ntawm 4% mus rau 47% [2]. Cov txiaj ntsig ntawm qhov kev siv no tseem ceeb heev. Nws kwv yees tias kwv yees li ntawm 2 billion tus neeg mob malaria thiab 6.2 lab tus neeg tuag tau raug tshem tawm thoob ntiaj teb thaum xyoo 2000 thiab 2021, nrog cov qauv tshuaj ntsuam xyuas qhia tias cov tshuaj tua kab-kho cov nets yog tus tsav tsheb loj ntawm cov txiaj ntsig no [2 , 3]. Txawm li cas los xij, cov kev nce qib no tuaj ntawm tus nqi: kev hloov pauv sai ntawm pyrethroid tsis kam hauv cov neeg mob malaria vector. Txawm hais tias pyrethroid insecticide-kho txaj nets tseem tuaj yeem muab kev tiv thaiv tus kheej tiv thaiv kab mob npaws hauv thaj chaw uas cov vectors pom cov pyrethroid tsis kam [4], cov qauv kev tshawb fawb kwv yees tias nyob rau qib siab dua, cov tshuaj tua kab-kho txaj nets yuav txo tau cov kab mob sib kis [5]. . Yog li, pyrethroid tsis kam yog ib qho kev hem thawj tseem ceeb tshaj plaws rau kev vam meej hauv kev tswj malaria.
Ob peb xyoos dhau los no, ib tiam tshiab ntawm cov tshuaj tua kab-kho cov txaj txaj, uas muab cov pyrethroids nrog cov tshuaj thib ob, tau tsim los txhim kho kev tswj cov kab mob malaria kis los ntawm cov yoov tshaj cum pyrethroid. Thawj chav kawm tshiab ntawm ITN muaj cov synergist piperonyl butoxide (PBO), uas potentiates pyrethroids los ntawm neutralizing detoxifying enzymes txuam nrog pyrethroid tsis kam, tshwj xeeb tshaj yog cov kev ua tau zoo ntawm cytochrome P450 monooxygenases (P450s) [6]. Bednets kho nrog fluprone (CFP), ib qho tshuaj tua kab azole nrog cov txheej txheem tshiab ntawm kev ua haujlwm ntawm tes ua pa, kuj tsis ntev los no tau muaj. Tom qab qhov ua kom pom ntawm kev txhim kho entomological cuam tshuam hauv tsev pheeb suab kev sim [7, 8], ib qho kev sim ntawm pawg randomized tswj kev sim (cRCT) tau ua los ntsuas cov txiaj ntsig kev noj qab haus huv ntawm cov nets piv nrog cov tshuaj tua kab-kho nets siv pyrethroids ib leeg thiab muab cov Cov ntaub ntawv pov thawj tsim nyog los qhia cov lus pom zoo los ntawm World Health Organization (WHO) [9]. Raws li cov ntaub ntawv pov thawj ntawm kev txhim kho kev kis kab mob los ntawm CRCTs hauv Uganda [11] thiab Tanzania [12], WHO tau pom zoo pyrethroid-PBO tshuaj tua kab-kho txaj txaj [10]. Cov pyrethroid-CFP ITN kuj tsis ntev los no tau tshaj tawm tom qab sib npaug RCTs hauv Benin [13] thiab Tanzania [14] pom tias tus qauv ITN (Interceptor® G2) txo qhov tshwm sim ntawm menyuam yaus malaria los ntawm 46% thiab 44%, feem. 10]. ].
Ua raws li kev siv zog tshiab los ntawm Ntiaj Teb Cov Nyiaj Txiag thiab lwm tus neeg mob malaria loj los daws cov tshuaj tua kab mob los ntawm kev ua kom cov ntaub so ntswg tshiab [15], pyrethroid-PBO thiab pyrethroid-CFP bednets twb tau siv nyob rau hauv cov cheeb tsam uas muaj kab mob. Hloov cov tshuaj tua kab ib txwm. kho txaj nets uas siv tsuas yog pyrethroids. Nyob nruab nrab ntawm 2019 thiab 2022, qhov kev faib ua feem ntawm PBO pyrethroid yoov tshaj cum muab rau sub-Saharan Africa tau nce los ntawm 8% mus rau 51% [1], thaum PBO pyrethroid yoov tshaj cum, suav nrog CFP pyrethroid yoov tshaj cum, "dual action" yoov tshaj cum yuav tsum. account rau 56% ntawm cov khoom xa tuaj. Nkag mus rau African lag luam los ntawm 2025[16]. Raws li cov ntaub ntawv pov thawj ntawm kev ua tau zoo ntawm pyrethroid-PBO thiab pyrethroid-CFP yoov tshaj cum txuas ntxiv mus, cov nets xav kom muaj ntau dua nyob rau xyoo tom ntej. Yog li, muaj qhov xav tau loj hlob ntxiv los sau cov ntaub ntawv sib txawv hais txog kev pom zoo siv cov tshuaj tua kab tshiab-kho txaj nets kom ua tiav cov txiaj ntsig siab tshaj plaws thaum scaled rau kev siv tag nrho.
Muab qhov kev nthuav dav ntawm pyrethroid CFP thiab pyrethroid PBO yoov tshaj cum, National Malaria Control Program (NMCP) muaj ib lo lus nug txog kev ua haujlwm: Puas yuav txo tau nws cov txiaj ntsig - PBO ITN? Yog vim li cas rau qhov kev txhawj xeeb no yog tias PBO ua los ntawm inhibiting yoov tshaj cum P450 enzymes [6], whereas CFP yog ib qho tshuaj tua kab mob uas yuav tsum tau ua kom dhau los ntawm P450s [17]. Yog li ntawd, nws yog qhov xav tias thaum pyrethroid-CFP ITN thiab pyrethroid-CFP ITN siv nyob rau hauv tib lub tsev, cov nyhuv inhibitory ntawm PBO ntawm P450 tuaj yeem txo cov txiaj ntsig ntawm pyrethroid-CFP ITN. Ntau qhov kev tshawb fawb hauv chaw soj nstuam tau pom tias ua ntej raug rau PBO txo qhov mob toxicity ntawm CFP rau yoov tshaj cum vectors hauv bioassays ncaj qha [18,19,20,21,22]. Txawm li cas los xij, thaum ua kev tshawb fawb ntawm kev sib txawv hauv kev ua haujlwm, kev sib cuam tshuam ntawm cov tshuaj no yuav nyuaj dua. Cov kev tshawb fawb tsis tau tshaj tawm tau tshuaj xyuas qhov cuam tshuam ntawm kev siv ntau hom tshuaj tua kab-kho nets ua ke. Yog li, kev tshawb fawb hauv cheeb tsam ntsuas qhov cuam tshuam ntawm kev siv cov tshuaj tua kab-kho pyrethroid-CFP thiab pyrethroid-PBO txaj nets hauv tib tsev neeg yuav pab txiav txim seb puas muaj peev xwm tawm tsam ntawm cov hom nets ua rau muaj teeb meem ua haujlwm thiab pab txiav txim siab qhov zoo tshaj plaws kev xa tawm. . rau nws cov cheeb tsam uniformly faib.
Post lub sij hawm: Sep-21-2023