Kudzivirira Kutsva Mukurwisana—neTibhii

TIBHII (TB) ihosha yevanhu yekare kwazvo inotapukira inouraya, uye inoramba ichityisidzira utano zvokuti World Health Organization (WHO) inoienzanisa nebhomba rine nguva yakarongwa. “Tiri kumhanyisana nenguva,” anonyevera kudaro mamwe mashoko eWHO nezveTB. Kana munhu akakundikana kuparadza bhomba iri, rimwe zuva angangozosangana nehosha isina mishonga “inoparadzirwa nemhepo, yakangoda kuti fananei neAIDS isingarapiki.” Nguva yasvika, inodaro WHO, yokupepuka pakuparadza kunogona kuitwa neTB. “Munhu wose anofema mhepo, kubva kuWall Street kusvika kuGreat Wall . . . , anofanira kunetseka nezvenjodzi iyi.”

Kunyanyisa here? Nyangwe. Chimbofungidzira chete kuti nyika yaizopengenuka sei kudai imwe hosha ikatadza kudzoreka ndokutyisidzira kupedza vagari vose, ngatiti vemuCanada mumakore gumi! Kunyange zvazvo izvi zvichinzwika senyaya, kutyisidzira kwacho ndekwechokwadi. Mupasi rose, TB inouraya vanhu vakawanda kupfuura AIDS, marariya, uye hosha dzemunzvimbo dzinopisa kana zvabatanidzwa: vanhu 8 000 pazuva. Mamiriyoni 20 evanhu zvino anorwara neTB chaiyo, uye mamiriyoni 30 angangofa nayo mumakore gumi ari mberi—nhamba huru kupfuura vagari vomuCanada.—Ona bhokisi rinoti “Kupararira kweTB Munyika Yose,” papeji 18.

Mashoko Akanaka Zvino

Zvisinei, nhasi pane tariro. Pashure pemakore gumi okuongorora, vaongorori vakawana imwe nzira ingaderedza TB kubva pakuva muurayi asingadzoreki kusvika pakuva anodzoreka. Dr. Hiroshi Nakajima, aichimbova mutungamiriri mukuru weWHO, akati nzira itsva iyi “imwe yedzinokosha kupfuura dzose nezvekufambira mberi pautano hwevanhu pamakore gumi.” Uye Dr. Arata Kochi, mutungamiriri weWHO Global TB Programme, anoti zvinopa mukana wokutanga usina kumbovapo “wokurwisa” denda reTB.” Chikonzero chemufaro wose uyu chii? Inzira inonzi DOTS.

DOTS ishoko rinomirira mashoko aya directly observed treatment, short-course. Chirongwa cheutano chinogona kurapa varwere vakawanda veTB mumwedzi mitanhatu kusvika kumisere vasina kumbopedzera kana zuva rimwe chete muchipatara. DOTS inotsamira pazvinhu zvishanu kuti ibudirire. Kana pasina chimwe chezvinhu zvacho, inodaro WHO, mukana wokurapa vane TB “unokundikana.” Zvinhu zvacho zvii?

● 1. Zvakananga: Njodzi inopfuura dzose yeTB kusaziva vanayo. Saka WHO inosimbisa kuti chokutanga, vashandi vezvoutano vanofanira kunangidzira nhamburiko dzavo pakuziva vanhu vari munzanga yavo vane TB inotapukira.

● 2. Kuongororwa: Chinhu chechipiri cheDOTS chinoita kuti gadziriro yezveutano—kwete murwere—ive nemutoro wokukunda pakurapa. Vashandi vezveutano kana vazvipiri vakadzidziswa, vakadai sevatengesi vemuzvitoro, vadzidzisi, kana kuti avo vaichimbova varwere veTB, vanofanira kuongorora varwere vachinwa mishonga yose inorwisana neTB. “Vanoongorora varwere” vanokosha pakubudirira nokuti chikonzero chikuru nei TB ichipfuurira kusvikira nhasi imhaka yokuti varwere vacho vanorega kushandisa mishonga nokukurumidza kwazvo. (Ona bhokisi rinoti “Nei Yave Kuwedzera—Zvakare?” riri papeji 18.) Pashure pemavhiki mashomanana chete okurapwa, vanotanga kunzwa zviri nani vorega kunwa mapiritsi avo. Nyamba, mishonga yacho inofanira kushandiswa kwemwedzi mitanhatu kusvika kumisere kuitira kuti muviri usare usisina utachiona hwose hweTB.

● 3. Kurapa: Mumwedzi yose mitanhatu kusvika kumisere iyi, vashandi vezveutano vanoongorora kubudirira kwokurapa vonyora kupora kunenge kuchiita murwere. Nenzira iyoyo, vanova nechokwadi chokuti varwere vacho varapwa zvakakwana uye havazotapuriri vamwe hosha yacho.

● 4. Short-Course: Kushandisa mubatanidzwa wakafanira uye uwandu hwakafanira hwemishonga inorwisa TB, inonzi short-course chemotherapy, kwenguva yakareba zvakafanira ndicho chinhu chechina chenzira yeDOTS. Mishonga yakabatanidzwa iyi ine simba rokuuraya utachiona hweTB.a Mishonga yacho inofanira kuramba ichiwanika nguva dzose kuitira kuti kurapwa kusavhiringidzike.

● 5. !: WHO inoratidzira chinhu ichi chechishanu cheDOTS nokuisa turavhunduko (!) pamagumo eshoko rokuti DOTS! Inomirira kutsigira nemari uye kuva nemitemo yakanaka. WHO inokurudzira gadziriro dzoutano kutsvaka kutsigirwa nemari nehurumende uye nemasangano asiri ehurumende uye kuita kuti kurapa TB kuve rutivi rwegadziriro yezvekurapa yenyika iripo.

Ichitaura nezvekutsigira nemari, nzira yeDOTS inoteterera vaumbi vemitemo vanosarudza kutsigira kana kusatsigira nemari. Bhangi reNyika Dzepasi Rose rinoti nezveDOTS “ndechimwe chezvirongwa zvokushandisa mari zvinobudirira chiripo mukurwisana . . . nehosha.” WHO inofungidzira kuti mari yose zvayo ingashandiswa panzira iyi munyika dzine urombo, ingangova $3 700 pamurwere. “Kashoma kuti isvike mari inopfuura $3,70 pamari inotambirwa nemunhu munyika dzichiri kubudirira, inogona kuwanikwa kunyange mumamiriro ezvemari akaipisisa.” Zvisinei, kuchipa kwacho hakurevi kuti hazvibatsiri.

Inoshanda Zvakanaka Here?

Vamiririri veWHO muna March 1997 vakazivisa kuti kushandiswa zvishoma kwenzira yeDOTS kusvikira zvino, “kwaikonzera kuderera kwekupararira kwedenda reTB kekutanga mupasi rose mumakumi amakore.” “DOTS kwainoshandiswa, nhamba yevari kupora iri kuwedzera nekanopfuura kaviri.” Zvirongwa zvokudzivirira zveDOTS zvakaitwa munzvimbo umo TB yakanyanya zvave kutoratidza kuti nzira yacho iri kushanda. Chimbofunga nezvenyaya shomanana dzokubudirira idzo WHO yakataura.

MuIndia “DOTS yave ichishandiswa munzvimbo dzokuratidzira dzine vanhu vanopfuura mamiriyoni 12. . . . Pavanhu vashanu vose vana vane hosha yetibhii vakarapwa zvino.” Papurogiramu yokudzivirira vanhu vanosvika miriyoni imwe muBangladesh, “87 muzana [yevarwere veTB] yakarapwa.” Pane chimwe chitsuwa cheIndonesia, chirongwa cheDOTS “chiri kurapa varwere vapfumbamwe pagumi vakatapukirwa.” MuChina, zvirongwa zvokudzivirira “zvakabudirira zvinoshamisa,” nokurapa kunosvika 94 muzana. Mune rimwe guta rekuSouth Africa, “vanopfuura 80 muzana [vevarwere veTB] vari kurapwa zvinobudirira.” Misi ichangobva kupfuura, DOTS yakashandiswawo muNew York City, nemigumisiro inoorora.

Pane zvakawanwa pakuongorora munyika dzakati wandei, anogumisa kudaro Dr. Kochi, zvinoratidza kuti nzira yacho “inogona kushandiswa kwese kwese uye inogona kuva nokubudirira pakurapa kwe85 muzana uye kupfuura.”

Hapana Kuwedzera Kukuru—Asi Pane Kubudirira

Nenzira yokurapa inogona kukunda nyore nyore hosha inouraya vanhu kupfuura dzose neisingadhuri, waizotarisira nzira yeDOTS kumisa kuwedzera kweTB. “Asi,” anodaro mushandi weWHO, “zvinoshamisa kuti nyika shomanana ndidzo dziri kushandisa nzira yokudzivirira TB yakaonwa kuti inorapa neWHO uye inoshandisa mari zvinobudirira.” Chokwadika, pakutanga kwa1996, nyika 34 chete ndidzo dzakanga dzashandisa nzira iyi mupasi rose.

Kunyange zvakadaro, pane kubudirira. Tisati tasvika muna 1993, WHO payakazivisa ngozi yeTB munyika yose, munhu mumwe pa50 wevairwara neTB akarapwa nenzira yeDOTS. Nhasi reshiyo yacho murwere mumwe pavarwere gumi voga voga. Zvinotaurwawo kuti, muna 1998 dzimwe nyika 96 dzakanga dzoshandisa nzira iyi yeDOTS. Kana nyika dzakawanda dzikashandisa DOTS, nhamba yevanofa neTB pagore ‘ichaderera nehafu mumakore gumi chete.’ Dr. Kochi anoti: “Tine chirongwa cheutano chakaonwa kuti chinobudirira chinongoda chete kushandiswa zvakafara kwazvo.”

Sezvo munhu ane ruzivo nezvishandiso zvokurwisa TB nokubudirira, chinhu chiri kushayikwa chete ndeche‘vanhu vachava nechokwadi chokuti mishonga iyi yashandiswa mupasi rose.’ Ndosaka rimwe bhuku rakanyorerwa vanachiremba nevamwe vashandi vezvekurapa munyika yose, WHO richibvunza kuti: “Tose takamirirei?”

[Mashoko Omuzasi]

[Mashoko okukwezva vaverengi ari papeji 17]

Sekondi imwe neimwe, mumwe munhu ari panyika anotapukirwa netibhii

[Mashoko okukwezva vaverengi ari papeji 17]

‘Mishonga inoraramisa inogara zvayo mumasherufu asi mamiriyoni achifa.’—Dr. Arata Kochi

[Mashoko okukwezva vaverengi ari papeji 19]

“Nzira yeDOTS ichava chimwe chezvinhu zvinokosha kwazvo zvakawanikwa zveutano hwevanhu pamakore gumi.”—WHO ndiyo yabudisa mashoko

[Bhokisi riri papeji 18]

Nei Yave Kuwedzera—ZVAKARE?

Mushonga wekurapa tibhii (TB) wakawanikwa anopfuura makore makumi mana apfuura. Kubvira ipapo, vanhu vanopfuura mamiriyoni 120 vakafa neTB, uye vamwe vanoda kusvika mamiriyoni matatu vachafa gore rino. Asi nei vanhu vakawanda kudaro vachiri kufa neTB asi mushonga uripo? Nemhaka yezvikonzero zvikuru zvitatu: kuregeredzwa, HIV/AIDS, uye multidrug-resistant TB.

Kuregeredzwa. Meso evanhu akanyanyotarisa hosha dzinotapukira dzakadai seAIDS uye Ebola. Zvisinei, vanhu vashomanana ndivo vanoziva izvi, kuti pamunhu mumwe nomumwe akafa neEbola muna 1995, 12 000 vakafa neTB. Chaizvoizvo, TB yakajairika munyika dzichiri kubudirira zvokuti vanhu ikoko vava kuiona sehosha yenguva dzose. Panguva iyoyowo, munyika dzakapfuma, TB yazobvumirwa kupararira kunyange zvazvo mishonga inobudirira kuirapa ichigara zvayo isingashandiswi mumasherufu. Kuregeredza uku kwenyika yose kwaratidzira kuva chikanganiso chine ngozi. Kunyange zvazvo kuva nehanya nezveTB kwenyika kwakanga kuchiderera, utachiona hweTB hwange huchiwedzera kusimba. Nhasi hunouraya vanhu vakawanda munyika dzakawanda kupfuura zvahwakamboita kare munhau yemunhu.

HIV/AIDS. TB ine shamwari yeHIV uye AIDS. Vanhu pavanotapukirwa neHIV—inoderedza gadziriro yomuviri yokurwisa hosha—vangangotanga hosha yeTB nekanoda kusvika ka30. Hazvishamisi kuti denda riripo zvino mupasi rose reHIV rawedzerawo nhamba yevarwerewo veTB! Zvinofungidzirwa kuti 266 000 yevanhu vaiva neutachiona hweHIV vakafa neTB muna 1997. “Ava ndivo varume nevakadzi,” anodaro Peter Piot, mutungamiriri weJoint United Nations Programme nezveHIV/AIDS, “vasina kubatsirwa nemishonga isingadhuri inorwisa TB yavaida kupedza hosha yavo yetibhii.”

Multidrug-Resistant TB. “Masuperbug,” asingagoni kurwiswa nemishonga yemunhu inorwisa hosha, zvinhu zvesayenzi zvokufungidzira, asi nezveTB, zvava kuva chinhu chaichoicho. Vanhu vanopfuura mamiriyoni 50 vangave vakatotapukirwa neTB yemultidrug-resistant (MDR). Varwere veTB vanorega kushandisa mishonga yavo pashure pemavhiki mashomanana nemhaka yokunzwa kuti vava nani, kana kuti mishonga yapera, kana kuti hosha yacho inonyadzisa havaurayi utachiona hwose hweTB mumuviri yavo. Somuenzaniso, mune imwe nyika yokuAsia, varwere vaviri veTB pavatatu vanorega kushandisa nzira dzokurapa nokukurumidza. Pavanorwarazve, hosha yacho ingava yakaoma kurapa nokuti utachiona hunenge hwakasara hunorwisawo uye hunokunda mushonga wose weTB uripo. Saka varwere vanoguma vava neTB iya isingarapiki—kwavari pachavo nekuna chero wavanenge vatapurira. Utachiona hunouraya uhwu hweMDR pahunongova mumhepo chete, tinosara nemubvunzo uyu usingafadzi, Munhu achazombokwanisa kudzivisa kupararira kwahwo here?

[Bhokisi riri papeji 18]

Kupararira kweTB Munyika Yose

Denda retibhii (TB) riri kupararira kwazvo, riri kudhura kurapa, uye riri kuuraya kwazvo gore rega rega. Mashoko akawanwa neWorld Health Organization anonyatsorondedzera kupararira kwakaita denda iri rinouraya chinyararire. Heino mimwe mienzaniso yacho: “Pakistan yave ichikundwa mukurwisana netibhii.” “Tibhii yadzoka pamwero mukuru muThailand.” “Nhasi, tibhii chimwe chezvinokonzera hosha kwazvo nerufu muBrazil.” “Tibhii yazoramba iripo pavanhu vemuMexico.” MuRussia “kuvapo kweTB kuri kuwedzera kwazvo.” MuEthiopia “tibhii iri munyika yacho yose.” “South Africa ndeimwe nyika ine nhamba yepamusoro yevane TB mupasi rose.”

Kunyange zvazvo pavarwere 100 veTB 95 vachigara munyika dzine urombo, TB iri kudzika midzi kunyange munyika dzakapfumawo. United States yakava nokuwedzera kwazvo pachirwere cheTB pakutanga kwema1990. Munyori wenhau wemuU.S. Valery Gartseff anoti TB “yadzokazve kuzotambudza vanhu veAmerica.” Nenzira yakafanana, Dr. Jaap Broekmans, mutungamiriri weRoyal Netherlands TB Association, akataura misi ichangobva kupfuura kuti denda reTB ra“zova rakaipisisa kuEastern Europe nedzimwe nzvimbo dzekuWestern Europe.” Hazvishamisi kuti, magazini inonzi Science, ya22 August 1997, inoti “tibhii iri kupfuurira kuva hosha inotyisidzira utano.”

[Bhokisi riri papeji 20]

Zvinoumba TB Zvakawanwa

Misi ichangopfuura iyi vaongorori vakabudirira mukunyora zvinoumba utachiona hwetibhii (TB). Basa iri rinotanga “chinhu chitsva mukurwisana nemumwe wevavengi vanouraya vanobudirira zvikuru vemunhu,” anodaro Dr. Douglas Young, weImperial College School of Medicine muLondon. World Health Organization inotaura kuti zvakawanikwa izvi “zvingava zvinokosha kwazvo pakutsvakurudza mishonga nemapiritsi zvinorwisa TB munguva yemberi.”—The TB Treatment Observer, September 15, 1998.

[Mifananidzo iri papeji 19]

Mishonga yakasanganiswa iyi inogona kuuraya utachiona hweTB

[Kwazvakatorwa]

Photo supplied by WHO, Geneva

Photo: WHO/Thierry Falise

[Mifananidzo iri papeji 20]

Zvinongoda $3 700 chete kurapa murwere

[Kwazvakatorwa]

Photo: WHO⁄Thierry Falise

Photo supplied by WHO, kuGeneva

[Vakatipa Mifananidzo iri papeji 17]

Photo: WHO/Thierry Falise

Photo supplied by WHO, Geneva

Photo: WHO/Thierry Falise