Ivyashobotse n’ivyananiranye mu vy’ukurwanya indwara

KU WA 5 Myandagaro 1942, Muganga Alexander Fleming yarabonye yuko umwe mu barwayi biwe akaba n’umugenzi wiwe yari ageze habi. Uwo mugabo w’imyaka 52 yari yafashwe na ya ndwara ya mugiga ifatira mu ruti rw’umugongo, kandi naho Fleming yakoze uko ashoboye kwose, umugenzi wiwe yararavye.

Imyaka 15 imbere y’aho, Fleming yagiye abona agwa ku bintu bihambaye bihingurwa n’ifira risa n’ubururu buvanze n’akabara k’urwatsi rutoto. Ivyo bintu yavyise penisiline. Yarabonye ko iyo penisiline yari ifise ububasha bwo kwica imikorobi yitwa amabagiteri; mugabo ntiyashoboye kubikuramwo penisiline itarimwo imvange, kandi yayigerageje gusa bwa muti wica imigera. Ariko rero, mu 1938 Howard Florey n’abo bari bafatanije kugira ubushakashatsi kuri Kaminuza y’i Oxford barihatiye gukora amapenisiline ahagije kugira bayageragereze ku bantu. Fleming yaraterefonye Florey, uno akaba yamwemereye kumurungikira penisiline zose yari afise. Ako kari ko karyo ka nyuma Fleming yari asigaranye ko kurokora umugenzi wiwe.

Gutera penisiline mu mitsi ntivyari bihagije, ari co gituma Fleming yaciye atera uwo muti nya mugenzi wiwe mu ruti rw’umugongo. Iyo penisiline yarishe imikorobi; maze mu kiringo c’indwi irenga gatoyi gusa, umurwayi wa Fleming yari asohotse ibitaro yakize neza. Ikiringo c’ugukoresha imiti bita antibiyotike, ikaba ari imiti yica imikorobi mu mubiri cari gitanguye, kandi intambwe nshasha ihambaye yari ishitsweko mu kigoro umuntu yariko aragira ko kurwanya indwara.

Ikiringo co gukoresha antibiyotike

Igihe antibiyotike zaboneka ari bwo bwa mbere, wamengo ni imiti y’igitangaza. Indwara zandukira ziterwa n’amabagiteri, iziterwa n’udukoko dutoduto cane twitwa ibizinu canke iziterwa n’utundi dukoko tutabonwa n’amaso zitari bwigere zishobora kuvurwa, ico gihe zarashobora kuvurwa zigakira. Bivuye kuri iyo miti mishasha, igitigiri c’abǎhitanwa na mugiga, umusonga be n’inyonko yitwa fièvre jaune caragabanutse bimwe bitangaje. Indwara umuntu yashobora kwandurira mu bitaro zahora zihitana abarwayi, zarashoboye kuvurwa mu misi mikeyi.

Kuva mu gihe ca Fleming, abashakashatsi barakoze n’izindi antibiyotike zitari nke, kandi ivy’ukurondera ubundi bwoko bushasha bwa antibiyotike ubu birabandanya. Muri iyi myaka 60 iheze, antibiyotike zarabaye ikirwanisho gihambaye mu vy’ukurwanya indwara. Iyo George Washington ubu aba akiriho, nta nkeka ko abaganga bomuvuye ya ndwara yiwe y’ibigoga bakoresheje antibiyotike, kandi mu ndwi imwe canke irenga gatoyi, yobaye kumbure yakize. Hafi nka twese, antibiyotike zishobora kuba zaratuvuye indwara zitandukanye twanduye. Ariko rero, vyaribonekeje ko antibiyotike zifise ingaruka mbi zimwezimwe.

Antibiyotike ntizishobora kuvura indwara ziterwa n’imigera, nka SIDA canke inyonko. Vyongeye, hari abantu bamwebamwe imibiri yabo yankana na antibiyotike zimwezimwe. N’ikindi kandi, za antibiyotike zifise ubushobozi bwo kwica utunyabuzima twinshi tubangamye, zirashobora kwica utunyabuzima dutoduto cane tutaboneka dufise akamaro mu mubiri wacu. Ariko kumbure, ingorane ikomeye ya antibiyotike, ni ukuzikoresha mu buryo burenze urugero canke gukoresha izidakwiye.

Gukoresha izidakwiye ni igihe abarwayi baba batamaze antibiyotike muganga yabandikiye, vyaba bitumwe n’uko bumvise batoye ka mitende canke bitumwe n’uko gufata iyo miti bizotwara igihe kirekire. Ico bivamwo ni uko nya antibiyotike bishika ntishobore kwica amabagiteri yose aba yarashwaye mu mubiri, ivyo rero bigaca bituma amabagiteri yihinduye imero kandi arinda imiti adapfa, agaca rero agwira. Ivyo vyama vyashitse ku bijanye n’umuti uvura igituntu.

Abaganga n’aborozi barāgīwe n’ikosa ry’ukurenza urugero mu vy’ugukoresha iyo miti mishasha. Ca gitabu Umuntu be n’imikorobi gisigura giti: “Akenshi abantu barandikiwe antibiyotike bitari ngombwa muri Leta Zunze Ubumwe za Amerika, kandi zirapfa gukoreshwa no mu bindi bihugu bitari bike. Zarahawe ibitungwa ari nyinshi cane, atari ku bwo kubivura indwara, ariko ku bwo gutuma bikura ningoga; iyo ikaba ari yo mvo nyamukuru yatumye imikorobi irushiriza kurinda imiti”. Nk’uko ico gitabu kibivuga, ingaruka bivamwo ni uko “dushobora kuba turiko turatuma izo antibiyotike nshasha zihera”.

Mugabo, turetse ukwo guhagarika umutima ku bijanye n’imikorobi irinda antibiyotike, igice kigira kabiri c’ikinjana ca 20 cabaye igihe c’intsinzi mu vy’ubuvuzi. Abashakashatsi mu vy’ubuvuzi basa n’abashoboye gutora imiti yo kurwanya hafi indwara iyo ari yo yose. Vyongeye, incanco na zo nyene zaratanze icizigiro c’uko indwara zishobora gukingwa.

Intsinzi siyansi y’ivy’ubuvuzi yashitseko

“Ugukingira abantu indwara ni co kintu gihambaye kuruta ibindi vyose cagiye cashikwako muri kahise kose mu bijanye n’ukubungabunga amagara y’abantu”. Ivyo vyavuzwe na Raporo y’amagara y’abantu mw’isi yose yo mu 1999. Ubuzima bw’abantu amamiliyoni buramaze kurokorwa kubera amasekeza yo gucandaga abantu ikivunga yagizwe mw’isi yose. Porogarama yagizwe y’ugukingira abantu indwara yarashoboye kurandurana n’imizi indwara y’ibihara, ikaba yari indwara yica yahitanye abantu benshi cane baruta abahitanywe n’intambara zose zo mu kinjana ca 20 tubafatiye hamwe. Vyongeye, amasekeza nk’ayo nyene asa n’ayaranduranye n’imizi ubukangwe (Raba uruzitiro ruvuga ngo “Intsinzi ku ndwara y’ibihara n’iy’ubukangwe”.). Abana benshi ubu baracandagwa kugira bakingirwe indwara zikunda kubangamira amagara.

Izindi ndwara zaragabanuwe hakoreshejwe uburyo busanzwe. Indwara ziterwa n’amazi mabi nka kolera ni gake usanga zitera ahantu bitwararika ivy’isuku kandi hari amazi meza. Mu bihugu vyinshi, kubera ko birushiriza kworoha gushikira abaganga be n’ibitaro kugira ngo umuntu yivuze, ivyo bituma indwara nyinshi zishobora gutorwa hanyuma zikavurwa zitarahitana abarwayi. Gufungura neza be n’ukubaho neza, tudasize inyuma n’ivy’ugukomeza amategeko ajanye n’ugutegura neza imfungurwa be n’ukuzibika neza, na vyo nyene vyaragize ico biterera kugira ngo amagara y’abantu agende amera neza.

Abahinga bamaze gutora ibitera indwara zandukira, inzego za Leta zitaho amagara y’abantu zarashoboye gutera intambwe ngirakimazi kugira ngo zihagarike ikiza kanaka coye kubandanya gukwiragira. Rimbura akarorero kamwe gusa. Ya ndwara yitwa peste bubonique yatera i San Francisco mu 1907, yahitanye abantu bakeyi kubera yuko ico gisagara caciye gitangura isekeza ryo kuyogeza imbeba kubera ko imbaragasa zo kuri izo mbega ari zo zatera iyo ndwara. Yamara rero, guhera mu 1896, iyo ndwara nyene yari yahitanye abantu imiliyoni cumi mu Buhindi mu myaka 12 kubera ko ikintu nyamukuru cayitera kitari bwamenyekane.

Ivyananiranye mu vy’ukurwanya indwara

Biribonekeza ko hari intsinzi zikomeye zashitsweko. Mugabo intsinzi zimwezimwe zashitsweko mu bijanye n’ukubungabunga amagara y’abantu, zabaye gusa mu bihugu vyo kw’isi bitunze kurusha ibindi. Indwara zishobora kuvurwa ziracahitana abantu amamiliyoni bivuye gusa ku vy’uko ata mahera ahagije ahari. Mu bihugu bikiri mu nzira y’amajambere, abantu benshi baracabuze isuku rikwiye, uburyo bwo kuvurwa bubereye be n’amazi meza. Kwironsa ivyo bintu vya nkenerwa vyararushirije kugora kubera abantu bava mu gihugu hagati bakimukira mu bisagara bininibinini mu bihugu bikiri mu nzira y’amajambere. Ivyo bituma ababa mu bihugu bikenye bashikirwa n’ico Ishirahamwe mpuzamakungu ryitaho amagara y’abantu (OMS) ryita “ubusumbasumbane mu vy’ugusangira umuzigo w’indwara”.

Kutabona kure kubera ubwikunzi ni co kintu nyamukuru gituma haba ubwo busumbasumbane. Ca gitabu Umuntu be n’imikorobi kivuga giti: “Zimwe mu ndwara zandukira kandi zica, zisa n’iziri kure [y’ibihugu biteye imbere]. Zimwezimwe muri izo zishika gusa canke zirangwa ahanini mu ntara z’ubushuhe no hepfo yazo”. Kubera yuko ibihugu bitunze canke amakompanyi akora imiti ata nyungu vyoca bihakura, biragonanwa gutanga amahera yo gukoresha mu kuvura izo ndwara.

Inyifato y’urwangara abantu bagira, na yo nyene iri mu bituma indwara zikwiragira. Nta karorero keza kuruta kerekana ivyo koza karuta ivya wa mugera wa SIDA, uwuva ku muntu uja ku wundi biciye ku bintu vy’amazimazi biva mu mubiri w’umuntu. Mu myaka mikeyi gusa, ico kiza carakwiragiye kw’isi yose (Raba uruzitiro ruvuga ngo “SIDA, ikiza co mu gihe cacu”.). Umuhinga mu vy’indwara z’ibiza yitwa Joe McCormick yemeza ati: “Ibiremwa-bantu ni bo ubwabo bawukwiragije. Kandi ukwo si ugushikuza, ni ko biri koko”.

Abantu borohereza gute umugera wa SIDA batabizi? Igitabu Ikiza cimirije (mu congereza) kivuga ko bitumwa n’ibi bintu bikurikira: Amahinduka yo mu kibano, canecane umugenzo uhari w’uko umuntu agira abo bahuza ibitsina benshi, yaratumye indwara zandukira biciye mu bihimba vy’irondoka zigwirirana ningoga na ningoga, bica birorohereza cane uwo mugera gushinga imizi vyongera bituma umuntu umwe amaze kwandura yandukiza abandi bantu benshi bitagoranye. Kuba mu bihugu bikiri mu nzira y’amajambere hakoreshwa cane inshinge zimaze kwandura canke zimaze gukora mu gutera mu mubiri ibiyayura umutwe canke mu gutera umuti umurwayi, na vyo nyene vyaragize ingaruka nk’iyo. Vyongeye, urudandaza rw’amaraso rurimwo amadolari imiliyaridi n’imiliyaridi rugirwa kw’isi yose na rwo nyene rwaratumye umugera wa SIDA uva kuri nyene gutanga amaraso ukaja kuri nyene kuyahabwa.

Nk’uko vyamaze kuvugwa, gukoresha antibiyotike mu buryo burenze urugero canke gukoresha izidakwiye vyaratumye haduka imikorobi irinda imiti. Iyo ngorane irakomeye kandi iriko irushiriza kwunyuka. Amabagiteri yitwa Staphylococcus, ayatuma ahanini ibikomere bisebura, yahora yicwa bitagoranye na antibiyotike zikomoka kuri penisiline. Mugabo, ubu izo antibiyotike usanga akenshi ata co zikimara. Ku bw’ivyo, abaganga baca bategerezwa gukoresha antibiyotike nshasha kandi zizimvye ibitaro vyo mu bihugu bikiri mu nzira y’amajambere bidashobora kuronka bivanye n’uburyo buke. Mbere na antibiyotike ziba ziherutse gusohoka birashika ntizibe zishoboye kwica imikorobi imwimwe, bigatuma indwara zandurirwa mu bitaro zirushiriza kwibonekeza kandi zikarushiriza guhitana abantu. Muganga Richard Krause yahoze ari umuyobozi w’ikigo ca Leta Zunze Ubumwe za Amerika kiraba ibintu vyankana n’umubiri w’umuntu be n’indwara zandukira, adondora adacisha ku ruhande ivyo muri kino gihe ko ari “ikiza c’imikorobi irinda imiti”.

“Ubu twoba twarorohewe?”

Muri izi ntango z’ikinjana ca 21, biribonekeza ko imbangamyi ziterwa n’indwara zitazimanganye. Ca kiza ca SIDA kikibandanya gukwiragira, imigera yadutse irinda imiti, be n’indwara kera zatema zigatongora zasubiye kwaduka, nk’igituntu na malariya, ivyo vyose birerekana ko urugamba rwo kurwanya indwara rukibandanya.

Joshua Lederberg yatsindiye ka gashimwe kitiriwe Nobel, yabajije ati: “Ubu twoba twarorohewe kuruta uko twari tworohewe mu kinjana giheze?”. Yavuze ati: “Mu mice myinshi, ibintu vyarunyutse. Twarirengagije imikorobi, tukaba rero turiko turibonera ingaruka zavyo”. Izo ngaruka zo muri kino gihe zoba zishobora kurwanywa hakoreshejwe akigoro gakomeye kagirwa na siyansi y’ivy’ubuvuzi be n’ibihugu vyose vyo kw’isi? Indwara nkurunkuru zandukira, zoba zizoteba zikaranduranwa n’imizi nka kumwe kwa ya ndwara y’ibihara? Ikiganiro cacu gisozera kiraca irya n’ino ivyo bibazo.

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Intsinzi ku ndwara y’ibihara n’iy’ubukangwe

Mu mpera z’ukwezi kwa Gitugutu 1977, Ishirahamwe mpuzamakungu ryitaho amagara y’abantu (OMS) ryaratoye umuntu wa nyumanyuma yafashwe n’indwara y’ibihara yari isanzwe izwi. Ali Maow Maalin, umutetsi wo ku bitaro yaba muri Somaliya, ntiyasinzikajwe cane n’iyo ndwara, kandi mu ndwi nkeyi yari atoye mitende. Abantu bose bakoranako na we baracandazwe.

Mu kiringo c’imyaka ibiri isa n’iyatevye kurangira, abaganga bararindiranye umushasharo. Agashimwe k’amadolari 1.000 (amafaranga y’amarundi arenga 1.000.000) karemerewe umuntu wese yosubiye kubona “uwurwaye koko ibihara” hanyuma akabivuga. Nta n’umwe yashoboye gutwara ako gashimwe, maze ku wa 8 Rusama 1980, ishirahamwe OMS rica ritangaza icese yuko “isi n’abayibamwo bose bikuyeko ingoyi z’indwara y’ibihara”. Nko mu myaka cumi imbere y’aho, indwara y’ibihara yahitana abantu nk’imiliyoni zibiri ku mwaka ku mwaka. Ari bwo bwa mbere muri kahise, indwara nkuru yandukira yarashoboye kuranduranwa n’imizia.

Indwara y’ubukangwe, ikaba ari indwara imugaza abana, yaratanze icizigiro c’uko ishobora na yo nyene kuranduranwa n’imizi. Mu 1955, uwitwa Jonas Salk yarahinguye urucanco rushobora gukinga ubukangwe, hanyuma amasekeza yo gukingira abantu indwara y’ubukangwe aratangura muri Leta Zunze Ubumwe za Amerika no mu bindi bihugu. Mu nyuma harakozwe urucanco rucishwa mu kanwa. Mu 1988, ishirahamwe OMS ryaratanguje porogarama yo kw’isi yose yo kurandurana n’imizi ubukangwe.

Muganga Gro Harlem Brundtland, akaba yari umuyobozi mukuru w’ishirahamwe OMS ico gihe, avuga ati: “Igihe twatangura kugira utwigoro two kurandurana n’imizi ubukangwe mu 1988, indwara y’ubukangwe yamugaza abana barenga 1.000 ku musi ku musi. Mu 2001, hariho abana badashika n’igihumbi bayirwara mu mwaka wose”. Ubu, ubukangwe busigaye gusa mu bihugu bidashika 10, naho hazokenerwa ayandi mahera kugira ngo afashe ivyo bihugu kurandurana n’imizi iyo ndwara.

[Akajambo k’epfo]

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Agahungu k’Akanyetiyopiya kariko karonka urucanco rw’ubukangwe rucishwa mu kanwa

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© WHO/P. Virot

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SIDA, ikiza co mu gihe cacu

SIDA yaradutse, ikaba ari ikintu gishasha gihanamiye abantu. Nk’imyaka 20 ihaciye kuva itowe, abantu barenga imiliyoni 60 baramaze kuyandura. Vyongeye, inzego za Leta zijejwe amagara y’abantu zibūra yuko ikiza ca SIDA “kikiri mu ntango z’ugukwiragira”. Igitigiri c’abandura kiriko “kiduga bwampi kuruta uko abantu bashobora kuba bahora bavyiyumvira”, kandi mu turere camaze kwiraramwo usanga kiyogeza inganda.

“Benshi cane mu bantu bafise umugera wa SIDA mw’isi yose usanga ari barya bakibasha ibikorwa”, nk’uko raporo y’Ishirahamwe mpuzamakungu ONU ibivuga. Ku bw’ivyo, abashakashatsi biyumvira yuko ibihugu bitari bike vyo mu gice ca Afirika co mu Bumanuko bizotakaza ibice biri hagati ya 10 na 20 kw’ijana vy’abantu bakibasha ibikorwa mu mwaka wa 2005. Iyo raporo ivuga kandi iti: “Incahagati y’imyaka abantu bo mu gice ca Afirika co munsi ya Sahara bizigira kubaho ubu ni 47. Iyo hataba hari SIDA, yobaye imyaka 62”.

Utwigoro twagizwe two gutora urucanco rwayo nta co twavuyemwo, kandi ibice 4 kw’ijana gusa vy’abantu imiliyoni zitandatu barwaye SIDA mu bihugu bikiri mu nzira y’amajambere ni bo baronka ibinini vyo gupfupfahaza. Ubu nta muti wa SIDA uriho, kandi abaganga bavuga yuko benshi mu bantu bamaze kwandura umugera wa SIDA amaherezo bazorwara iyo ndwara.

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Aba ni abasoda b’umubiri bitwa lymphocyte T bamaze gufatwa n’umugera wa SIDA

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Godo-Foto

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Uwukora mw’ipimiro ry’indwara ariko yihweza umugera wihinduye utoroshe kurwanya

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CDC/Anthony Sanchez