TB isingadavire kumishonga
ZIMBABWE iri kuita mabasa makukutu ekurwisa chirwere cherurindi asi dambudziko redenda iri riri kuramba richikura zvichitevera kudyidzana kwariri kuita neutachiona hweHIV nechirwere cheAID necheshuga izvo zvinoita kuti rinonoke kupera uye richiramba kupedzwa nemishonga, iyo inozivikanwa seMulti-Drug Resistant TB (MDR-TB).
Izvi zvakabuda pamusangano wekurwisa chirwere ichi wakaitirwa vatori venhau nesangano reInternational Union Against Tuberculosis and Lung Disease kuKadoma munguva pfupi yadarika.
Vachitaura pamusangano uyu, Dr Martin Mapfurira, avo vanova murongi mukuru anoona nezvechirwere cherurindi kubazi rezveutano nekurerwa kwevana, vanoti Hurumende iri kusangana nenyaya dzakati wandei dzechirwere cherurindi chinova chisingadairi mishonga.
“Chirwere cherurindi icho chisingakasiki kudairana nemishonga (MDR-TB) chatova mutoro mukuru kunyika nekuti chinodhura kuti chinge chichiwanirwa mishonga inochipedza. Kunonoka kuvhenekwa chirwere ichi ndiyo imwe mviro-mviro inoita kuti chizoramba kudairana nemishonga nekuti chinenge chatokomba,” vanodaro.
Dr Mapfurira vanoti Hurumende iri kuedza kurwisa chirwere ichi izvo zvinoonekwa nekuderera kwachakaita nenyaya 3 000 zvisinei nekuti kudyidzana kwachiri kuita neHIV kwakaonekwa kuchideredza budiriro yekurapwa kweTB.
“Asika, izvi hazvirevi kuti vanhu vese vane chirwere cherurindi vanenge vaine HIV. Zvisinei, ongororo yakaitwa inoratidza kuti chikamu che75% chevane chirwere cherurindi masoja avo emumuviri anenge asisiri kunyatsorwisa zvirwere. Zvirwere zvakadai seshuga ndizvo zvimwe zvinoderedza masoja emuviri kuti asakwanisa kurwisa TB kusanganisira HIV,” vanodaro.
Dr Charles Sandy, avo vanova deputy director weAids and TB Unit kubazi rezveutano nekurerwa kwevana, vanoti nyaya 38 367 dzechirwere cherurindi dzakavepo mugore ra2011 kana zvichienzaniswa ne41 305 dzemuna 2012, zvichireva kuti dzakaderera nechikamu che7,1%.
“Kuderera uku kwakakonzerwa nekuwaniswa kwemishonga yemaAnti-Retroviral Drugs munyika yese saka tinozvipembedza tisingakanganwi kutenda vatsigiri vedu vese muzvirongwa izvi,” vanodaro.
Zvisinei neshanduko huru iyi, nyika ichiri kusangana nedambudziko rechirwere ichi chiri kuramba kupedzwa nemishonga iripo.
Mugore ra2011, varwere 156 vakaonekwa vaine mhando yechirwere cheruridzi urwu, cheMDR-TB uye huwandu uhwu hwakaramba hwakakwira kuenda pa244 muna 2012.
Chirwere cherurindi chinonetsa kurapika chichikonzerwa nemabhakitiriya ayo asingabvume kuparadzwa nemishonga yakadai seIsoniazid neRifampin.
MDR-TB inogona kuvapo asi inorapika zvekutouraya utachiona uhwu nechikamu che100% kana mishonga ikashandiswa nemazvo.
Zvakaonekwa kuti vamwe varwere vanokundikana kupedza mishonga yavo mushure mekunge vava kunzwa zviri nani kana kuti vachinge vaona isiri kupindirana navo (side effects) uye kunonoka kuwaniswa mishonga muzvipatara zvinova zvinoita kuti vapedzisire vasingachabvumwi nemishonga iyi.
“Zvimwe zvipatara zvinogona kushaya mishonga iyi nenguva kana kuti varwere vanogona kunge vachidhurirwa nezvifambiso apo zvipatara zvinenge zviri kure, izvo zvinoita kuti vakundikane kutora mushonga yavo nenguva.
“Vamwe varwere vanogona kurutsa mushure mekutora mishonga zvichiita kuti vasapore nekukasika.
“MDR-TB inokonzerwa nebhakitiriya rinonzi mycobacterium tuberculosis rinova rinoparadza mapapu nedzimwe tsinga dzemuuropi uye mwandabvu,” vanodaro Dr Sandy.
Dr Sandy vanoti nzira imwe chete yekuita kuti vanhu vange vachipedza dambudziko reMDR-TB kutora mishonga yavo nenguva uye yese sekutarwa kwazvinenge zvakaitwa nemachiremba.
Zvisinei, panguva iyo nyika iri kuedza kurwisa chirwere cherurindi, varwere vari kuwana nyevenutso huru apo mishonga iyi iri kuwaniswa pachena.
Asi pachiri nemamwe matambudziko akadai sekudhurirwa nezvimwe zvinodiwa mukurapwa kwechirwere ichi zvinosanganisira mari dzekudhindisa makadhi (user fees), ongororo sedzechikararwa dzinoitwa neGene Expert Machine kana maX-ray nezvimwe.
Mumwe murwere akakurukurwa naye neKwayedza kuKadoma Hospital anoti akabatwa neMDR-TB nekuda kwekuti aikundikana kuwana mishonga yake nenguva sezvo achigara chinhambwe chemakiromita makumi matatu kubva pachipatara uye ari kutora mishonga yemaARVs.
Ongororo yakaitwa nesangano reWorld Health Organisation inoratidza kuti chirwere cheMDR-TB chinotora nguva refu kuti chirapwe chichipera uye chinorwadza.
Kana murwere achinge apinda muchikamu chepiri chekutora mapiritsi (second line) akakundikana kuatora nemazvo anobatwa neExtesive Drug Resistant-TB inova inonetsa kurapika zvekuti munhu anogona kuzorasikirwa neupenyu uye zvirwere izvi zviri nyore kutapurirana.
Muzvipatara varwere vane rurindi vanoiswa mumipanda yavo voga kuitira kuti vasatapurire vamwe vasina uye varapi nevashanyi vanoshandisa mamasiki ekudzivirira kutapurirwa asi hazvirevi kuti vanenge vachisarudzwa.
Mune mamwe matunhu akadai seMashonaland East, varwere vane MDR-TB vari kurapirwa kudzimba izvo zvinoita kuti vasaongororwe nemazvo nekuda kwekuti vamwe vacho vanenge vachigara kure.
VaMasimba Nyamuchera vanova murongi kusangano reZimbabwe National Network For People Living With HIV (ZNNP+) vanoti pachine mukaha mukuru maringe neruzivo kuvanhu vari munharaunda pamusoro pechirwere ichi.
“Vanhu vane chirwere cherurindi vari kusangana nenyaya dzerusarura dzakawanda apo vapepi vavo vanenge vachitya kutapurirwa saka vatori venhau vane basa guru rekukusha mashoko echenjedzo kuti chirwere ichi chinoparadzirwa sei nedziviriro yacho.
“Munguva yakatanga HIV, vanhu vaive neutachiona uhwu vaisemwa zvikuru vamwe vachivigwa vari mumasaga asi nekuda kwekuwaniswa ruzivo, rusarura urwu rwaderera. Vachengeti vevarwere vanofanira kuongororwawo sezvo vari panyatwa,” vanodaro.
Vanokurudzira veruzhinji kuti vavhure mahwindo edzimba nedzimotokari nguva dzose sezvo mabhakitiriya eTB achiparadzwa nyore muzuva uye mumabazi nedzimwe nzvimbo dzinoungana veruzhinji munofanira kupinda mhepo yekufema yakakwana.
Ongororo yakaitwa nesangano reWHO inoratidza kuti chirwere cherurindi chinoparadzirwa kuburikidza nekukosora, kuhetsura, kusvipa apo majemisi anoenda mumhepo afemewa neveruzhinji uye chikamu che1/3rd chevanhu pasi rose vane Latent TB inova inenge isina zviratidzo, nokudaro havakwanisi kutapurira vamwe.