Tizilombo Ta matenda Tibwezera Chilango

ZAKA za zana la 20 zaona kutukuka kodabwitsa kwa sayansi ya zamankhwala. Kwa zaka zikwi zambiri, anthu kwenikweni akhala osatetezereka ku mliri wa tizilombo takupha ta matenda. Koma zinthu zinayamba kusintha chapakati pa ma 1930 pamene asayansi anapeza sulfanilamide, mankhwala oyamba ogonjetsa mabakiteriya popanda kuvulaza kwenikweni munthu wodwala.a

M’zaka zomwe zinatsatira, asayansi anapanga mankhwala atsopano amphamvu ochiritsa matenda oyambukira—chloroquine ya malungo ndi mankhwala ochiritsa chibayo, scarlet fever, ndi TB. Pofika mu 1965 anali atapanga mankhwala osiyanasiyana oposa 25,000. Asayansi ambiri anati matenda oyambitsidwa ndi mabakiteriya sanalinso odetsa nkhaŵa kwambiri kapena ofunika kufufuza. Ndi iko komwe, nkufufuziranji za matenda amene anayembekezera kuti sadzakhalakonso posapita nthaŵi?

M’maiko otukuka padziko, akatemera atsopano anachepetsa kwambiri imfa za chikuku, matsigwidi ndi chikuku cha ku Germany. Mkupiti waukulu wakupereka akatemera a poliyo, womwe unachitika mu 1955, unali wachipambano kwambiri kwakuti chiŵerengero cha anthu odwala nthendayo ku Western Europe ndi North America chinatsika kuchoka pa 76,000 chakacho kufika pa ochepera 1,000 mu 1967. Nthomba, nthenda yaikulu yakupha, inathetsedwa padziko lonse.

Zaka za zana lino zaonanso kupangidwa kwa maikulosikopo yamagetsi, makina amphamvu kwambiri kwakuti amatheketsa asayansi kuona mavairasi amene ali aang’ono kuposa chikhadabo cha munthu kuchichepetsa kuŵirikiza miliyoni imodzi. Mamaikulosikopo otero, limodzi ndi makina ena opita patsogolo, zatheketsa kudziŵa bwino nthenda zoyambukira ndi kulimbana nazo kuposa ndi kalelonse.

Chilakiko Chinaoneka Ngati Chotsimikizirika

Chifukwa cha zimene anapezazi, odziŵa za mankhwala anali ndi chidaliro kwambiri. Tizilombo ta matenda oyambukira tinali kugonjetsedwa ndi zida za sayansi yamakono ya zamankhwala. Inde, anakhulupirira kuti chilakiko cha sayansi pa tizilombo ta matenda chidzachitika mwamsanga, kotheratu! Ngati mankhwala ochiritsa nthenda yakutiyakuti kunalibe panthaŵiyo, anali kudzakhalako posapita nthaŵi.

Kalelo mu 1948, nduna yoona nkhani zakunja ya United States George C. Marshall ananena monyada kuti chilakiko pa matenda onse oyambukira chinali pafupi. Patapita zaka zitatu, bungwe la World Health Organization (WHO) linanena motsimikiza kuti malungo a ku Asia posapita nthaŵi adzakhala matenda “osadetsanso nkhaŵa kwenikweni.” Pofika chapakati pa ma 1960, chikhulupiriro chakuti nyengo ya chaola ndi miliri inali itapita chinali chofala kwambiri kwakuti dokotala wamkulu wa United States William H. Stewart anauza madokotala kuti nthaŵi inafika ya kuleka kuda nkhaŵa ndi matenda oyambukira.

Matenda Akale Abukanso

Komabe, nkhani yokhudza matenda oyambukira sinaleke kuwadetsa nkhaŵa. Tizilombo ta matenda sitinazimiririke papulanetili chabe chifukwa chakuti sayansi inapanga mankhwala ndi akatemera. M’malo mogonjetsedwa, tizilombo takupha ta matenda todziŵika tinabweranso mwamphamvu! Ndiponso, tizilombo tina takupha ta matenda tinabuka—tizilombo ta matenda timene madokotala sanali kudziŵa kale. Motero, tizilombo ta matenda takale ndi tatsopano tanyanyuka, tikumaika pangozi anthu miyandamiyanda padziko lonse, kuwadwalitsa, kapena kuwapha.

Matenda akupha omwe anati anawathetsa abukanso, akupha kuposa ndi kalelonse ndi ovuta kwambiri kuchiritsa ndi mankhwala. Chitsanzo chimodzi ndi cha tuberculosis (TB). Posachedwapa bungwe la WHO linati: “Chiyambire 1944, mankhwala a TB agwiritsiridwa ntchito kwambiri ku Japan, North America ndi Ulaya kuti achepetse kwambiri matenda a TB ndi imfa zake. Komabe, ntchito yochepetsera TB yanyalanyazidwa m’maiko omatukuka, . . . zikumachititsa nthendayo kubukanso m’maiko olemera mu mtundu wowopsa kwambiri ndi wosamva mankhwala ambiri.” Lerolino TB, imene nthaŵi zambiri imabwera ndi mabakiteriya oyenda m’mpweya okhala m’mapapu, imapha pafupifupi anthu mamiliyoni atatu chaka chilichonse—oposa 7,000 patsiku. Pofika chaka cha 2005, imfa zake zingawonjezeke kufika mamiliyoni anayi chaka chilichonse.

Matenda ena akale akupha akuwonjezekanso. Kolera tsopano yakhala mliri m’madera ambiri a Afirika, Asia, ndi Latin America; anthu ambirimbiri amadwala ndi kufa. Ku Asia kwabuka mtundu wina wa kolera watsopano kwenikweni.

Dengue, imene udzudzu wa Aëdes aegypti umawanditsa, ikufalikira mofulumira; tsopano anthu 2.5 biliyoni ali pangozi ndi nthendayi m’maiko oposa 100 padziko lonse. Chiyambire ma 1950, mtundu watsopano wa nthenda yakupha ya kukha mwazi yabuka ndi kufalikira m’Madera Otentha onse. Amati imapha anthu pafupifupi 20,000 chaka chilichonse. Monga momwe zilili ndi matenda ochuluka oyamba ndi mavairasi, kulibe katemera woletsa nthendayo ndipo mankhwala palibe amene angaichiritse.

Malungo, amene sayansi panthaŵi ina inakhulupirira kuti idzawathetsa, tsopano amapha pafupifupi anthu mamiliyoni aŵiri chaka chilichonse. Zonse ziŵiri maparazaiti a malungo ndi udzudzu umene umawanyamula zakhala zovuta kwambiri kupha.

Matenda Atsopano Osakaza

Mwinamwake odziŵika kwambiri pa matenda atsopano amene abuka posachedwapa kusakaza anthu ndiwo AIDS yowopsayo. Nthenda yosachiritsikayi imayamba ndi vairasi imene inali yosadziŵika mwina zaka khumi ndi ziŵiri zapitazo. Komabe, pofika chakumapeto kwa 1994 chiŵerengero cha anthu padziko lonse okhala ndi vairasiyo chinali pakati pa 13 ndi 15 miliyoni.

Matenda ena oyambukira amene anali osadziŵika kale akuphatikizapo hantavirus pulmonary syndrome. Yofalitsidwa ndi mbeŵa, inabuka kummwera koma chakumadzulo kwa United States ndipo inapha oposa theka la amene anati anadwala nayo. Mitundu iŵiri ya hemorrhagic fever—yonse yatsopano, yonse yakupha—yabuka ku South America. Matenda ena owopsa abukanso—mavairasi amaina achilendo ndi odabwitsa—Lassa, Rift Valley, Oropouche, Rocio, Q. Guanarito, VEE, monkeypox, Chikungunya, Mokola, Duvenhage, LeDantec, vairasi ya mu ubongo ya Kyasanur Forest, kachilombo ka Semliki Forest, Crimean-Congo, O’nyongnyong, Sindbis, Marburg, Ebola.

Kodi Nchifukwa Ninji Pakubuka Matenda Atsopano?

Pokhala ndi chidziŵitso ndi chuma chonse chimene sayansi yamakono ya zamankhwala ili nacho, kodi nchifukwa ninji matenda akupha akuvuta kwambiri kugonjetsa? Chifukwa choyamba nchakuti pali maulendo ochuluka omwe anthu akupanga lerolino. Kayendedwe kamakono kangachititse mliri wakumalo amodzi kufalikira mofulumira padziko lonse. Maulendo apandege amapeputsa kayendedwe ka nthenda yakupha, imene imakhala mwa munthu wodwala, kuchokera kudera lina la dziko kumka ku dera lina lililonse la dziko pamaola oŵerengeka.

Chifukwa chachiŵiri chimene chimachirikiza tizilombo ta matenda ndicho kuwonjezeka komafulumira kwa chiŵerengero cha anthu cha dziko—makamaka m’mizinda. Ndithudi, m’mizinda mumakhala zinyalala. Zinyalalazo zimakhala ndi zotengera zapulasitiki ndi matayala odzala madzi a mvula. M’Madera Otentha, zimenezo zimasonkhezera kuswana kwambiri kwa udzudzu umene umanyamula matenda akupha onga malungo, yellow fever, ndi dengue. Ndiponso, monga momwe nkhalango yoŵirira ingasonkhezere moto, momwemonso anthu okhala mopanikizana kwambiri amapereka mikhalidwe yoyenera yakuti TB, fuluwenza, ndi matenda ena oyenda ndi mpweya afalikire.

Chifukwa chachitatu cha kubukanso kwa tizilombo ta matenda chikukhudza kusintha kwa khalidwe la anthu. Tizilombo ta matenda timene timafalitsidwa mwa kugonana tachuluka ndi kufalikira chifukwa cha kugonana kwa munthu mmodzi ndi anthu ambiri pamlingo wosayerekezeka, kumene kwakhalako chakumapeto kwa zaka za zana la 20 lino. Kufalikira kwa AIDS ndiko chitsanzo chimodzi chabe.b

Chifukwa chachinayi chimene tizilombo takupha ta matenda tikuvutira kugonjetsa nchakuti munthu waloŵerera m’tchire ndi nkhalango za mvula. Mlembi Richard Preston akuti m’buku lake lakuti The Hot Zone: “Kubuka kwa AIDS, Ebola, ndi tizilombo tina tilitonse ta m’nkhalango za mvula kukuoneka kukhala zotulukapo zake za kuwononga malo ndi zamoyo m’madera otentha. Mavairasi amene akubukawo akuchokera ku mbali zowonongeka za zamoyo ndi malo awo okhala padziko lapansi. Ambiri a iwo akuchokera ku mbali zowonongeka za nkhalango za mvula za m’madera otentha . . . Nkhalango za mvula za m’madera otentha zili nkhokwe zazikulu za moyo papulanetili, zikumakhala ndi zochuluka za zomera ndi mitundu ya nyama padziko. Nkhalango za mvula zilinso nkhokwe yake yaikulu koposa ya mavairasi, pakuti zamoyo zonse zimakhala ndi mavairasi.”

Motero, anthu akhala pafupi ndi tizilombo ndi nyama zina zamwazi wofunda zimene mavairasi amakhalamo popanda ngozi iliyonse, kuswana, ndi kufa. Koma pamene vairasi “ilumpha” kuchokera mu nyama kuloŵa mwa munthu, vairasiyo ingakhale yakupha.

Malire a Sayansi ya Zamankhwala

Zifukwa zina zimene matenda oyambukira akubukiranso zikukhudza sayansi ya zamankhwala. Mabakiteriya ambiri tsopano samamva mankhwala amene kale anali kuwapha. Chodabwitsa nchakuti mankhwalawo ndiwo athandiza kupanga mkhalidwe umenewu. Mwachitsanzo, ngati mankhwala amangopha 99 peresenti ya mabakiteriya owopsa mwa munthu wodwala, peresenti imodzi ya otsalawo amene sanamve mankhwala tsopano amakula ndi kubalana monga mtundu wolimba wa namsongole m’munda wogaulidwa chatsopano.

Odwala amawonjezera kuipa kwa vutolo pamene satsiriza mlingo wa mankhwala operekedwa ndi dokotala wawo. Odwala angaleke kumwa mankhwala atangoyamba kumva bwino. Pamene tizilombo ta matenda tofooka koposa tingakhale titaphedwa, tolimba koposa timapulumuka nitiswana mwakachetechete. Pamilungu yoŵerengeka, nthendayo imayambanso, koma tsopano imakhala yovuta, kapena yosatheka, kuichiritsa ndi mankhwala. Pamene mtundu wosamva mankhwala wa tizilombo ta matenda timeneti uloŵa mwa anthu ena, pamakhala vuto lalikulu la thanzi la anthu onse.

Posachedwapa akatswiri ku bungwe la WHO anati: “Kusamva [mankhwala ndi zinthu zina zopha tizilombo] ndiko mliri m’maiko ambiri ndipo kusamva mankhwala ambiri sikumasiyira madokotala mpata weniweni wochiritsira matenda ambiri omawonjezereka. M’zipatala mokha, mumabuka matenda oyambukira amabakiteriya pafupifupi miliyoni imodzi tsiku lililonse padziko lonse, ndipo ochuluka ake samva mankhwala.”

Kuika mwazi, kochitidwa kwambiri kuyambira pa nkhondo yadziko yachiŵiri, kwathandizanso kuwanditsa matenda oyambukira. Ngakhale kuti sayansi yayesayesa kutsimikizira kuti mwazi ulibe tizilombo takupha ta matenda, kuika mwazi kwathandizira kwambiri kuwanditsa hepatitis, cytomegalovirus, mabakiteriya osamva mankhwala, malungo, yellow fever, nthenda ya Chagas, AIDS, ndi matenda ena ambiri owopsa.

Mmene Zinthu Zilili Lerolino

Pamene sayansi ya zamankhwala yaona kuwonjezeka kwa chidziŵitso m’zaka za zana lino, pakali zinsinsi zambiri. C. J. Peters amafufuza tizilombo towopsa ta matenda ku Centers for Disease Control, laboletale yotchuka ya America ya umoyo wa anthu. Pofunsidwa mu May 1995, iye anati za Ebola: “Sitikudziŵa chifukwa chake munthu imamuwononga kwambiri, ndipo sitikudziŵa zimene imachita [kapena] kumene imakhala, pamene siikuchititsa miliri imeneyi. Sititha kuipeza. Kulibe banja lina la mavairasi . . . limene sitimalidziŵa konse monga limeneli.”

Ngakhale pamene pali chidziŵitso chothandiza cha mankhwala, ndi akatemera olimbana ndi matenda, kuwagwiritsira ntchito kwa aja owafuna kumafuna ndalama. Mamiliyoni ndi amphaŵi. World Health Report 1995 ya WHO ikuti: “Umphaŵi ndiwo chifukwa chachikulu chimene makanda samapatsidwira akatemera, chifukwa chimene kwakhalira kopanda madzi abwino ndi zimbudzi, chifukwa chimene mankhwala ochiritsa ndi machiritso ena samapezekera . . . Chaka chilichonse m’maiko omatukuka ana 12.2 miliyoni azaka zosafika 5 amafa, ochuluka ndi zochititsa zimene zingaletsedwe ndi masenti oŵerengeka chabe a [United States] pa mwana aliyense. Iwo amafa kwakukulukulu chifukwa cha kusasamala kwa dziko, koma ochuluka amafa makamaka chifukwa chakuti ndi amphaŵi.”

Pofika mu 1995, matenda oyambukira ndi maparazaiti anali akupha kwambiri padziko, akumawononga miyoyo ya anthu 16.4 miliyoni chaka chilichonse. Nzachisoni kuti anthu miyandamiyanda akukhala m’mikhalidwe imene imalola kubuka ndi kuwanda kwa tizilombo takupha ta matenda. Talingalirani za mkhalidwe womvetsa chisoni umene ulipo lerolino. Anthu oposa biliyoni imodzi ndi amphaŵi adzaoneni. Theka la chiŵerengero cha anthu padziko alibe njira yotsimikizirika yopezera machiritso ndi mankhwala ofunika. M’makwalala a mizinda yaikulu yodzala anthu mumayendayenda ana onyanyalidwa mamiliyoni ambiri, amene ochuluka amadzibaya ndi jekeseni za anamgoneka ndi kuchita uhule. Mamiliyoni ambiri a othaŵa kwawo amavutika m’misasa yauve mmene muli kolera, kamwazi, ndi matenda ena.

Pankhondo ya munthu ndi tizilombo ta matenda, mikhalidwe yayanja kwambiri tizilombo ta matenda.

[Mawu a M’munsi]

[Mawu Otsindika patsamba 24]

“M’zipatala mokha, mumabuka matenda oyambukira amabakiteriya pafupifupi miliyoni imodzi tsiku lililonse padziko lonse, ndipo ochuluka ake samva mankhwala.” World Health Organization

[Bokosi patsamba 25]

Pamene Tizilombo ta Matenda Tibwezera

Kachilombo ka matenda kotchedwa bakiteriya “kamalemera galamu 0.00000000001. Namgumi wabluu amalemera pafupifupi magalamu 100,000,000. Komabe bakiteriya ingaphe namgumi.”—Bernard Dixon, 1994.

Mitundu ina ya mabakiteriya owopedwa koposa opezeka m’zipatala ndiyo Staphylococcus aureus. Mitundu imeneyi imasautsa odwala ndi ofooka, ikumachititsa matenda akupha a mwazi, chibayo, ndi toxic shock. Malinga ndi ziŵerengero zina zotengedwa, staph imapha anthu pafupifupi 60,000 ku United States chaka chilichonse—kuposa aja amene amafa pangozi za galimoto. M’kupita kwa zaka, mitundu imeneyi ya mabakiteriya yakhala yosamva mankhwala kwambiri kwakuti pofika mu 1988 panali mtundu umodzi wokha wa mankhwala owagonjetsa, mankhwalawo ndi vancomycin. Komabe, posapita nthaŵi, panayamba kumveka mbiri ya mitundu yosamva vancomycin padziko lonse.

Komabe, ngakhale pamene mankhwala akuchita ntchito yake, pamabuka mavuto ena. Chapakati pa 1993, Joan Ray anapita kuchipatala ku United States ku opaleshoni yamasiku onse. Anayembekezera kupita kunyumba patangopita masiku oŵerengeka. M’malo mwake, anakhala m’chipatalamo masiku 322, makamaka chifukwa cha matenda amene anadwala pambuyo pa opaleshoni. Madokotala analimbana ndi matendawo mwa kumpatsa mankhwala ochuluka, kuphatikizapo vancomycin, koma tizilombo ta matenda tinabwezera. Joan akuti: “Ndinalephera kugwiritsira ntchito manja anga. Ndinalephera kugwiritsira ntchito miyendo yanga. . . . Ndinalephera ngakhale kutenga buku kuti ndiŵerenge.”

Madokotala analimbikira kuyesa kupeza chifukwa chimene Joan anali wodwalabe atampatsa mankhwala miyezi yambiri. Kupima kwa m’laboletale kunasonyeza kuti kuwonjezera pa nthenda ya staph, Joan anali ndi bakiteriya ya mtundu wina m’thupi—enterococcus yosamva vancomycin. Malinga ndi dzinalo, bakiteriya imeneyi sinakhudzidwe ndi vancomycin; ndipo inaoneka ngati yosamva mankhwala ena onse.

Ndiyeno madokotala anatulukira zimene zinawachititsa kakasi. Mabakiteriyawo sanali osamva chabe mankhwala amene anayenera kuwapha koma, mosiyana ndi zimene anayembekezera, iwo anali kugwiritsiradi ntchito vancomycin kuti akhale ndi moyo! Dokotala wa Joan, katswiri pa matenda oyambukira, anati: “[Mabakiteriyawo] amafuna vancomycin imeneyo kuti aswane, ndipo ngati saipeza sakula. Chotero, m’lingaliro lina, akugwiritsira ntchito vancomycin monga chakudya.”

Pamene madokotala anasiya kupatsa Joan vancomycin, mabakiteriya anafa, ndipo Joan anapeza bwino.

[Chithunzi patsamba 26]

Tizilombo ta matenda timachuluka pamene odwala sakugwiritsira ntchito bwino mankhwala

[Chithunzi patsamba 27]

Kuika mwazi kumawanditsa tizilombo ta matenda akupha