Ɔkwan Foforo a Wɔfa so Ko Nsamanwaw

NSAMANWAW (TB) yɛ nsanyare a akum nnipa akyɛ sen biara, na ɛda so ara yɛ yare a ɛyɛ hu araa ma Wiase Nyinaa Akwahosan Ahyehyɛde (WHO) de toto topae a ɛregye nna apae ho. WHO amanneɛbɔ bi a ɛfa TB ho bɔ kɔkɔ sɛ: “Nneɛma gye ntɛmpɛ paa ma yɛn.” Sɛ onipa anhwɛ anni ɔhaw yi ho dwuma a, daakye ɔyare bi a nnuru ntumi no a “nkurɔfo benya no mframa mu na enni sabea te sɛ AIDS pɛpɛɛpɛ” bɛba. WHO ka sɛ bere asõ sɛ yɛde yɛn ani to fam hu sɛnea TB redi awu no. “Obiara a ɔhome fi Wall Street kosi Great Wall . . . , no wɔ asiane mu.”

Ɛyɛ asɛm a wɔaka agugu mu anaa? Dabida. Wo de susuw sɛnea anka nnipa ani bɛbere afa wɔ wiase, sɛ ɔyare bi a ebetumi atɔre nnipa a wɔn dodow te sɛ nnipa a wɔwɔ Canada nyinaa ase wɔ mfe du mu yi ne ti a! Ɛwom, eyi te sɛ anansesɛm de, nanso ɛyɛ asiane a ɛwɔ hɔ paa ara. Wɔ wiase nyinaa no, TB kunkum nnipa pii sen AIDS, atiridiinini, ne nyarewa afoforo pii a wɔaka abom: nnipa 8,000 da biara. Seesei nnipa bɛyɛ ɔpepem 20 na TB ayɛ wɔn denneennen, na ebetumi akunkum nnipa ɔpepem 30 wɔ mfe du a edi hɔ no mu—nnipa dodow a wɔsen Canada nnipa.—Hwɛ adaka mu nsɛm “TB Ntini a Agye Wɔ Wiase Nyinaa” a ɛwɔ kratafa 24 no.

Anidaso a Ɛwɔ Hɔ

Nanso, anidaso wɔ hɔ nnɛ. Nhwehwɛmufo asɔ nneɛma ahwɛ mfe du ma wɔabenya ɔkwan a wobetumi afa so adi TB so nkonim na ankunkum nnipa basabasa. Oduruyɛfo Hiroshi Nakajima a bere bi na ɔyɛ WHO kwankyerɛfo panyin, frɛɛ ɔkwan foforo yi “ayaresa mu mpɔntu a ɛsen biara wɔ mfe du yi mu no biako.” Na Ɔbenfo Arata Kochi a ɔyɛ WHO Wiase Nyinaa TB Nhyehyɛe no kwankyerɛfo no ka sɛ ama wɔanya hokwan nea edi kan a wɔde “betu TB nsanyare no ase.” Dɛn na ɛde anigyesɛm yi nyinaa aba? Ɔkwan bi a wɔfrɛ no DOTS.

DOTS yɛ din tiawa a wɔde gyina hɔ ma directly observed treatment, short-course (ayaresa a wɔde ani si obi so tee hwɛ ma no aduru bere tiaa mu). Ɛyɛ ɔkwan a wɔfa so sa wɔn a wɔbɔ TB no yare wɔ asram asia kosi awotwe mu a wɔnna ayaresabea da koro mpo. DOTS gyina nneɛma anum so na atumi ayɛ yiye. WHO ka sɛ, sɛ nneɛma anum no mu biara nnim a, “yɛhwere” hokwan a yebetumi de asa wɔn a wɔbɔ TB yare no. Dɛn ne saa nneɛma yi?

● 1. Ani a Wɔde Si Obi So: TB a ɛyɛ hu paa ne nea ɛhyehyɛ nkurɔfo ho a wonhui no. Enti WHO si so dua sɛ nea edi kan koraa no, nea ɛsɛ sɛ ayaresafo de wɔn ani si so ne sɛ wɔbɛhwehwɛ nnipa a wɔbɔ TB a ebetumi asan afoforo wɔ wɔn mpɔtam hɔ no.

● 2. Ɔhwɛ: Ade a ɛto so abien wɔ DOTS mu no de ayaresa no ho asodi to ayaresafo so—ɛnyɛ ɔyarefo no. Ayaresafo anaa nnipa a wɔatete wɔn a wɔatu wɔn ho asi hɔ te sɛ wɔn a wɔte sotɔɔ ano, akyerɛkyerɛfo, anaa nnipa a bere bi na wɔbɔ TB no hwɛ hu sɛ ayarefo no anom TB aduru biara a wɔakyerɛw ama wɔn. “Wɔn a wɔhwɛ ayarefo” no ho hia paa na nneɛma atumi akɔ yiye efisɛ ade titiriw nti a TB da so wɔ hɔ de besi nnɛ ne sɛ ayarefo no gyae nnuru no fa ntɛm dodo. (Hwɛ adaka mu nsɛm “Dɛn Nti na Ɛrekɔ Soro—Bio?” a ɛwɔ kratafa 24 no.) Bere a wɔafa aduru no adapɛn kakraa bi no, wɔte nka sɛ wɔn ho ye a, na wɔagyae fa. Nanso, ɛsɛ sɛ wɔkɔ so yɛ aduru no asram asia kosi awotwe ansa na atumi atu TB ɔyare mmoawa no nyinaa ase afi nipadua no mu.

● 3. Aduruyɛ: Wɔ saa asram asia kosi awotwe yi mu no, ayaresa adwumayɛfo no hwɛ sɛnea aduruyɛ no nkɔso te, na wɔyɛ ɔyarefo no nkɔso ho kyerɛwtohɔ. Saa kwan no so no, wɔhwɛ hu sɛ ayarefo no ho atɔ wɔn koraa a wontumi mfa yare no nsan afoforo.

● 4. Bere Tiaa Mu: DOTS ayaresa no mu ade a ɛto so anan ne TB nnuru a ɛfata a wɔkeka bom de dodow a ɛsɛ, a wɔfrɛ no bere tiaa mu aduruyɛ a ano yɛ den, yɛ adwuma bere tenten a ɛsɛ. Saa nnuru a wɔkeka bom no tu TB ɔyare mmoawa no ase korakora.a Bere nyinaa ɛsɛ sɛ nnuru no bi wɔ hɔ sɛnea ɛbɛyɛ a aduruyɛ no bɛtoam.

● 5. !: WHO de nteɛm sɛnkyerɛnne si DOTS! akyi de gyina hɔ ma DOTS ayaresa no mu ade a ɛto so anum no. Ɛno ne ɛka a ɛwom ne ɛho nhyehyɛe pa a wɔbɛyɛ. WHO hyɛ ayaresafo nkuran sɛ wonnye sika fam mmoa a ɛsɛ mfi aban mpanyimfo ne ahyehyɛde ahorow a ɛnhyɛ aban nsa hɔ, na wɔmfa TB nka nyarewa a wogu so reyɛ ho adwuma wɔ ɔman no mu no ho.

Sika fam no, akunini a biribi wɔ wɔn nsam no ani gye DOTS ayaresa no ho. Wiase Sikakorabea no aka DOTS ho asɛm sɛ “akwan a ɛka nnim koraa a wɔfa so ko . . . nyarewa no mu biako.” WHO bu akontaa sɛ, sɛ wɔfa saa ayaresa kwan no so wɔ aman a ahia wɔn no mu a, ɛka a wɔbɔ wɔ ɔyarefo biara ho no bɛyɛ $100. “Mpɛn pii no ɛka no nnu (U.S.) sɛnt 10 wɔ onipa biako biara ho wɔ aman a afei na wɔrenya nkɔanim no mu, na ne tua nyɛ den wɔ mmeae a ahia wɔn paa no mpo.” Nanso ɛka a ennim pii no nkyerɛ sɛ ɛnsow aba pii.

Edi Mũ Dɛn?

WHO ananmusifo bɔɔ amanneɛ wɔ March 1997 mu sɛ DOTS a wɔde adi dwuma kakra no “ama wiase nyinaa TB nsanyare no akɔ fam sɛnea ebi mmaa da wɔ mfe pii mu.” “Faako a wɔde DOTS dii dwuma no, anka nnipa a wonyaa ayaresa no dodow reyɛ abu abɔ ho.” Wɔasɔ DOTS ahwɛ wɔ mmeae a na TB abu so wɔ hɔ ma ɛreyɛ adwuma dedaw. Susuw aba a asow a WHO bɔɔ ho amanneɛ no mu kakraa bi ho hwɛ.

Wɔ India no, “wɔasɔ DOTS ahwɛ wɔ mmeae bi a sɛ wɔka hɔ nnipa bom a ɛbɛboro ɔpepem 12. . . . Seesei sɛ nnipa 5 nya TB a, wɔsa 4 yare.” Bere a wɔsɔ hwɛe wɔ Bangladesh wɔ nnipa ɔpepem biako ho no, “nnipa [a wɔbɔ TB no] ɔha biara mu 87 nyaa ayaresa.” Wɔ Indonesia supɔw bi a wɔsɔɔ DOTS hwɛe wɔ so no, “nnipa 10 a wɔwɔ yare no bi a ebetumi asan biara mu 9 renya ayaresa.” Bere a wɔsɔ hwɛe wɔ China no, “ɛkɔɔ yiye paa,” efisɛ nnipa ɔha biara mu 94 na wonyaa ayaresa. Wɔ South Africa kuropɔn bi mu no, “nnipa [a wɔbɔ TB] no bɛboro ɔha biara mu nkyem 80 na wonya ayaresa.” Nnansa yi ara, wofii DOTS ase wɔ New York City nso, na ɛsow aba paa.

Ɔbenfo Kochi ka sɛ nea ɛdaa adi bere a wɔsɔ hwɛe wɔ aman pii mu no kyerɛ sɛ “wobetumi de adi dwuma wɔ baabiara, na ebetumi ama nnipa a ɛyɛ wɔn no ɔha biara mu nkyem 85 ne akyiri ho atɔ wɔn.”

Amamfoɔ Ntu Nguu So—Nanso Ɛrenya Nkɔanim

Esiane sɛ DOTS yɛ ɔkwan a wɔfa so tu nsanyare a ekum nnipa sen biara no biako ase nti, obi bɛhwɛ kwan sɛ amamfoɔ betu agu so. WHO panyin bi ka sɛ: “Nanso nea ɛyɛ nwonwa ne sɛ aman kakraa bi pɛ na wɔde ɔkwan a WHO asɔ ahwɛ a ɛka pii nnim a wɔfa so ko TB no redi dwuma.” Nokwarem no, wɔ 1996 mfiase no, na aman 34 pɛ na wɔde adi dwuma wɔ wɔn man no mu baabiara.

Ne nyinaa akyi no, nkɔanim aba. Ansa na 1993 a WHO de too gua sɛ TB ho asɛm abɛyɛ biribi a ɛsɛ sɛ wodi ho dwuma ntɛm so reba no, na nnipa a wɔbɔ TB no mu 50 biara mu 1 pɛ na onya DOTS so mfaso. Ɛnnɛ dodow no adu nnipa 10 biara mu 1. Wɔbɔ amanneɛ sɛ wɔ 1998 mu no, aman bɛyɛ 96 na na wɔde DOTS di dwuma. Sɛ aman pii de DOTS yɛ adwuma a, anka nnipa dodow a wonya TB afe biara no ‘so bɛtew aba fã wɔ mfe du pɛ mu.’ Ɔbenfo Kochi ka sɛ: “Yɛanya ayaresa nhyehyɛe a yɛasɔ ahwɛ a nea ehia ara ne sɛ wɔde bedi dwuma wɔ mmeae pii.”

Esiane sɛ nnipa wɔ nimdeɛ ne nneɛma a wobetumi de atu TB ase nti, nea aka ara ne ‘nnipa a wɔbɛhwɛ ama wɔde saa nnuru yi adi dwuma wɔ wiase nyinaa.’ Ɛnyɛ nwonwa sɛ WHO bisa wɔ nhoma bi a wɔkyerɛw maa wiase nnuruyɛfo ne ayaresafo afoforo mu sɛ: “Dɛn na yɛn nyinaa retwɛn?”

[Ase hɔ asɛm]

[Asɛm a wɔafa aka wɔ kratafa 23]

Anibu biara, obi nya nsamanwaw wɔ asase so

[Asɛm a wɔafa aka wɔ kratafa 23]

‘Nnuru a egye nkwa gugu baabi resɛe kwa bere a nnipa ɔpepem pii wuwu.’Ɔbenfo Arata Kochi

[Asɛm a wɔafa aka wɔ kratafa 25]

“DOTS  ayaresa no bɛyɛ ayaresa mu nkɔanim a ɛho hia sen biara wɔ mfe du yi mu.” WHO krataa

[Kratafa 24 adaka]

Dɛn Nti na Ɛrekɔ Soro—BIO?

Bɛboro mfe aduanan a atwam ni na wonyaa nsamanwaw (TB) ano aduru. Efi saa bere no, nnipa bɛboro ɔpepem 120 na TB akunkum wɔn, na ebekunkum nnipa bɛyɛ ɔpepepem 3 bio afe yi. Dɛn nti na TB da so kunkum nnipa pii saa, bere a ano aduru wɔ hɔ? Nneɛma titiriw abiɛsa ntia: anibiannaso, HIV/AIDS, ne TB a nnuru ntumi no.

Anibiannaso. Wiase no de n’ani asi nsanyare te sɛ AIDS ne Ebola so. Nanso, wɔ 1995 mu no, sɛ Ebola kum nnipa biako biara a, na TB kunkum nnipa 12,000. Nokwasɛm ne sɛ, TB abu so wɔ aman a wonnyaa nkɔso pii mu araa ma afei de wobu yare yi sɛ biribi a wontumi nyɛ ho hwee. Bere koro no ara mu no, wɔ aman a wodi yiye mu no, wɔama TB kwan ma ahyeta bere a nnuru a ɛyɛ nnam gugu hɔ resɛe kwa. Saa wiase nyinaa anibiannaso yi yɛ mfomso a anibere wom. Bere a TB ho adwennwene a wiase no wɔ rebrɛ ase no, na mmoawa a wɔde TB ba no nso renya ahoɔden. Ɛnnɛ ɔyare yi ka nnipa pii wɔ aman pii so sen bere biara a abɛsen kɔ wɔ adesamma abakɔsɛm mu.

HIV⁄AIDS. TB ne HIV ne AIDS na ɛnam. Sɛ nkurɔfo nya HIV—a ɛbrɛ nnipadua no nkwaadɔm a ɛko tia nyarewa no ase—a, wobetumi anya TB mpɛn 30. Enti ɛnyɛ nwonwa sɛ mprempren HIV nsanyare no ama nnipa dodow a wɔyare TB no nso dodow akɔ soro! Wobu akontaa sɛ TB kunkum nnipa a na wɔwɔ HIV no 266,000 wɔ 1997 mu. Peter Piot a ɔyɛ Kwasafo Nhyehyɛe a Amanaman Nkabom no Ayɛ Ama HIV/AIDS no kwankyerɛfo no ka sɛ: “Eyinom yɛ mmarima ne mmea a, wɔannya TB aduru a ne bo nyɛ den koraa a na wohia na wɔde ako wɔn nsamanwaw no so mfaso.”

TB a Nnuru Ntumi No. Ɛyɛ nyansahu mu ayɛsɛm mu na wɔka sɛ “mmoawa bi a nnuru ntumi wɔn” wɔ hɔ, nanso wɔ TB fam de, asɛm no reyɛ abɛyɛ nokware. Ebetumi aba sɛ nnipa bɛboro ɔpepem 50 anya TB a nnuru ntumi no (MDR) yi bi dedaw. Ayarefo a wogyae wɔn nnuru nom wɔ adapɛn kakraa bi akyi esiane sɛ wɔte nka sɛ wɔn ho ye, esiane sɛ wɔn nnuru no asa, anaa esiane sɛ yare no yɛ fɛre nti no ntumi ntɔre mmoawa a wɔma TB no nyinaa ase mfi wɔn nipaduam. Sɛ nhwɛso no, wɔ Asia man bi mu no, nnipa 3 biara a wɔbɔ TB no mu 2 gyae wɔn aduru no yɛ ntɛm. Sɛ wɔsan yare bio a, yare no bɛyɛ den sɛ wɔbɛsa efisɛ ɔyare mmoawa a aka no ne aduru a wɔde sa TB biara di asi na wodi so nkonim. Ne saa nti, ayarefo no ba benya TB a wɔko a ɛnko—wɔne obiara a wɔde yare yi san no. Na sɛ saa MDR mmoawa a wɔn ho yɛ hu yi keka wɔn ho a, asɛm a ɛyɛ hu a yebisa ne sɛ, So onipa betumi adi wɔn so?

[Kratafa 24 adaka]

TB Ntini a Agye Wɔ Wiase Nyinaa

Nsamanwaw (TB) nsanyare no kɔ so trɛw, ɛho ka kɔ soro, na edi awu pii afe biara. Amanneɛbɔ horow a Wiase Nyinaa Akwahosan Ahyehyɛde no nsa aka kyerɛ nea ama owudifo a wonhu no yi retrɛw no. Ɛho nhwɛso horow bi ni: “Pakistan kɔ so di nkogu wɔ asi a wɔne nsamanwaw di no mu.” “Nsamanwaw asan ayi ne ti wɔ Thailand a ɛretɔ werɛ.” “Ɛnnɛ, nsamanwaw ka nneɛma a ɛde nyarewa ba na ekunkum nnipa paa wɔ Brazil no ho.” “Nsamanwaw akɔ so agye ntini paa wɔ Mexicofo mu.” Wɔ Russia no “nnipa dodow a TB yɛ wɔn no rekɔ soro ntɛmntɛm.” Wɔ Ethiopia no “nsamanwaw reyɛ nkurɔfo wɔ ɔman no mu nyinaa.” “South Africa ka mmeae a nnipa dodow a wɔbɔ TB no dɔɔso paa wɔ wiase nyinaa no ho.”

Ɛwom sɛ nnipa 100 biara a wɔbɔ TB no mu 95 wɔ aman a wodi hia paa wɔ wiase nyinaa no mu de, nanso TB regye ntini paa wɔ aman a wodi yiye nso so. Nnipa a wɔbɔ amanneɛ sɛ wɔbɔ TB wɔ United States no dodow kɔɔ soro prɛko pɛ wɔ 1990 mfe no mfiase. U.S. sɛnkyerɛwfo Valery Gartseff ka sɛ TB “aba bio rebɛhaw Amerikafo.” Saa ara nso na Ɔbenfo Jaap Broekmans, a ɔyɛ Netherlands Adehyeman Kuw a Ɛhwɛ TB Ho Nsɛm So no kwankyerɛfo kae nnansa yi ara sɛ TB nsanyare “no mu afi ase reyɛ den wɔ Europa Apuei fam ne Europa Atɔe fam mmeae bi nso.” Ɛnyɛ nwonwa sɛ, nsɛmma nhoma Science, a wotintimii wɔ August 22, 1997, ka sɛ “nsamanwaw da so ara yɛ yare a ɛyɛ hu paa.”

[Kratafa 26 adaka]

Wɔahu Nea Ɛde TB Ba

Nnansa yi ara nhwehwɛmufo ayɛ nhwehwɛmu ahu aboawa a ɔde nsamanwaw (TB) ba no awosu nyinaa. Oduruyɛfo Douglas Young a ɔwɔ Ntoaso Sukuu a Wosua Akwahosan ho ade wɔ London no ka sɛ, saa nkɔanim yi yɛ “ade foforo koraa wɔ asi a yɛne adesamma atamfo a wotumi di nkonim sen biara no biako redi no mu.” Wiase Nyinaa Akwahosan Ahyehyɛde no bɔ amanneɛ sɛ saa ade foforo a wɔahu yi “betumi aboa pii wɔ nhwehwɛmu a daakye wɔbɛyɛ wɔ TB nnuru mu no mu.”—The TB Treatment Observer, September 15, 1998.

[Kratafa 25 mfonini ahorow]

Saa nnuru a wɔaka abom yi betumi akunkum TB mmoawa no

[Nsɛm Fibea]

Photo supplied by WHO, Geneva

Photo: WHO/Thierry Falise

[Kratafa 26 mfonini ahorow]

Egye $100 na wɔde asa obi yare

[Nsɛm Fibea]

Photo: WHO/Thierry Falise

Photo supplied by WHO, Geneva

[Mfonini Ahorow Fibea wɔ kratafa 23]

Photo: WHO/Thierry Falise

Photo supplied by WHO, Geneva

Photo: WHO/Thierry Falise