Rukundo Nenhamo
“Nhau yetibhii mukati memakore 30 apfuura yave iri yorukundo nenhamo—rukundo rwevasayendisiti vakagovera zvokudzora nazvo uye pakupedzisira kupedza hosha yacho, uye nhamo yokukundikana kwakapararira kushandisa zvavakawana.”—J. R. Bignall, 1982.
TIBHII (TB) yave ichiuraya kwenguva yakareba. Yakatambudza vaInca vePeru nguva refu vaRungu vasati vaenda nezvikepe kuSouth America. Yakabata vaEgipita mumazuva apo vanaFarao vaitonga nembiri. Zvinyorwa zvakare zvinoratidza kuti tibhii yakanyangira vose vari vaviri vakuru nevaduku muBhabhironi rakare, Girisi, uye China.
Kubvira muzana remakore rechi18 kusvikira mumavambo ezana remakore rechi20, TB yaiva chinoparira rufu chikurusa munyika yokuMadokero. Pakupedzisira, muna 1882, chiremba weGermany Robert Koch akazivisa pachena kuwana kwake bacillus inoparira hosha yacho. Makore gumi nematatu gare gare Wilhelm Röntgen akawana maX ray, anoita kuti zvibvire kuongorora mumapapu evanhu vapenyu zviratidzo zvepakakuvadzwa netibhii. Tevere, muna 1921, vasayendisiti vechiFrench vakagadzira nhomba inodzivirira TB. Yakatumidzwa zita revasayendisiti vakaiwana, BCG (Bacillus Calmette-Guérin) ndiyo nhomba bedzi inodzivirira hosha yacho. Kunyange zvakadaro, TB yakapfuurira kuuraya zvinotyisa.
Mushonga, Pakupedzisira!
Vanachiremba vaitumira varwere veTB kuzvipatara zvokuzororera nokunaya. Zvipatara izvi kazhinji kazhinji zvaiva mumakomo, umo varwere vaigona kuzorora nokufema mhepo yakanaka. Ipapo, muna 1944, vanachiremba muUnited States vakawana streptomycin, mushonga wokutanga wakawanwa kuva unorwisa TB uchibudirira. Kugadzirwa kwemimwe mirimo inorapa TB kwakakurumidza kutevera. Pakupedzisira, varwere veTB vaigona kurapwa, kunyange vari mumisha yavo vamene.
Sezvo mwero yokuzadzwa yakaderera zvikuru, nguva yemberi yakaratidzika kuva inofadza. Zvipatara zvokuzororera nokunaya zvakavharwa, uye kupa mari yokunzvera TB kwakamira. Zvirongwa zvokudzivirira zvakaregwa, uye vasayendisiti navanachiremba vakatsvaka zvimwe zvinonetsa zvitsva mune zvokurapa.
Kunyange zvazvo TB yakanga ichiri kuuraya zvikurusa munyika ichiri kusimukira, chokwadi zvinhu zvaizovandudzika. TB yakanga yava nhau. Ndizvo zvakafungwa nevanhu, asi vakanga vasina kururama.
Kudzoka Kunouraya
Mukati mema1980, TB yakatanga kudzoka zvinotyisa uye zvinouraya. Ipapo, muna April 1993, World Health Organization (WHO) yakazivisa TB se“njodzi yenyika yose,” ichiwedzera kuti “hosha yacho ichauraya vanhu vanopfuura mamiriyoni 30 mumakore gumi anotevera kutoti chiito chokukurumidza chikaitwa kudzivisa kupararira kwayo.” Kwaiva kuzivisa kwokutanga kworudzi irworwo munhau yeWHO.
Kubvira ipapo, hapana “chiito chokukurumidza” chakadzora kupararira kwehosha yacho. Chinetso chacho, kutaura idi, chatonyanya kuipa. Nguva pfupi yapfuura, WHO yakashuma kuti vanhu vakawanda vakafa neTB mukati ma1995 kupfuura mune rimwe gore ripi neripi munhau. WHO yakanyeverawo kuti vanhu vanosvika kuhafu yebhiriyoni vangarwara neTB mukati memakore 50 anotevera. Nenzira inowedzera, vanhu vaizova vanyajambwa veTB iyo kazhinji kazhinji, isingarapike nemishonga yakawanda.
Nei Pane Kudzoka Kunouraya?
Chimwe chikonzero ndechokuti mukati memakore 20 apfuura, zvirongwa zvinodzora TB zvakaderera kana kuti zvakanyangarika mumativi akawanda enyika. Izvi zvakaparira kunonoka kuziva uye kurapa avo vane hosha yacho. Izvozvowo, zvakaguma nenzufu dzakawanda nokupararira kwehosha yacho.
Chimwe chikonzero chokuoneka kweTB kukura kwenhamba yevarombo, vasina zvokudya zvakakwana vanogara mumaguta ane vanhu vakatsvikinyidzana, zvikurukuru maguta makuru enyika ichiri kusimukira. Nepo TB isina kuganhurirwa kuvanhu varombo—munhu upi noupi anogona kubata TB—migariro isina utsanana neyokutsvikinyidzana inoita kuti zvive nyore kuti hosha ipfuudzwe kubva pamunhu kuenda pamunhu. Inowedzerawo mikana yokuti simba remiviri yevanhu rokurwisa hosha rinete zvikuru zvokutadza kurwisa hosha.
HIV neTB—Chinetso Chakapetwa Ruviri
Chinetso chikuru ndechokuti TB yaita mubatanidzwa unouraya neHIV, vhairasi yeAIDS. Pavanhu vanofungidzirwa kuva miriyoni imwe vakafa nezvirwere zvakabatana neAIDS mukati ma1995, zvichida chikamu chimwe muzvitatu chakafa neTB. Iyi imhaka yokuti HIV inonetesa kukwanisa kwomuviri kudzivisa TB.
Muvanhu vazhinjisa kuzadzwa neTB hakumbopfuurira kusvika pakuvarwarisa. Nei? Nemhaka yokuti mabacillus eTB anovharirwa mukati memasero anonzi mamacrophage. Imomo, anovharirwa nesimba romuviri womunhu rokurwisa hosha, zvikurukuru nemaT lymphocyte, kana kuti maT cell.
Mabacillus eTB akafanana nemhungu dziri mumatengu ane zvivharo zvakasimba. Matengu ndiwo mamacrophage, uye zvivharo maT cell. Apo vhairasi yeAIDS inosvika, zvisinei, inokudubura zvivharo zvematengu. Apo izvozvo zvinoitika, mabacillus anobuda uye akasununguka kuparadza rutivi rwupi norwupi rwomuviri.
Varwere veAIDS, nokudaro, sezvingabvira zvikuru vanorwara neTB kupfuura vanhu vane simba romuviri rokurwisa hosha richiri kushanda. “Vanhu vane HIV havatane kuzadzwa,” yakadaro nyanzvi yeTB muScotland. “Varwere vaviri veHIV pane imwe kiriniki muLondon vakabata hosha yacho pashure pokugara mumukoto apo mumwe murwere weTB akapfuudzwa napavari ari pamubhedha une mavhiri.”
Nokudaro, AIDS yakabatsira kuwedzera murakatira weTB. Maererano neimwe fungidziro, panosvika gore ra2000, murakatira weAIDS uchaguma nemamiriyoni 1,4 evarwere veTB vangadai vasina kumbovapo. Chinoparira chinokosha mukuwedzera kweTB hachisi bedzi chokuti vanyajambwa veAIDS havatane kubata hosha yacho asi kuti vanogonawo kupfuudza TB kune vamwe vanhu, kubatanidza avo vasina AIDS.
TB Isingarapike Nemishonga Yakawanda
Chinoparira chokupedzisira chiri kuita kuti kurwisa TB kuome zvikuru kuvapo kwemarudzi eTB asingarapike nemishonga. Aya marudzi akasimba anoita kuti hosha yacho isarapikezve, sezvazvakanga zvakaita munguva apo kwakanga kusina mishonga.
Nenzira inoshamisa, kutadza kushandisa murimo unorapa TB ndicho chinoparira TB isingarapike nemishonga yakawanda chikuru. Kurapa TB kunobudirira kunotora inopfuura mwedzi mitanhatu uye kunoda kuti murwere anwe mirimo mina nguva dzose asingapotsi. Murwere angafanira kumedza mapiritsi akawanda segumi nemaviri pazuva. Kana varwere vakasanwa mirimo nguva dzose kana kuti vakasapedza kunwa mishonga yose, marudzi eutachiona hweTB akaoma kana kuti asingabviri kuuraya anotanga. Mamwe marudzi outachiona haafi nemirimo inoshandiswa zvikuru inosvika minomwe yeTB.
Kurapa varwere vane TB isingarapike nemishonga yakawanda hakuna kungooma bedzi, kunodhurawo. Mutengo wacho unogona kuva unopfuura nekanoda kusvika ka100 kupfuura mutengo wokurapa vamwe varwere veTB. MuUnited States, somuenzaniso, bhiri rokurapa murwere mumwe chete ringapfuura $2 500 000!
WHO inofungidzira kuti vanhu vanenge mamiriyoni 100 munyika yose vangave vakazadzwa marudzi eTB asingarapike nemishonga, mamwe acho asingarapike nemirimo inorapa TB ipi neipi inozivikanwa. Aya marudzi anouraya anotapukira sezvinongoita mamwe marudzi anozivikanwa zvikuru.
Kudzivirira Nokurapa
Chii chiri kuitwa kurwisa iyi njodzi yomunyika yose? Nzira yakanakisisa yokudzora nayo hosha yacho ndeyokuziva nokurapa hosha yacho ichiri kutanga. Izvi hazvingobetseri bedzi vari kutorwara asiwo zvinomisa kupararira kwehosha yacho kuvamwe.
Kana TB ikasarapwa, inouraya vanopfuura hafu yevanyajambwa vayo. Kana ikanyatsorapwa, zvisinei, TB inorapika muzvinoitika zvinenge zvose kana isina kuparirwa norudzi rwusingarapike nemirimo inoverengeka.
Sezvataona, kurapa kunobudirira kunoda kuti varwere vapedze mishonga yose. Kazhinji kazhinji, havadaro. Nemhaka yei? Eya, kukosora, fivha, uye zvimwe zviratidzo kazhinji kazhinji zvinonyangarika mavhiki mashomanene pashure pokunge kurapa kwatanga. Naizvozvo, varwere vakawanda vanogumisa kuti vapora uye vanorega kunwa mushonga.
Kurwisa chinetso ichi, WHO inokurudzira chirongwa chinonzi DOTS, mabhii anomirira “kurapwa kwenguva pfupi, kunoongororwa zvakananga.” Sezvinokarakadza zita racho, vanorapa vanotarisa kuti vave nechokwadi chokuti varwere vavo vanomedza mishonga yavo mimwe nemimwe, kweinopfuura mwedzi miviri yokutanga yokurapwa. Bva, izvi hazvisi nyore nguva dzose kuita nemhaka yokuti vakawanda vevanotambudzwa neTB vanogara makashatisisa menzanga. Sezvo upenyu hwavo kazhinji kazhinji hwakazadzwa nenhamo nezvinetso—vamwe havatongorina misha—denho yokuva nechokwadi nguva dzose kuti vanonwa mishonga yavo inogona kuva huru.
Naizvozvo pane kariro yokukurira denda iri parudzi rwomunhu here?
[Bhokisi riri papeji 5]
Pepa Remaidi eTB
Rondedzero: TB ihosha iyo kazhinji kazhinji inokuvadza nokusakadza mapapu, asi inogona kupararira kudzimwe nzvimbo dzomuviri, zvikurukuru uropi, itsvo, nemapfupa.
Zviratidzo: TB yemapapu inogona kuparira kukosora, kuondoroka nokusada kudya, kudikitira kwakakomba usiku, kupera simba, kutadza kufema zvakanaka, uye marwadzo omuchipfuva.
Kuzivikanwa kwainoitwa: Kubayiwa mushonga nepaganda kunogona kuratidza kana munhu akava nebatano noutachiona. X-ray yomuchipfuva inogona kuratidza kukuvadzwa kwemapapu, uko kungaratidza hosha yeTB. Kunzverwa kwemakararwa omurwere mulaboratory ndiyo nzira yakavimbika zvikurusa yokuwana nayo utachiona hweTB.
Ndiani anofanira kunzverwa: Avo vane zviratidzo zveTB kana kuti zvimwe vakava nebatano yapedyo, inodzokororwa nomurwere weTB—zvikurukuru mumakamuri asina mhepo yakanaka.
Nhomba: Kunongova nenhomba imwe bedzi—inozivikanwa seBCG. Inodzivisa TB muvana asi haishandi kuvayaruki nevakuru. Nenzira yakanakisisa, nhomba yacho inodzivirira kwemakore anenge 15. BCG inodzivirira bedzi avo vasina kutapurwa; haibatsiri vanhu vakatotapurwa.
[Bhokisi riri papeji 6]
TB Nefashoni
Kungaratidzika kuva kwechienzi, mukati mezana remakore rechi19, TB yaiyemurwa, sezvo vanhu vairangarira kuti zviratidzo zvehosha yacho zvaikudziridza mirangariro yokuda, nokuva nyanzvi.
Munyori wemitambo nemabhuku weFrance anonzi Alexandre Dumas akanyora pamusoro pemavambo ema1820 muMémoires rake kuti: “Zvaiva mufashoni kutambura marwadzo omuchipfuva; munhu wose aive akaondoroka, zvikurukuru vadetembi; zvaiva mufashoni kufa usati wasvika makore makumi matatu.”
Mudetembi weEngland Lord Byron sezvinoshumwa akati: “Ndinoda kufa nokuondoroka [TB] . . . nemhaka yokuti vasikana vose vanozoti, ‘Tarisa Byron uyo anonzwisa urombo, anofadza sei pakufa!’”
Munyori weAmerica Henry David Thoreau, uyo sezviri pachena akafa neTB, akanyora kuti: “Kuora uye hosha kazhinji kazhinji zvakaisvonaka, . . . sekupisa muviri kunochinja chinja kwomunhu ari kupera muviri neTB.”
Ichitsinhira pamusoro peuku kufarirwa kweTB, imwe nyaya yaiva muThe Journal of the American Medical Association yakataura kuti: “Kudiwa uku kunoshamisa kwehosha yacho kwakapararira muzvinodiwa nomunhu oga mufashoni; vakadzi vaivavarira kuva nechitarisiko chakacheneruka, choundonda, vaishandisa zvizorwa zvakacheneruka, uye vaida hembe dzejira, dete—kungofanana nezvinotsvakwa nemamodel anhasi anozvinyima zvokudya kuti aonde.”
[Bhokisi riri papeji 7]
Zviri Nyore Kubata TB Here?
“Hakuna kupi kana kupi kwokuhwanda utachiona hwetibhii,” anonyevera kudaro Dr. Arata Kochi, mutungamiriri weWHO Global TB Programme. “Munhu upi noupi anogona kubata TB kupfurikidza nekungofema jemusi reTB bedzi rinenge rakosorerwa kana kuti kuhotsirirwa mumhepo. Majemusi aya anogona kuramba ari mumhepo kwemaawa; kunyange makore. Tose tiri mungozi.”
Munhu asati arwara neTB, zvisinei, zvinhu zviviri zvinofanira kuitika. Chokutanga, anofanira kuzadzwa utachiona hweTB. Chechipiri, kutapurwa kunofanira kufambira mberi kusvika pakuva hosha.
Kazhinji kazhinji, vanhu vasingaratidzi zviratidzo havagoni kuzadza vamwe. Kunyange zvazvo zvichibvira kubata hosha yacho kupfurikidza nokuva pedyo kwenguva pfupi nemunhu anogona kuparadzira zvikuru, TB inoparadzirwa sezvingabvira zvikuru kupfurikidza nokuramba uchiva pedyo, sezvinoitika pakati pemitezo yemhuri inogara makatsvikinyidzana.
Mabacillus anofemwa nomunhu anotapurwa anoberekana muchipfuva. Muvanhu vapfumbamwe mugumi, zvisinei, simba romuviri rokurwisa hosha rinomisa kupararira kwehosha yacho, uye munhu anenge atapurwa haazorwari. Pane dzimwe nguva, zvisinei, mabacillus ari mumuviri asi asingarwarisi anogona kunyandurwa kana simba romuviri rokurwisa hosha rikaneteswa zvakakomba neHIV, chirwere cheshuga, kurapwa kwegomarara nemishonga, kana kuti zvimwe zvikonzero.
[Vakatipa Mufananidzo uri papeji 4]
New Jersey Medical School—National Tuberculosis Centre
[Mufananidzo uri papeji 7]
Ma“bacillus” eTB anoburitswa nevhairasi yeAIDS akafanana nemhungu dzinoburitswa mumatengu