Ukhiye wokunqoba iMDR TB wukuyigwema
UKUBHEBHETHEKA kwezifo ezithathelanayo nezingathelelani kuyinselelo ebhekene noMnyango wezeMpilo KwaZulu-Natal. Kulezi zifo kubalwa esikashukela nesofuba. Umnyango ukubeke eqhulwini ukulwa nokubhebhetheka kwalezi zifo, ikakhulukazi esofuba okunezinkomba zokuthi sidla lubi kangangoba sesedlula nemiphefumulo yabantu abaningi emhlabeni ukwedlula esegciwane lengculazi.
Inselelo yokulwa nezifo ibhekene nathi sonke njengabaholi bezinhlaka ezahlukene, amalungu omphakathi nabezindaba imbala.
Ngokombiko we-World Health Organization (WHO) uma abantu abawu-200 kwabangu-100 000 behaqwe yisifo sofuba, lokhu kusuke kuthathwa njengenhlekelele. Nakuba ziphezulu izibalo zabhaqwe yigciwane lofuba eNingizimu Afrika, nokho KwaZulu-Natal kunenhlansi ekhombisa impumelelo ekulweni nokubhebhetheka kwaleli gciwane njengoba isibalo sabanalo, sehla sisuka ku-897/100 000 ngo-2013, saya ku-808/100 000 ngo-2014. Kwathi ngo-2015 sehla sisuka ku-678/100 000 saya ku-580/100 000 ngo-2016. Lapha KwaZulu-Natal, sinawo amasu okuhlonza lesi sifo kubantu nokwelapha abanaso. Ezibhedlela nasemitholampilo kuzo zonke izifunda sinobuchwepheshe bemishini ye-Gene Xpert ekwazi ukuveza ukuthi umuntu unalo yini ufuba, emuva kwamahora amabili nje vo.
Abantu abaningi abanesifo sofuba esejwayelekile belashwa izinyanga eziyisithupha. Sifisa ukukugcizelela ukuthi zimbili izinhlobo zeTB, yilesi esijwayelekile kanye nalolu hlobo oludlondlobala lugcine selusezingeni elixakile, lungadambiseki nangengxubevange yamaphilisi igcine isiyiMDR-TB. Lokhu kudalwa wukungawadli amaphilisi ngokwemiyalelo ekhishwe abezempilo nokuthelelana kwabantu.
Ukwelapha iMDR TB kuthatha cishe iminyaka emibili. Ngeshwa, ngenxa yobucayi beMDR TB kuyenzeka imishanguzo yokulwa nayo eyimijovo (aminoglycosides) iphazamise umuzwa wokuzwa noma ukusebenza kwezindlebe. Njengezinye izindlela zokwelapha, ukulwa neMDR TB kumuntu akulula, futhi kubucayi. Ukwenza isibonelo nje, inhlobo nesibalo samaphilisi aphuzwa wumuntu oneMDR kuncike eminyakeni nasesisindweni sakhe.
Siwumnyango siyazichazela iziguli ngokubaluleka kokudla imishanguzo ngendlela efanele, siphinde sizichazele ngobungozi bemishanguzo ethile.
Esibhedlela saseMontebello, kubantu abawu-492 abafakwe ohlelweni lwemishanguzo yeMDR, bawu-123 abanezingqinamba zokuzwa.
Kuzokhumbuleka ukuthi vele lapha eNingizimu Afrika jikelele, balinganiselwa ku-10% abantu abangezwa kahle ngenxa yezinga lomsindo eliphezulu ezweni jikelele. Noma kunjalo, umnyango ubusuvele uqalile ukutholela iziguli izinsiza ezizothuthukisa ukusebenza kwezindlebe zazo, njengoba eziwu-9 sezizitholile, ezinye zisazosizwa.
Uma kwenzeka izikhungo zethu zezempilo ziba nezingqinamba ekunakekelweni kwabantu abaneMDR, sibadlulisela esibhedlela iKing Dinuzulu, okuyisikhungo esinobuchwepheshe obusezingeni lomhlaba emkhakheni wokwelashwa kwazo zonke izinhlobo zesifo zofuba. Enye yezinto ezibangela ukwanda kwesibalo sabantu abaneTB, eNingizumu Afrika yigciwane lesandulela-ngculazi ngoba yehlisa amasosha emzimbeni alwa nokungenwa yizifo, lokhu okwenza kube nzima ukulwa neTB. Nokho lokhu akusho ukuthi abantu abangenayo iHIV ingeke yabangena iTB. Nakuba belinganiselwa ku-65% abantu abaneHIV abangenwa yiTB – okuyisibalo esiphezulu - nokho siwumnyango siyakujabulela ukuthi ziyenyuka izibalo ezikhomba ukwelashwa ngempumelelo kwabantu abaneTB njengoba ngo-2005 zasuka ku-55% zaya ku-88,6% ngo-2016.
Empeleni akekho noyedwa umuntu okufanele aze abe neMDR noma abulawe yilesi sifo ngoba isifo sofuba siyagwemeka futhi siyelapheka.
Njengengxenye yomkhankaso wokuqinisekisa ukuthi abantu badla amaphilisi ngendlela efanele, sesibumbe amaqembu ahambela imiphakathi ebheka abantu asebeyeke ukudla imishanguzo yeTB neHIV isikhathi singakashayi ukuze babuyiselwe ohlelweni olufanele.
Ungasihlangabeza kanjani ekulweni nokubhebhetheka kweTB?
Vula amawindi uma ugibele isithuthi somphakathi noma usegunjini elinabantu abaningi
Vala umlomo uma uthimula noma ukhwehlela
Uma oseduze kwakho ekhwehlela vala umlomo bese umufulathela
Uma uhlaselwa wukukhwehlela okungapheli kuze kudlule amasonto amabili hamba uyohlolela igciwane leTB.
Uma unegciwane iHIV, hambela umtholampilo uyohlola ukuthi ayikakungeni yini iTB
Uma uneTB, phuza imithi yakho ngokwemiyalelo yabezempilo.
Sifisa ukubonga bonke abasebenzi bezempilo nezinhlangano ezihlanganyela nathi ngeqhaza abaqhubeka nokulibamba kulo mbhidlango wethu wokulwa nokubhebhetheka kweTB.
*UDKT Sibongiseni Dhlomo uwuNgqongqoshe wezeMpilo KwaZulu-Natal