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Offline IsseGole

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CHOLERA "SHUBAN BIYOOD"
« on: February 09, 2007, 07:08:40 PM »
CHOLERA "SHUBAN BIYOOD"

Waxaa soo badanayay baryihii dambe akhbaarta ka imanaysa gobolada Hiiraan iyo shabeellada dhexe ee sheegaya in daacuun caloole uu ka dillaacay halkaasi oo dad badan ay la bukaan dad kalena ay u geeriyoodeen. Marka sidaa awgeed baa waxaan garannay inaan soo qorno mawduuc ku saabsan kolerada si ay uga faa’idaystaan bulshada soomaaliyeed ee uu ku wajahanyahay mawduucu iyo sidoo kale ardada soomaaliyeed ee caafimaadka baranaysa, kuwaasoo aan jecelnahay inay ka qayb qaataan wacyi galinta bulshada iyo ka hortagga cudurka intii ay awoodaan.

Qoraalkan waxaa laga soo tarjumay kitaabka la yiraahdo Park’s textbook of preventive and social medicine. Waa kitaab uu qoray K. Park, oo ka hadlaya cilmiga ka hortagga “preventive”, iyo caafimaadka bulshada. Waa kitaabka number 1 ee qaybtan reference ahaan loo isticmaalo, marka waxaan rajaynaynaa inaad ka heshaan.

   1.Maxay tahay Cholera ama shuban biyood?
Waa cudur ay sababto bakteeriyada ama jeermiska loo yaqaan vibrio cholera, oo sababa shuban biyood bulshada ku dhex faafa. Badanaa waxaa la dareemaa mushkilada koolerada markuu safmar dhoco, oo dad badan ay u dhintaan.
Qofka markuu qaado jeermiska, wuxuu huurinayaa dhowr saacadood illaa maalin wakhti la eg, oo markaa ka dib ay soo baxayso calaamadihii cudurka haddii la helo shuruudo dhowr ah.
Shuban biyood ba'an oo qofku illaa 40 jeer uu galayo suuliga, oo uu xigo matag, fuuq-bax, muruq xanuun iyo kaadi yaraan baa ugu muhimsan calaamadaha laga arkayo bukaanka. Haddii bukaanka markaa si dagdag ah aanan loogu celin biyihii ka lumay waxaa dhacda inuu u dhinto fuuqbax 40%.

   2.Safmarka koolerada:
Cudurkani siyaabo badan buu ku dhacaa markii laga hadlayo deegaanka uu asiibayo. Saf-mar "epidemic or outbreak" waxaa looga dan leeyahay in mar quran iyadoon digniin aanay jirin uu cudurku dillaaco isagoo abuuraya mushkilo baaxad wayn oo keenta jirro iyo geeri badan oo ku dhacda dadka deegaankaas uu ka dhacay daggan. Laba arrimood baa xaddidaya dhibaatada waynankeeda; midi waxay ku xirantahay jeermiska masuulka ka ah awooddiisa adkaysi "virulence and resistence" iyo tirada jeermiska loo baahanyahay si cudur xun u dhoco. Tan kale waa deegaanka iyo siday diyaar ugu yihiin dadka daggan deegaankaasi, sida nadaafadda iyo aqoonta ay leeyihiin. Si kastaba ha ahaatee, inkastoo aan la joojin Karin koolera hadday deegaan gasho laakin, laakin ma sababi karto dhibaato badan haddii la helo nadaafad guud iyo mid gaar ahaaneed oo fiican.
Safmarku wuxuu ku fiicanyahay in si dhakhso ah uu ku gaaro meeshiisa ugu sarraysa "peak" uuna durbo hoos u soo dhoco, sababtoo ah qayb badan oo bulshada ka mid ah baa noqonaysa waxa loo yaqaan "subclinical cases" oo jirkoodu iska difaacayaa cudurka. Sidaa awgeed cudurka koolerada waa cudur isaga iskiis iskaga dhamaada. Badanaana waxaa ka hor tagga la billaabaa mar uu gaaray meeshii ugu sarraysay.
Waxaa sidoo kale dhacda in kooleradu ay degaan iska dagto "endemic" oo ay markaa xilliyo gaar ah soo baxdo "seasonal fluctuation".

   3.Cawaamisha ka qayb qaata faafitaanka cudurka:
A) Jeermiska "agent": waxay soo saartaa sun loo yaqaan "endotoxin" oo ay ku sii dayso xiidmaha iyadoo sababaysa shuban. Cimilooyinka way u adkaysan ogtahay kooleradu laakin dhowr daqiiqo haddii la karkariyo ayaa ku filan inay dhimato. Kaydka ay ku jirto bakteeriyadu, oo ah dadka uu shubanku ku dhacay "cases" iyo dadka xambaarsan "carriers" oo aanay ka soo muuqan calaamadaha cudurka, ayaa iyagu u fududeeya inay si sahal ah ugu sii gudubto dadka kale.
B) Qofka ama bukaanka "host": dadkoo dhan oo da' kasta leh iyo jinsi kasta way ku dhici kartaa koleradu. Meelaha dad badani isugu yimaadaan sida xajka iyo ciidaha ayay aad ugu fiddaa bakteriyadani. Waxay badanaa ku dhacdaa dadka saboolka ah, kuwa nadaafadda aanan ku dadaalin iyo kuwa aqoonta yar leh. Difaaca jirka iyo caafimaadka guudna qayb libaax bay ka cayaaraan ka dhicidda kooleradu.
C) Degaanka "environment": Ceelasha, waraha, iyo biyo galeennada kala duwan waxay gudbiyaan bakteeriyada, siiba haddii saxaro ay ku dhex walaaqanto isla markaana la cabbo ama loo isticmaalo howlaha guriga. Fatahaadaha sidoo kale qayb bay ka qaataan dillaaca cudurka.

   4.Sidee loo kala qaadaa?
A) Saxarada dadka qaba cudurka haddii ay gaarto ceelasha, webiyada, harooyinka iyo laasaska waxay u gudbaysaa dadkii cabba ama isticmaala.

B) Cunnada iyo cabitaanka iyadoo raacda: gacmo aan la iska dhaqin markii la saxaroodo iyo cunnada ka hor, iyo dad qaba cudurka oo ka shaqeeya cunnada sida makhaayadaha oo kale ayaa ka mid ah siyaabaha ay ku gudubto kooleradu.

C) Xiriir toos ah: dadka la tacaamula qashinsaarka, matagga, dharka, iyo guriga dadka bukaanka ah ama dariskoodaba, haddii aysan iska ilaalin waxaa dhacda inay ka qaadaan cudurka.

   5.Calaamadaha Koolerada:
Dhibaatada ay sababayso kooleradu waxay ku xirantahay dhakhsada ama dagdagga uu qofku ku waayo biyaha jirkiisa ku jira. 90% xaaladaha kooleradu waa fududyihiin oo ma sababaan dhibaato badan, lagamana garan karo shubannada kale. Waxay ku billaabanaysaa faaruqin "evacuation" lagu samaynayo dareerihii jirka ku jiray, shuban ba'an oo uu xigo matag ayaa dhacaya. Fuuq-baxa ka dhasha arrintani "collapse" waxaa lagu gartaa qofka bukaanka indhihiisa oo god gala, sidoo kale daamankiisa iyo calooshiisa, qallayl daran, kaadi yari, neeftoo sariic noqota, iyo jirkoo is baddal uu ku dhoco. Bukaanku markaa nervous buu noqonayaa, harraad daran baa qabanaya, xanuun murqaha lugaha iyo caloosha ah ayaa qabanaya. Halkaa waxaa suura gal ah oo dhacda inuu u dhinto bukaanku fuuqbaxaasi, haddii aanan si dagdag ah loogu celin biyihii ka lumay. Haddii aanu dhimanna, wuxuu ku soo noqonayaa sidiisii hore oo wuu soo kabsanayaa "recovery".

   6.Sidee looga hor tagi karaa koolerada?
A.In la hubsado inay tahay kolera "verification of diagnosis"

B.In la ogaysiiyo dadka ay khusayso sida masuuliyiinta, WHO, iwm. "notification"

C.In la dabagalo bukaanka meelaha ay joogaan oo wakhti hore la daweeyo, isla markaana laga hor tago inay dad kale u sii gudbiyaan.

D.In la furo xarumo caafimaad oo lagu dawaynayo dadka jirran, haddii isbitaal aan la helin in iskool ama garoon laga dhigo xarun. Xaaladaha daranna in isbitaal loo wareejiyo.

E.Soo celinta biyaha ka lumay bukaanka "Rehydration therapy":
1) ORS "oral rehydration solution": Waa biyo lagu daray sonkor iyo cusbo oo la cabbayo. Waxaa ORS'ta lagu qasayaa hal liter oo biyo ah oo aanan la karkarin. Haddii la waayo ORS waxaa la isku darayaa hal liter oo biyo ah iyo sonkor "20gm" iyo cusbo "5gm" oo sidaa lagu cabbayaa. Harraadku inta uu jiro in la cabbo weeye biyahaasi iyo illaa ay ka qarsoomayso calaamadaha fuuqbuxu. Carruurta: caruurta ka yar 2 sano waxaa la siinayaa 1 qaaddo daqiiqaddiiba, kuwa intaa ka waynna waa inay cabbaan intay doonayaan. Haddii cunuggu uu matago 10 daqiiqo ka dib baa lagu billaabayaa si tartiib ah. Haddii calaamadihii fuuqbuxu qarsoomaan intii loogu tala galay buu dhamaysanayaa cunuggu.
2) Faleembada: WHO waxay u qorshaysay in haddii qofku uu ka sii daro ama ay anfici waydo ORS-tu, in laga siiyo biyaha xididka, waxaa la siinayaa Ringer's Lactate ama DTS "diarrhoeal treatment solution". Haddii labadaasba la waayo Normal Saline baa la siinayaa bukaanka, walaw aysan wax tar badan lahayn. Carruurta sanadka ka yar waxaa la siinayaa saacadda u horraysa 30ml/Kg, shanta saacadood ee xigtana 70ml/Kg. Dadka kale waa in la siiyo 30ml/Kg nuska saac ee ugu horreeya, laba saac iyo bar ku xigtana waa in la siiyo 70ml/Kg. Waa in halkii ama labadii saacba la qiimeeyaa in bukaanku uu soo roonaanayo iyo in kale, haddii uusan soo roonaanayn waa in la boobsiiyo I.V. drips-ka, haddii indhuhu bararaanna "puffiness" waa in la joojiyo faleembada.
3) Joogtaynta "maintenance therapy": markii la soxo khatarta jidha, waxaa la siinayaa bukaanka biyo badan inta uu oonku ka hayo, waxaana biya-siintaasi loo barbardhigayaa inta saxarada lagu waayo.

F. dawooyinka la siin karo bukaanka:
Antibiotics, markii mataggu dhamaado ayaa afka laga qaadanayaa. Doxycycline hal mar oo 500mg baa dadka waawayn la siinayaa. Dumarka uurka leh waxaa u fiican Furazolidone. Caruurtana waxaa u fiican Trimethoprium-Sulfomethoxazole. Tetracycline iyo Furazolidone waa la siin karaa dadkoo dhan 4 jeer maalintii ilaa 3 maalmood. Erythromycine iyo Chloramphenicole waxaa la qaadanayaa haddii la waayo dawooyinka hore oo dhan.

Dawooyinka mataga joojiya iyo kuwa shubanka joojiya iyo kuwa calool xanuunka loo isticmaalo kulligood lama siiyo bukaanka koolerada.

G. Sanitation measures; nadaafadda degaanka:
1) Biyaha: maadaama biyuhu yihiin meesha ugu muhimsan ee lagu gudbiyo cudurka, waxaa khasab ah in la helo biyo nadiif ah si fiicanna looga shaqeeyay dadkoo dhanna la gaarsiiyo. Chlorine ayaa lagama maarmaan ah in loo sahlo dadka inay helaan. Dadkaan haysanna waa inay iska karkariyaan biyaha kuwa la cabbayo iyo kuwa la isticmaalayaba.
2) Cunnada: cuntada la gadayo waa in la kontoroolo nadaafaddeeda. Dadka ka shaqeeya makhaayadahana waa in ay oofiyaan shuruudaha shaqadaasi. Nadaafadda guud ahaan sida tan guriga, suuliyada, dikhsiga; iyo tan gaar ahaaneed sida ciddiyaha iyo faradhaqa saxarada ka dib iyo cunnada ka hor: waa in aad loogu dadaalaa.
3) Saxarada: waa in qashin saarka dadka meel loogu tala gala oo laga fogeeyaa inay gaaraan biyaha iyo cuntada. Maadaama arrintani aysan ka suuroobaynin waddankeenna waxaa lagama maarmaan ah in dadka lagu wacyi galiyo sidii ay ugala fogaan lahaayeen saxarada meelaha biyaha laga cabbo.
4) Daahirin "disinfection": Bukaanka saxaradiisa, mataggiisa, dharkiisa, alaabtiisa kale, gurigiisa iyo xataa dariskiisa waa in la daahiriyaa oo maadooyin kiimiko ah lagu shubaa. Dadka ka shaqaynaya howshanna waa inay laf ahaantooda is ilaaliyaan.

H. Chemoprophylaxis: antibiotic ka hor tag ah.
Dadka ku dhow-dhow qofka cudurku ku dhacay ee wali caafimaadka qaba waa in la siiyo antibiotic ka hor tag ah. Tetracycline laba jeer maalintii illaa saddex maalmood baa la isticmaalaa. Doxycycline 500mg oo hal mar ahna aad buu u faa'ido badanyahay.

I.Tallaalka Koolerada:
Laba nooc baa jira:
a) Mid la isku durayo: laba jeer baa la isku durayaa oo 4 ilaa 6 usbuuc u dhaxayso, waa bakterio la dilay. Haddii laba mar la waayo hal mar baa la qaadanayaa iyadoo laba jibbaaran;
b) Mid afka laga qaadanayo: laba nooc buu leeyahay, mid la dilay iyo mid nool oo la daciifiyay "live attenuated". Caruurta iyo dadka caafimaadkoodu liito lama siiyo talaalkan. Laba nooc weeye kanina waxaana u dhexeeya 10 ilaa 14 bari, wuxuuna leeyahay jaanis 60% oo ka hor tag ah muddo saddex sanadood ah.

J.Wacyi galin: Health education
Arrinta ugu muhimsan – sida la ogsoonyahay – marka laga hadlayo ka hortagga cudurka shuban biyoodka waxa weeye in dadka lagu baraarujiyo dhibta uu leeyahay cudurku iyo sida sahlan ee looga hortagi karo. Waa in la dareensiiyo ahmiyadda ay leedahay ORS-ta, faa'idada ay leedahay dhakhso soo sheegidda bukaanka si loo daweeyo oo loo badbaadiyo, faa'idada ay leedahay cunno iyo biyo nadiif ah isticmaaliddooda, iyo karkarintu sahlanaanteeda iyo fa'aidadeeda, iyo gacmaha dhaqashadooda suuliga markii laga soo boxo ahmiyadda ay ku leedahay yaraynta cudurka iyo dhimashadaba. Waa in dadka siminaarro loo sameeyo oo la baraa dhibaatada ay leedahay kooleeradu iyo siday dadka kale u sii wacyi galin lahaayeen.


Waad ku mahadsantihiin soo booqashada forumka ardada caafimaadka soomaaliyeed, waxaan idiin rajaynayaa inaad faa'ido badan kala baxdaan halkan. Wixii su'aal iyo talo ku saabsan qoraalkan waxaad kala soo xiriiri kartaan idinkoo iimayl iigu soo diraaya halkan ciise83@somalidoc.com , Mahadsanidiin.
Dr Ciise Bashiir oo ku magac dheer Dr Ciise Dheere.
Sana'a Yemen.


Towards a better healthy Somalia!!
Unless all parts of the society participate equally in the health process, nothing could be expected.

Offline Admin

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Re: CHOLERA "SHUBAN BIYOOD"
« Reply #1 on: February 11, 2007, 11:31:18 AM »
Associated Press says:
115 people killed near shabelle river because of Cholera
http://www.indystar.com/apps/pbcs.dll/article?AID=/20070208/LOCAL17/702080454/1012
God help us
"you never cure a patient, you treat pain often but you always comfort the patient."
www.somalidoc.com

Offline Admin

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Re: CHOLERA "SHUBAN BIYOOD"
« Reply #2 on: February 22, 2007, 04:30:25 PM »
University of Michigan developed a mathematical model which shows promise for predicting cholera outbreaks!!!
hope this available in somalia and can be applied easily!
http://www.medicalnewstoday.com/medicalnews.php?newsid=63388&nfid=43325
Regards
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By: Dr.Mahdi
"you never cure a patient, you treat pain often but you always comfort the patient."
www.somalidoc.com

Offline IsseGole

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CHOLERA IN SOMALIA!!
« Reply #3 on: March 04, 2007, 11:37:42 AM »
Waxaa wax aad looga noxo ah sida aan caadiga ahayn ee uu shuban biyoodku ugu sii fidayo qaybo badan oo soomaaliya ah, Hiiraan buu ku billaabay, shabeellada dhexe baa xigtay, Baardheere sidoo kale, haddana Banaadir buu soo galay oo muqdisho ayuu fara kulul ku hayaa.
Dadka badanaa uu ku dhacayo cudurku waa haweenka iyo caruurta, dadka da'da ahna waa ka mid dadka uu dhibta wayn ku hayo. Dadka danyarta ah (low socioeconomic) ayaa la arkay iyadana ay yihiin dadka ugu badan ee uu cudurku ku dhacay una dhimanaya. Nadaafad xumada iyo daryeelka aan la daryeelayn caruurta yar, taasina waa sabab aad u wayn oo ka qayb qaadanaysa in caruurtu sida ugu wayn uu u asiibo cudurku.
Waxaa la sheegayaa in sababta uu muqdisho u soo galay cudurku ay ka timid dadkii ka qaxay ee gobollada tagay oo misana ku soo laabtay magaalada iyagoo sida cudurkii.
Dadka badan baa u dhintay cudurka illaa hadda, walaw aan la hayn tiro xaddidan haddana tiradu ma yara. Dad kale oo badanna waa la il daranyihiin.
Isibtaallada magaalooyinkaas iyo tuulooyinkaas cudurku ku dhacay waxaa ka jira dawo yari, sariiro yari, lacag yari, iyo dad yari (man, material, and money resources are deminished if not lacking). Hay'adaha caalamiga ah ee caafimaadka ka shaqeeya iyo kuwa gobolkaba waxaa aad looga codsanayaa inay wax la soo gaaraan isbitaalladaas waxa ay u baahanyihiin si looga boxo dhibta jidha.
Waxaa la rajaynayaa inuu dhowaan iska dhamaan doono cudurku, laakin ka hor waxaa loo baahanyahay in dadka jirranna la daweeyo, kuwa u dhintayna si fiican loo meeleeyo, kuwa u dhowdhow dadkii uu ku dhacayna la tallaalo ama dawooyin ka hor tag ah la siiyo, shacabka intiisa kalena ay iska ilaaliyaan sababaha keenaya cudurka ee nadaafad xumida iyo asbaabihii kale ee aan kor ku soo sheegnayba.
Dadkii dhintay Ilaahay ha u naxariisto, kuwa xanuunsanna Ilaahay ha caafiyo, kuwa caafimaadka qabana Ilaahay haka ilaaliyo wixii dhib u keenaya.
Ciise Dheere.
Towards a better healthy Somalia!!
Unless all parts of the society participate equally in the health process, nothing could be expected.