DARYEELKA CAAFIMAADKA HOOYADA IYO DHALAANKA

DOTT. Abuukar Nuur Xuseyn Takhtarka Cudurrada Caruurta

“BUUGGA JADEECADA”

Talaalku waa xaq ay leeyihiin caruurta waana waajib saaran waalidiinta

“Every death due to measles could be prevented with a simple vaccination that costs less than a dollar per child.”

JADEECO

Jadeecadu waxay ka mid tahay cudurrada Soomaalida ay ku tilmaami jirtay Lixda Cuduro ee Dilaagaa ah, kuwaas oo ka jira Dalkeena Soomaaliya.

Somaliya waxa ay ka mid tahay dalalka saboolka ah oo aan gaarin isku filnaansho dhaqaale ay ku daryeeli karto caafimaadka bulshada waxaana waddanka oo gabi ahaan ka jirin siyaasad, barnaamijyo iyo stratejiyo lagu hormariyo laguna howl geli lahaa caafimaadka bulshada guud ahaan gaar ahaana midda caruurta iyo hooyada taasoo keentay in kumanaan caruur iyo hooyooyin aan la talaalin ay u geeriyodaan ama ay u naafoobaan cudurka jadeecada iyo cudurada kale ee la midka ahi.

Jadeecada waa cudur ba'an oo si dhaqsi ah bulshada ugu faa'fo, waxaa keena fiirus ooka tirsan qoyska Paramixovirus nooca Morbillivirus.

Jadeecada meel kasta ee aduunka ayee ka dillaaci kartaa hase ahaatee wadamada horay u hormaray waxay ku dadaaleen kuna gulaysteen in Cudurkaani ay ka badbaadiyaan caruurta iyo dhamaan bulshada taasoo u suuro gelisay adeegsiga balaaran ee Talaalka. Daraasad la sameeyay sanadku markuu ahaa 1997 waxaa lagu soo bandhigay in Jadeecada ay saamaysay 31 milyan qof oo 1milyan qof u geeriyootay, milyankaas qofood ee u dhimatay Jadeecada kala bar (500.000) waxay ka soo jedeen Qaaradda Afrika (Africa sub-saharan).Daraasad kale ee WHO samaysay waxay qiyaastay sanadkii 2001 in 30-40 milyan qof uu cudurka Jadeecada saameeyay, 750,000 ilaa 1 milyana ay u geeriyodeen.Wadamada ay Jadeecadu ku badan tahay (Endemic area) waqti kasto ayuu ka dilaaci kartaa siiba xilliyada dugsiyada ay furan yihiin.Afartii sano Jadeecada marbay si balaaran u faaftaa (measles outbreak),oo ay si ba'an u saameesaa caruurta. Sanadkii hore 2014 cudurka Jadeecada si balaaran ayuu ugu faafay Soomaaliya (measles outbreak):

FURUURUCA JADEECADA

Bayaanka ay si wadajir u soo saareen WHO iyo Unicef ayaa lagu qeexayaa culayska uu leeyahay cudurka Jadeecada iyo dhibaatada uu caruurta u gaysan karo:

“ The infection rate - according to the latest figures - is four times higher than the average recorded in the same period of 2013, while a vaccination campaign should be carried out urgently, to stop thousands of preventable deaths, "they said UNICEF and WHO (World Organisation health) in a joint statement."We have a very large number of Somali children malnourished," said the head of UNICEF in Somalia Sikander Khan.”

"The malnourished children can get sick more easily and are more likely to die or remain disabled for life, such as losing your sight, hearing or bringing damage to the brain, as a result of measles," said the head of WHO in Somalia, Ghulam Popal, stressing that the epidemic is "extremely worrying", with 10% of infected children who are likely to die from complications.In recent months, about half a million Somali children have been vaccinated, but are at least five million in total - according to the UN - those in need of protection. In some areas of the country on the Horn of Africa, particularly in the south and central regions, including areas where African Union troops are battling Islamic fundamentalists Shebab - immunization rates are just 15%. Less than a third of children under one year of age were vaccinated throughout the country in 2013.450,000 children die each year (one child every minute) due to this disease in the African continent so that measles causes more deaths among African children that HIV, Tuberculosis and Malaria.Every death due to measles could be prevented with a simple vaccination that costs less than a dollar per child.Unicef, Red Cross, ONU, USA have created long-term campaign with the aim to vaccinate 200 million children at risk throughout Africa (This will prevent 1.2 million deaths).

450,000 children die each year (one child every minute) due to this disease in the African continent,that measles causes more deaths among African children, that HIV, Tuberculosis and Malaria.Every death due to measles could be prevented with a simple vaccination that costs less than a dollar per childUNICEF, the Red Cross, UN and US have created long-term campaign with the aim to vaccinate 200.milioni of children at risk throughout Africa.(This will prevent 1.2 million deaths.)

Cudurrada faafa Jadeecadda waa midka ugu dhaqsiyaha badan ee bulshada ku faafa, ka mid ah kuwooda ugu dhimashada badan iyo kuwooda ku reebo caruurta waxyeelada culus. Bulshada waxay ku kala qaadaa ama isuugu gudbisaa cudurka Jadeecadda hawada, qofka Jadeecadda qabto wuxuu firuska qofka kale ugu gudbiyaa goortuu hadlayaa, ama qoslaaya, ama hindhisaya., ama qufucaya.

Sida lagu garto cudurka Jadeecadda waa mid aad u adag xilliyada hore goortuu firuska ku tarmaya jirka gudahiisa oo aana jirin wax astaamo ah oo lala xiriirin karo, 12-14 maalmood ka dib ayaa la tuhmi karaa cudurka Jadeecadda goortay soo ifbaxaan aastaama ugu horeeya kuwaaso ah:

1) Qandho2) Indho xanuun iyo indho cun-cun3) hergab4) afka gudahiisa oo dhibo cad lagu arko (Koplik spots).5) Dhuun xanuun6) Qufac daran.

4-5 maalmood ka dib aya jirkoo idil furuurux ka soo baxaya, furuuruxan ayaa wehliyo cun-cun xilligan ayaa la xaqiijin karaa in cudurka uu yahay Jadeeco.Xilliga boogsashada ayaa soo hagaagaya maalinba maalinta ka dambayso caafimaadka bukaanka haseyeeshee waa xilligani goortay soo ifbaxayaan dhibaatooyinka uu qofka ku reebi karo, siiba caruurta da'dooda ka hoosayso 5 sano ayee soo gaartaa dhibaatooyinka culus.

Furuuruxa Jadeecada

Koplik spots

Way adag tahay in caruurta ilaa sanad jirka lagu arko Cudurka Jadeecada haddii Hooyada uurka ka hor uu ku dhacay Jadeeco amaba laga talaalay.Waxaan og nahay in Hooyada xilliga uurka ay u gudbiso cunuga unugyada ka hortagga cudurka Jadeecada unugyadaasi oo ilaa muddo sanad ah ka difaacaya cunugga Jadeecada. Haddana waxaa suuro gal ah in Jadeecada ee saameeso caruurta da'dooda aad u yar bil ilaa sanad.

Ilaa iyo iminka ayaa la xaqiijiyay in 4 caruur oo da'dooda ka hoosayso sanad ay Jadeecadu haleeshay.

1) 1 Cunug oo 4 bilood jira2) 2 Cunug oo 7 bilood jira3) 1 Cunug oo 11 bilood jira

Dhacdadaani waxaa loo asbaabeeyay in:

a) In Hooyada aysan qaadan talaalka ka hortagga cudurka Jadeecada.b) In Hooyada uusan ku dhicin cudurka Jadeecada.c) In ay jirto nafaqa darro.

Haddii Hooyada ay qaado Cudurka Jadeecada xilliga uurka waxaa suuro gal ah in cunuga uu dhicisoobo ama uu uurka ku dhinto.

Dhibaatooyinka la xiriira Cudurka Jadeecadda:

1) Dhaga xanuu ama fasaska dhagaha ama maqal la'aan.2) Indha la'aan3) Pneuumonia4) Encephalitis waa dhibaatada ugu halista badan oo ka mas'uul noqon karto

naafo, qalal, maqal la'aan, arag la'aan iyo dhimasho.

Saadasha (Prognosis):

Saadaasha cudurka Jadeecadda maaha mid xun maaadaama waqtiyadii ugu dambeeyay uu sare u kacay isticmaalka antibiotiga ka hortaga dhibaatooyinka la xiriira fasasyada bacterialka.Badi dhimashada waxay la xiriirta Encephalitis.Saadashada ma wanaagsana dadka difaaca jirkooda hoos u dhacsanyahay (immuno- deficiency) iyo caruurta nafaqa darrada haysato.

Daaweenta Cudurka Jadeecadda:

Ma jirto daawo u qaas ah Cudurka Jadeecadda.Hase ahaatee waxaa laga maarmaan noqon karo isticmaalka antibiyootigo goortay soo if baxaan dhibaatooyinka la xiriira Jadeecadda.Fitamiin A qaadashadeeda ayaa la xaqiijiyay in ay u wanaagsantahay dadka ku dhacaCudurka Jadeecada qaasatan caruurta da'dooda ka hoosaysa 2 sano iyo kuwa nafaqa darrada haysato.

Jadeecadu Daawo ma laha.

MACLUUMAADKA DHIMASHADA:

Wadamada reer galbeedka iyo kuwa hor'umarka ku dhaqaaqay ayaa aad ugu yar faafidda cudurka jadeecada iyo dhimashada la xiriirto maadaama ay wadamadaani ay si balaaran u adeegsadeen talaalka MMRka.Wadamada Saboolka qaasatan kuwa Qaaradda Afrika dhimashada la xiriirta cudurka Jadeecadda waxaa lagu qiyaasay 30% taasoo u sabab ah adeegsi la'aanta talaalka MMRka ama adeegsiga talaalka MMRka uusan gaarsiisneen heerkii loo baahnaa.Faafidda cudurka Jadeecadda ayaa maanta ah halista ugu weyn ee nolosha dadka, gaar ahaan carruurta kuwooda nafaqa darrada haysata iyo caruurta ay ku yartahay fitamiin A.Waxaa la qiyaasay in cudurka Jadeecadda uu meesha afaraad kaga jiro 10ka sababoodugu muhiimsan ee loo dhinto.Midda kale Jadeecadda waxay ka mid tahay cudurrada indhala'aan ku ridda caruurta.

Talaalka MMR iyo Autismka:

Dhoowr jeer ayaan la kulmay waalidiin badan ee soomaaliyeed ka cabsi qaba in ay caruurtooda ka talaalaan Cudurka Jadeecada ama gebi ahaanba diidan talaalaka MMRka, iyagoo ka muuqatay wel-wel xoogan ee la xiriira dhibaatada uu lahaan karotalaalka MMRka ama shakiga ay ka qabaan in uu Talaalkaasi mas'uul ka noqon karo cudurka Autismka ama uu jiro wax xiriir ahi u dhaxeeyo MMR iyo Autismka.Waxaan kaloo la kulmay waalidiin Soomaaliyeed leh caruur Autismka qaba oo aaminsan in Talaalku MMRka uu u sabab yahay Autismka caruurtooda.Run ahaantii wel-welka iyo cabsida ka muuqato waalidiinta Soomaaliyeed waa dareen ay la wadaagaan walidiin kale ee wadama kale kasoo jeeda gaar aahaan wadamada Reer Galbeedka. Waa su'aal mar marwalba soo noq-noqoto una baahan in jawaab sax ah laga bixiyo ooay waalidiinta Soomaaliyeed ku qanci karaan inkastoo mar hore culumada saaniska xaqiijiyeen in uusan jirin wax dhibaato uu leeyahay Talaalka MMRka uusana ka mas'uul ahayn Autismka.Wargayska caafimaad ee loo yaqaano Lancet ayaa lagu soo daabacay 1998 maqaal uuqoray dhakhtar Ingiriis ah Andrew Wakefield isagoo ku doodayo in tallaalku MMRkuuu sabab u yahay cudurada xiidmaha ee la xiriira Kanner Sindrome (Autism Spectrum Disorder). Maqaalka Wakefield wuxuu dhaliyay dood cilmiyeed balaaran oo muddo dheer socotay ku dhawaad 12 sano. Wakefield dhab ahaantii doodiisa ma ahayn mid si rasmi ah u muujinaysay in talaalkaMMRka uu ka mas'uul yahay Kanner Sindrome haddana meelo badan ee doodiisa mugdi ahayd ayuu ifi waayay. Nasiibdarro Mr.Wakefield doodiisa aan sal cilmiyeed ku fadhin waxay sababtay in hoos u dhac balaaran ku yimaada tirada adeegsiga talaalka ka hortagga cudurka Jadeecada ee dalka Mareekanka, Ingiriiska iyo wadamo kale ee Europe, hoos u dhacaa oo sabab u noqday kiisas farabadan oo dhibaatooyin xambaarsan oo ay ka midyihiin Encephalilitis iyo dhimasho. Guddiga anshaxa ee General British Medical, ka dib markii baaritaan taxadir uu sameeyay, ayuu natiijo culus ka soo saaray sida Wakefield uu u soo bandhigay baaritaan aan daacad ahayn oo waxyeelo culus ugaysatay caruur badan qaarkoodna ku naf waayay. Warbixinta Guddiga Sayniska waxay sii sheegtay in Wakefield uu hoos u dhac balaaran u gaystay sumcadda Caafimaadka. Wakefield naftiisa waxaa laga cayriyay Royal College ee Takhaatiirta oo aan mar dambe u shaqayn Karin.

TALAALKA JADEECADA :

Ujeeedada laga leeyahay in caruurta laga talaalka cudurka Jadeecada waa:

1. In cunuga laga difaaco dhibaatooyinka culus uu wato cudurka Jadeecada, kuna reebi karo.

2. In cunuga jirkiisu uu lahaadaa difaac joogta ah.3. In la xakameeyo in Jadeecadu ay ku faafto bulshada.

Talaalka loogu talagalay ka hortagga cudurka Jadeecada waa talaal ka samaysan fiiruska jadeecada oo nool laakin awoodiisa hoos loo dhigay, farsamadaan waxay suro gelisay in difaaca jirka uu sare u kaco islamarkaana uu awood u yeesho xakameenta cudurka.

Waxaa jira 3 nooc ee Talaalka Jadeecada:

a) Nooca Schwarzb) Nooca Moratenc) Nooca Edmonston-Zagreb. Inkastoo Talaalka Jadeecada kaligii la adeegsan karo, haddana waxaa caadi ah inin Cudurrada jadeecada, Qaamooqashiirka iyo Jadeeco Jarmalka hal mar laysla wada qaato iyagoo loo adeegsanayo Talaalka MMR.

WAQTIGA TALAALKA:

Waa muhiim in caruurta laba jeer ma seddax jeer la Talaala:

1) Goorta cunugu uu da'diisu yahay (wareegtada 1aad) 12-15 bilood2) Goorta cunuga uu da'diisu yahay (wareegtada 2aad) 4-6 sano

Jadwalkaan waa kan ay adeegsadaan wadama horay u hor'maray, kuwa saboolka ah ama wadamada soo koraya marxaladaha jira owgeed ayuu jadwalka talaalka ugu duwan yahay, wadamadaani waxay isticmaalaan jadwal ay ka soo shaqaysay WHO.

1) Wareegtada 1aad markuu cunuga jirsado 6 bilood.2) Wareegtada 2aad markuu cunuga jirsadu 12-15 bilood.3) Wareegtada 3aad markuu cunuga jirsado 4-6 sano.4) Soo qabo oo talaal (Catch up) 4-6 ; 11-12 sano.

FIIRO GAAR:

Waxaa suuro gal ah in 5% caruurta la talaalay in jirkooda uusan jawaab ka bixin.(No responder.)

TALAALKA DADKA WAAWEYN:

Dadka da'dooda ka sareesa 18 sano oo aan weligood qaadan Talaalka MMRka ama uusan cudarka ku dhicin waa in ay mar qura istilaalan.Dumarka ku jira xilliga Uurka waxaa talo ah oo wanaagsan in talaalka jadeecada amatalaalkasto ka sameesan jeermi nool oo awoodiisa hoos loo dhigay in laga ilaaliyo waayo waxaa suuro gal ah in uu dhibaateeyo cunuga uurka ku jiro.

DHAMAAD.