Ogaanshaha cudurka Daacuunka (Diagnosis)
Qofka lagu tuhunsan yahay ee loo malaynaayo inuu qabo cudurka Daacuunka waxa lagu ogaan karaa laba siyaabood:
Astaamaha iyo calaamadaha cudurka Daacuunka ee aan soo sheegnay oo lagu arko qofka qaba (clinical diagnosis).
Calaamadaha iyo astaamaha cudurka Daacuunka ee aan soo sheegnay oo lagu arko qofka qaba taas oo u baahan in lagu saleeyo meesha uu degan yahay ee ku nool yahay. Sidoo kale taariikhda safarkiisa (travel history) meelaha uu qofku safarka ku tegay ama soo maray oo ah meelaha la og yahay in cudurka Daacuunku ka dillaacay ama ka jiro oo lagu sheegay.
Waxa kale oo lagu ogaan (xaqiijin) karaa baadhitaanka shaybaadhka caafimaadka (laboratory diagnosis) oo xaqiijiya jiritaanka cudurka, marka laga baadho muunadaha ama saamiga (samples) qofka buka laga soo qaado taas oo lagu ogaado marka lagu sameeyo beerid ama abuurid (culture). Waxa kale oo la adeegsada mararka qaarkood qalabka molecular biolojiga noocyadiisa ay ka mid yihiin PCR iyo DNA probes kuwaas oo lagu ogaado noocyada (strains) Vibrio cholerae ee sababa safmarka. Tusaale ahaan inay tahay Vibrio cholerae 01, 0139 ama Vibrio cholerae El Tor.
Sidaan hore u soo sheegnay, qaybta saddexaad ee ogaanshaha cudurka Daacuunka ee muhiimka ah waa in laga hubiyo bukaanka inaanu qabin cudurro badan oo ay Daacuunka iskaga mid yihiin xagga calaamadaha iyo astaamaha shuban biyoodka (watery diarrhoea). Kuwaas oo noqon kara cudurro ay sababaan bakteeriyada, derisku noosha iyo fayrasyada kale. Waxa keliya ee lagu kala saari karo oo lagu xaqiijin karo daacuunka iyo cudurada kale inta badan waa baadhitaanka shaybaadhka caafimaadka iyo jawaabta laga helo muunadaha laga baadhay cuduradaas.
Daaweynta Cudurka Daacuunka (Treatment)
Cudurka Daacuunka, guud ahaan aad bay u sahlan tahay in la daaweeyo. Hase yeeshee, waxay ku xidhan tahay xaaladda bukaanku siday tahay, da’diisa, degaankuu ku nool yahay iyo heerka xanuunku le’eg yahay.
Xanuunka heerkiisa waxa lagu qiyaasi karaa inta jeer iyo qiyaasta ama mugga shubanka (diarrhoea), taas oo noqon karta shuban sahlan/khafiif ah (mild diarrhoea), shuban dhexdhexaad ah (moderate diarrhoea) iyo shuban daran/xoog leh (severe diarrhoea). Sifooyinkaasi waxay tilmaamaan inta fuuqbuxu le’eg yahay kuwaas oo sahlaya sidii loo qorshayn lahaa daaweynta iyo badbaadinta bukaanka.
Tallaabooyinka ugu waaweyn ee lagu daaweyn karo Daacuunka waxaa ka mid ah:
In la daweeyo lagana hortago fuuqbaxa iyo shooga si bukaanka loo badbaadiyo. Taas oo ah in sida ugu habboon ee saxda ah bukaanka loogu sameeyo fuuqcelis si jidhkiisa loogu soo celiyo biyihii iyo macdantii ka baxday (water and salt).
Waxaa si fudud loogu daaweyn karaa in bukaanka loo sameeyo fuuqcelis (rehydration therapy) iyadoo la isticmaalayo ORS (Oral Rehydration Solution). Waxa mid ah ORSyada la isticmaalo inta badan tusaale ahaan: Hartmann’s solution oo ay WHO ku talo bixisay in lagu isticmaalo waddamada saboolka ah ee cudurka Daacuunku ku badan yahay. Waa muhiim in lagu jaangooyo ORSka qofka buka da’diisa iyo xaaladdiisa caafimaad.
In haddii loo baahdo ama ay noqoto lagama maarmaan la daweeyo cudurka laftiisa oo la isticmaalo noole dilayaasha (antibiotics) si loo dabar gooyo inaan bakteeriyadu ku korin kuna tarmin mindhicirka oo aan cudurku u sii fidin.
Inta badan, noole dilayaasha looma baahna in loo isticmaalo daaweeyn ahaan waxana ka haboon in lagu dedaalo sidii qofka bukaanka ah biyihii ka baxay si deg deg loogu soo celiyo. Isticmaalka noole dilayaashu haddaan loo baahnayn waxay dhiirigelisaa kakanaanta bakteeriyada (bacterial resistance).
In laga daaweeyo bukaanka calaamadaha iyo waxyaabaha kale ee uu ka cabanaayo oo daryeel wanaagsan loo fidiyo bukaanka.
Xakamaynta iyo ka hortagga cudurka Daacuunka (control and prevention)
Sidaan soo sheegnay, cudurka Daacuunka fiditaankiisa waxa suurtageliya nadaafad darrada cuntada la cuno iyo saxadhowr/fayadhowr la’aanta degaanka siiba biyaha la cabbo. Taas oo sababta aakhirka in laga qaado cudurka.
Ka hortagga iyo xakamaynta cudurka Daacuunka waxa fure u ah barnaamij ama hannaan ballaadhan oo wejiyo badan kana duulaya sidii loo yarayn lahaa dhimashada dadka, sidii loo daaweyn lahaa bukaanka, nadaafadda biyaha, saxadhowrka, abaabulka bulshada, bixinta tallaalka afka laga qaato ee Daacuunka, sahamiska/ilaalaynta (surveillance) iyo isha ku haynta xaaladda guud ee cudurka Daacuunka.
Siyaabaha looga hortagi karo si loo xakameeyo cudurka Daacuunka faafitaankiiisa waxa ka mid ah in la qaado tallaabooyinka soo socda:
Waa in mudnaanta koowaad la siiyo sidii loo yarayn lahaa dhimashada dadka isla markaana loo daaweyn lahaa bukaanka.
Waa in lagu dedaalo sidii loo ogaan lahaa sidee cudurka Daacuunku ku bilaabmay, meeshee ka bilaabmay iyo sidee ku faafay si loo qorsheeyo hababka saxda ah ee lagu xakamayn karo Daacuunka.
Waa in biyaha la cabbo si hagaagsan loo daaweeyo oo nadaafadooda la ilaaliyo si dadku u helaan biyo nadiif ah.
Waa in biyaha la cabbo la iska kariyo intaan la cabbin ka hor meelaha aan lahayn biyaha nadiifta ah ee qasabada biyaha.
Waa in cuntada aad laysaga kariyo lagana fogaadaa cuntooyinka iyo cabbitaanka lagu gado meelaha debedda ah ee ku taxan waddooyinka hareerahooda.
Waa in dadka bukaanka daryeela si fiican isu nadiifiyaan oo saabuun iwm ku faraxashaan.
Waa in saxarada iyo waxyaabaha kale ee sadhaysan si hagaagsan loo maamulo oo meel ku haboon lagu shubo isla markaana lagu qubo si aan fidista cudurku u sii socon (proper waste management system).
Waa in sare loo qaadaa nadaafadda shakhsiga si looga hortago gudbinta cudurka Daacuunka bulshada dhexdeeda.
Waa in dadka socotada ah ee ka yimaadda degaannada lagu tuhunsan yahay cudurka Daacuunka isha lagu hayo xaaladdooda caafimaad inay wax iskabeddeleen iyo in kale. Mararka qaarkood haddii aad looga baqo inay bukaan, waa la karantiimayaa (Quarantine).
Waa in tababar ku saabsan saxadhowrka, nadaafadda iyo maaraynta cuntadu inay tahay tallaabo muhiima xagga ka hortagga cudurka loo fidiyo wadhatada jidadka cuntada ku iibiya (street vendors) iyo guud ahaan shaqaalaha ka shaqeeya meelaha cuntada sida makhaayadaha, hudheellada iwm.
Waa in la bixiyaa tallaalka Daacuunka waqtiga safmarka si dadka looga samata bixiyo cudurka Daacuunka intaanu ku dhicin ka hor.
Waa in bulshada lagu waaniyo inay isticmaalaan cuntooyinka ashitada ama asiidhka leh (acidifying foods) sida liinta noocyadeeda kala duwan, yaanyada ama tamaandhada, tamariinta, ciirta ama caanaha gadhoodhka/garoorka ah (yoghurt) iwm. Cuntooyinka ashitada lehi waxay ka hortagaan oo yareeyaan cholerae sababtoo ah asiidka cuntada iyo caloosha ayay bakteeriyadu u nugushahay.
Gunaanad iyo talo soo jeedin
Cudurka Daacuunku, waa cudur halis ah oo maroojiya caloosha iyo mindhicirka keenana shuban aad u badan, matag iyo tabaryari aad ah. Taasina waxay horseedaa in qofka qaba cudurka Daacuunku ay biyuhu ka dhammaadaan jidhkiisa oo uu fuuq-bax (dehydration) ku dhaco oo haddaan si deg-deg ah wax looga qaban keeni kara geeri ama dhimasho.
Cudurka Daacuunka, dadku waxay qaadaan marka ay cunaan cunto ama ay cabbaan biyo wasakhaysan/sadhaysan (contaminated) oo ay ku jirto bakteeriyada cudurka sababta ee Vibrio cholerae. Waddamada cudurkan halista ahi uu ka dillaaco inta badan wuxu sababaa safmar (epidemic) taas oo ay dad badani hal mar wada qaadi karaan ama uu Daacuunku mar wada helo.
Sidaan wada ognahay cudurka Daacuunku, inta badan waa ku soo noqnoqdaa geyiga Soomaalida. Sidaas darteed, waxa loo baahan yahay in laga gaashaanto oo laga hortago dhibaatada caafimaad iyo waxyeellada kale ee bulshada Soomaaliyeed ka soo gaadha goor walba. Waxa lama huraan ah, in la sameeyo qorsheyaal iyo istaraatijiyad leh tallaabooyin la taaban karo oo la dhaqan gelin karo muddada gaaban (short-term) iyo muddada fog (long term).
Qorshaha muddada gaaban ee waqtigan lagu jiro abaaraha iyo bilowga xilli roobaadka, waxa ugu muhiimsan in lagu dedaalo sidii ummadda tabaalaysan wax loo tari lahaa laguna dedaalo inaan Daacuunku ku sii fidin meelaha kale. Baahida ugu weyn ee jirtaa imminka, waa macaluul iyo biyo la’aan sahlaya in xaaladda guud ee caafimaadku xumaato oo cudurada faafaa dalka ku sii kordhaan, sida Daacuunka iyo cudurada kale ee shubanka sababa.
Si looga hortago cudurka Daacuunka muddada gaaban, waxa la qaadi karaa tallaabooyinkan soo socda:
In daraasad iyo sahamis lagu sameeyo waddanka si loo ogaado sidee cudurka Daacuunku u bilaabmay, halkee ka bilaabmay iyo sidee ku faafay si loo qorsheeyo hababka saxda ah ee lagu xakamayn karo Daacuunka.
In la dejiyo barnaamajka xakamaynta iyo ka hortagga cudurka Daacuunka iyadoo la adeegsanayo tabaha ugu haboon.
In la bilaabo olole wacyigelin ah si bulshadu u ogaadaan caafimaad darrada ka iman karta Daacuunka.
In lagu dedaalo sidii loo yarayn laha safarka loo socdaalayo meelaha la sheegay in cudurku ka dillaacay si aan cudurku u sii gudbin ama u gaadhin gobollada kale.
In laga war hayo goobaha dadku Daacuunka ugu dhinteen si loo ogaado xaaladda guud ee degaamadaas isla markaana laga kaalmeeyo wixi dhibaato ah ee ka soo gaadhay cudurka Daacuunka.
In la diiwaangeliyo dadka la ogaaday inuu ku dhacay cudurka Daacuunku si loo ogaado tiro koobka iyo dadka u geeriyooday Daacuunka.
Guud ahaan, haddii horukac lagu sameeyo xaaladaha nolosha ee dadka deggan tuulooyinka ama magaalooyinka, cudurka Daacuunku ma huri karo qaadistiisuna aad bay u yaraataa. Haddii ay xumaadaan xaaladaha nolosha dadku (cunto, biyo iyo dawo la’aan) waxa imanaysa in caafimaadka dadku guud ahaan uu xumaanaayo, taas oo keenaysa in bulshadii oo dhammi ay u jilicsanaato qaaditaanka cudurada. Sidaan horeba u soo sheegnay badiyaa, cudurka Daacuunku wuxu keenaa dhimasho aad u fara badan, siiba waddamada saboolka ah haddii uu ku dhaco sida geeska Afrika.
Qorshaha muddada fog (long-term) ee wax laga qabanayo Daacuunka iyo dhammaan cudurada faafa, waa inuu leeyahay ku talogal barnaamaj ka hortag ah oo ay ugu mudan tahay sidii bulshada Soomaaliyeed loogu heli lahaa biyo nadiif ah.
Waayo, cudurka Daacuunka waxa laga qaadaa waa biyaha wasakhda ah ee sadhaysan oo ay ku jirto bakteeriyada cudurka sababtaa (Vibrio cholerae). Waxa gudbiya oo faafiya ama sii fidiyaa waa biyaha, waxa lagaga hortagi karaana waa biyaha nadiifta ah. Waana habraaca iyo habka keliya ee wadammada horumaray iyo dalalka kale ee soo korayaa kaga gaashaanteen cudurka Daacuunka oo looga cidhib tiray wadammadaas waa cabbista iyo isticmaalka biyaha nadiifta ah.
Sidaa awgeed, biyaha nadiifta ah ayaa ah sirta aan dawada iyo tallaalka ahayn ee dunidu kaga adkaatay ka hortagga iyo xakamaynta cudurka Daacuunka iyo cudurada kale ee sababa shubanka iwm.
Biyihu, waa daawo aan u baahnayn in warshad lagu sameeyo oo dhul iyo cirba laga helo laakiin u baahan in la farsamaysto oo la iska hagaajiyo lagana faa’iidaysto. Sidaas darteed, dawada keliya ee lagu daaweyn karo lagagana hortagi karo cudurka Daacuunka isla markaana ugu qiimaha jaban waa biyaha nadiifta ah (drinking and using clean water).
Sida ay sheegtay WHO, dhulka Soomaalida, boqolkiiba in ka yar 23% (90%) dhibaatada cudurada faafa oo ah kuwa ugu badan geeska Afrika iyo guud ahaan qaaradda Afrika. Sida laga soo xigtay WHO, boqolkiiba 63-69% waxa Afrika dadku u dhintaan cudurada faafa (infectious diseases).
Infectious diseases are the first leading cause of death in the Africa: What can we do?
Tallaabooyinka kale ee lagaga gaashaaman karo cudurka Daacuunka iwm waxa ka mid ah:
In la sameeyo oo la abaabulo maamul isku dhaf ah oo ay iska kaashadaan laamaha maamulka dawliga ah isla markaana laga qayb geliyo bulshada ujeedadiisuna tahay sidii looga hortagi lahaa Daacuunka iyo cudurada kale ee faafa muddada gaaban iyo ta fogba.
In bulshada lagu wargeliyo istaraatijiyada iyo tabaha lagu yaraynaayo Daaccunka iwm, meelaha muhiimka ah ee laga abbaaraayo iyo waxyaabaha u fududeeya gudbinta cudurkan si wacyigelintaasu u suurtogeliso in dadweynuhuna dhinacooda ka qayb qaataan barnaamajka xakamaynta Daacuunka.
in la hagaajiyo nadaafada iyo saxada bulshada (Good sanitation)
In la habeeyo qashinka (garbage) oo si ku habboon loo tuuro, meelo loogu talogalayna lagu ururiyo aakhirkana si hagaagsan loo gubo (Proper waste disposal system).
In hannaanka musqulaha iyo meelaha dadku ku saxaroodaan laga ilaaliyo inay ku darsamaan meelaha biyaha lagu kaydiyo iyo ceelasha biyaha laga cabbo (Proper sewage and drainage system).
In kor loo qaado dhaqanka nadaafad wanaagga sida gacmaha oo la iska maydho marka la isticmaalo musqusha/suuliga iyo ka hor intaan la diyaarin cuntada (Improved hygiene practice).
In la horumariyo waxbarashada beesha dhinaca caafimaadka (community health education) si kor loogu qaado wacyigooda caafimaadka dadweynaha si ay uga qayb qaataan ka hortagga iyo xakamaynta cudurada faafa sida Daacuunka iwm (Community health education programmes).
In lagu dheerigeliyo bulshada siiba degaamada uu ka dhici karo safmarka Daacuunku inay isticmaalaan waxyaabaha yarayn kara waxyeelada iyo fidista Daacuunka sida ku darista dheecaanka liita (lime juice) biyaha iyo cuntada.
In barnaamajyada wacyigelinta caafimaadka dadweynaha (public health) laga sii daayo idaacadaha, TVyada iyo warbaahinta baraha bulshada (social media).
In joogto laga dhigo wacyigelinta caafimaadka siiba xilliyada ay dillaaci karaan cudurada faafa gaar ahaan xilliga roobka iyo waqtiyada abaaraha si looga hortago cudurada.
In dalka laga hirgeliyo shaybaadhka caafimaadka guud ee cudurada faafa iyo saxadhowrka (Public health microbiology laboratory) kaas oo suurta gelinaya baadhitaanka cudurada (infections) iyo ka hortagooda.
Ugu dambeyn, si xal waara loogu helo oo looga hortago isla markaana lagu xakameeyo cudurka Daacuunka iyo cudurada kale ee faafa. Waa in la jabiyo meertada cudurka (infection cycle). Taas oo ah biyaha iyo cuntada sadhaysan (wasakhda leh ee jeermisku ku jiro), nadaafad xumada gaar iyo guud ahaaneed iyo saxadhowr la’aanta degaanka (saxarada iyo qashinka meel walba yaal).Tallaabadaasi, waxay suurtagal noqonaysaa marka lagu guulaysto in la helo biyo nadiif ah (clean drinking water), saxadhowr tayo leh iyo ku dhaqanka nadaafad wanaaga (Improved hygiene practice).
Haddaba, sidii biyo nadiif ah lagu heli lahaa iyo sida loo hirgelinayo waa hawl u taal inta ummadda hogaanka u ah iyo cidda jaangoysa ee dejisa hannaanka siyaasadda caafimaadka dalka.
Dr. Yasin Abdi
Senior Healthcare Scientist, Clinical Microbiologists at UK National Health Service (NHS), London.
Yabdi67@gmail.com
Filed Under: Blog, Public Health
Dr. Yasin Abdi – August 2014 Background Africa as a continent accounts for 15% of the world’s population, yet bears 24% of the global disease burden according to World Health Organisation (WHO) figures. Despite the positive prognosis coming out of Africa in terms of its economic potential and growth, sadly Africa has the highest rates […]