AhabanzaAmakuruHanzeUbuzima

Sobanukirwa Indwara ya Hepatite B

Muri iyi minsi hasigaye hari urusobe rw’indwara nyinshi zirigutwara ubuzima bw’abantu batari bake.Uyu munsi urubuga imboni.rw rwifuje kubagezaho bimwe mutari muzi ku ndwara y’umwijima(Hepatite B).

Urubuga healthnet.com ruvuga koHepatite B ari imwe mu ndwara zifata umwijima iterwa n’agakoko ka Virus. Iyi ndwara kuri ubu ni imwe mu zihangayikishije isi yose kuko abantu basaga miliyoni Magana atanu (500,000,000) nibo bavugwa nk’abamaze kuyandura kandi ko byibura ihitana abangana na miliyoni imwe buri mwaka ku isi. Iyi ndwara yibasira cyane abantu batuye mu bihugu bikiri mu nzira y’amajyambere. Hepatite B ishobora guhinduka karande (chronique) cyangwa ikaba yahindukamo izindi ndwara z’umwijima nk’urushwima (cirrhose) cyangwa kanseri y’umwijima. Iyi ndwara ntikunda kugaragara mu bana bari munsi y’imyaka 12 ahanini kubera baba bataratangira kwishora mu busambanyi ariko uko umuntu ayandura akiri muto niko byongera ibyago byo guhinduka karande.

IBITERA INDWARA

Nkuko twabikomojeho hejuru iyi ndwara y’umwijima iterwa n’agakoko kitwa’’Hepatitis B Virus” igira impine ya HBV ,iyo virus akaba ari nayo ikomokaho iri zina rya Hepatite B. Iyi virus ya HBV ishobora kwandura iva ku muntu ijya ku wundi binyuze matembabuzi yo mu mubiri nk’amaraso, amasohoro n’ibindi(yandura inshuro ijana kurenza Sida) . Inzira zimenyerewe cyane ni izi zikurikira:

  • Gukora imibonano mpuzabitsina idakingiye
  • Gukoresha ibikoresho bikomeretsa by’uyirwaye harimo inshinge, uburoso bw’amenyo
  • Umubyeyi akaba yayanduza umwana we mu gihe amutwite, amubyara cyangwa amwonsa
  • Guterwa amaraso cyangwa guhabwa urugingo rw’umuntu uyisanganywe.

Ntibivuze ko uko ariko konyine wayandura, inzira zose zatuma uhura n’amatembabuzi yo mu mubiri w’umuntu uyirwaye nawe byakwanduza indwara ya Hepatite B.Abantu bafite ibyago byinshi byo kwandura Hepatite B twavuga: abantu bavukiye ahantu haba abarwayi baduye HBV, umuntu waryamanye n’abantu benshi batandukanye,abatinganyi, abakora kwa muganga,abakoresha ibiyobyabwenge byo mu nshinge,abagore batwite n’abandi.

UKO INDWARA IZAHAZA UMUBIRI

Mbere yuko tureba uko indwara izahaza umubiri reka tubanze turebere hamwe ubusanzwe icyo umwijima w’umuntu umara.Umwijima ni inyama iherereye mu nda mu gice cy’iburyo ahagana hejuru munsi y’urucamakoma(diaphragme) ari narwo rutandukanya mu nda no mu gatuza. Umwijima rero ugira umimaro myinshi cyane mu mubiri w’umuntu ariko reka tuvugemo mike y’ingenzi kuruta iyindi.

  • Ufasha mu gusohora imyanda imwe ikomoka ku mavuta umuntu aba yariye mubiri ubinyujije mu cyo bita indurwe (bile)
  • Ukora zimwe mu ntungamubiri(proteines) na vitamini zijya mu maraso
  • Umwijima ufasha mu kubika isukari itahise ikoreshwa n’umubiri ukaza kuyisohora aruko ikenewe
  • Usukura amaraso ugakuramo imiti n’ibiyobyabwenge
  • Niwo uyobora ibijyanye no kuvura kw’amaraso ngo umuntu adakomeza kuva mu gihe akomeretse
  • Niwo usukura ibintu byose byinjiye mu mubiri bimeze nk’uburozi.

Nyuma yo kubona imwe mu mimaro y’umwijima reka turebere hamwe uko indwara ya Hepatite B izahaza umubiri. Iyo virus ya Hepatite B imaze kwinjira mu mubiri iragenda  ikajya mu mwijima igafata uturemangingo twawo(hepatocytes). Virus ubwayo ntago ariyo itera ikibazo kinini ahubwo ubudahangarwa bw’umuntu(immunite) iyo bubonye ko hari uturemangingo turimio virusi buhita butegeka ko twicwa. Kandi nkuko twabibonye haruguru umwijima ugira umumaro munini,iyo rero uturemangingo twawo dupfuye n’uko ukora bigenda bigabanuka. Uko ubudahangarwa k’umuntu kurwanya iyo virusi niko ibimenyetso bigaragara gusa indwara ya Hepatite ica mu ntera 5 iyo virus Yamaze kugera mu mubiri.

  1. Intera ya 1:igihe virus iba itaragaragara neza mu mubiri.iyo ntera imara kuva ku byumweru 2 kugeza kuri 4 ku muntu mukuru wari ufite ubudahangarwa buzima.mu bana bakivuka bo iyi ntera ishobora kumara n’imyaka. Muri iki gihe nubwo nta bimenyetso umuntu aba agaragaza ariko virus yo iba iri kubyara izindi mu mubiri.
  2. Intera ya kabiri:umubiri uba uri kurwana na virusi muri iki gihe ubudahangarwa bw’umuntu buba butangiye gukora bugerageza gusohora virusi.ubu bwo virusi ishobora gupimwa ikaboneka mu mubiri.iki gihe ku murwayi niho aremba akanya gato atangira no kugaragaza ibimenyetso turi buze kubona hasi.iyi ntera nayo imara ibyumeru kuva kuri 3 kugeza kuri 4. Ku muntu uyimaranye igihe hashobora gucamo imyaka nk’10 mbere yo kurwara urushwima cyangwa kanseri y’umwijima.
  3. Intera ya 3:indwara karande gusa virusi isinziriye kuri iki gihe virusi ntiba ikibyara cyangwa ikabyara abana bake batagaragara mu mubiri. Ni kuri iyi ntera kandi virus zitangira kuva mu maraso zinjira mu turemangingo tw’umwijima(hepatocytes)
  4. Intera ya 4: indwara karande nyirizina iyi ntera ishobora kuva ku ntera ya gatatu cyangwa se itiriwe ibaho umuntu agahita ajya ku ntera ya kane avuye ku ya kabiri. Iki gihe umurwayi aba abana na HBV ku buryo bwa karande kandi agaragaza ibimenyetso.
  5. Intera ya 5:gukira kugera kuri iyi ntera akenshi bisaba gufata imiti.iki gihe virus ntiba ikigaragara mu mubiri. Umubiri uba ufite za anticorps zihagije zirwanya agakoko ka HBV

Izo ntera zose dushobora gukuramo uburyo 2 bukomeye umuntu yarwaramo indwara ya Hepatite B. umuntu ashobora gufatwa by’ako kanya akaremba(Hepatite aigue) cyangwa indwara ikaba karande(hepatite chronique).Abagera kuri 5 ku ijana mu barwayi nibo bagira uburwayi bwa karande ni ukuvuga ko virusi iba imaze byibura amezi 6 mu maraso yabo no mu mwijima. Kurwara kanseri y’umwijima ni kimwe mu bituruka ku ndwara y’akarande ya Hepatite B bitewe n’uko uturemangingo twawo hafi ya twose tuba twarapfuye.

IBIMENYETSO

Akenshi indwara ya Hepatite B ntigararagaza ibimenyetso kuko haba hari benshi bayifite wanayipima ukayibona mu maraso ariko ibimenyetso bitaragaragara. Muri rusange ugereranije igihe indwara imara itaragaragaza ibimenyetso kiri hagati y’ukwezi 1 n’6. Mu kureba ibimenyetso by’iyi ndwara turagabanyamo ibice 2. Indwara y’ako kanya cyangwa indwara ya karande.

Indwara y’ako kanya (Hepatite Aigue)

Umuntu ugifatwa n’indwara agaragaza ibi bimenyetso (1/3 cy’abarwayi ntabyo bagaragaza)

  • Isesemi no kubura ubushake bwo kurya
  • Kumva unaniwe
  • Kubabara mu nda ahagana haruguru iburyo no kuribwa umutwe no mu ngingo
  • Kuruka no guhitwa
  • Umuriro
  • Uretse ibyo bimenyetso bisanzwe hari ibigaragaza ko umwijima wafashwe
  • Guhinduka umuhondo (bihera mu maso ariko no ku ruhu wabibona)
  • Inkari zijimye n’amazirantoki yeruruka

Iyo hapimye ibipimo by’umwijima (enzymes hepatiques) usanga byiyongereye. Kugirango indwara ihinduke karande biterwa n’igihe wayanduriye kuko kuba waranduye Hepatite ukiri muto urugero uri kuvuka ibyago byo kuba karande ni 90 ku ijana.

Indwara ya karande

Iyo umuntu afite Indwara ya karande ibimenyetso biba bakomeye kurenzaho. Akenshi usanga abayigendana baba batabigaragaza ariko iyo izahaje umuntu ugira ibimenyetso nka biriya ariko bigakomera. Ikindi hazamo ibimenyetso by’izindi ngingo zifatwa zitari umwijima nk’ubwonko kuko imyanda umwijima wakabaye usohoka hari iba mwinshi ikajaya mu maraso ikajya mu bwonko bikaba byanatera kugwa muri koma Ku bimenyetso bigaragara iyo umwijima wangiritse bakomeye ni urushwima (cirrhoses) umwijima uhinduka nk’ibuye umuntu akanagira amenshi menshi mu nda atari ahasanzwe.iyo cirrhose niyo ishobora kuzabyara kanseri y’umwijima (hepatocellular carcinoma)Ikindi kuvura kw’amaraso kuba ikibazo kuko twabonye ko ibivurisha amaraso bitunganwa n’umwijima. Umurwayi karande wa Hepatite B aba ameze nk’uwariye nabi kuko hari intungamubiri nyinshi aba atakibona.

UKO INDWARA IVURWA

Hambere nta miti ya Hepatite B yabagaho. Imiti ibonetse vuba ariko imbogamizi ni uko ihenda si ubushobozi bwa buri wese bwabasha kuyigura

Indwara y’ako kanya(Hepatite B aigue)

Iyo indwara y’umwijima ikiri mbisi ntago aba ri ngombwa guhita unywa imiti,gusa ku bantu bose si kimwe kuko ubudahangarwa bwabo butangana. Kwa muganga bakugira inama yo kujya ugerageza ukaruhuka no kunywa ibinyobwa byinshi havuyemo ibisindisha(alcool). Hari igihe rero biba ngombwa ko bamuvura twavuga n’iyo arembye cyane,ibimenyetso bimaze igihe kini cyangwa iyo atangiye kugira ibibazo bijyanye no kuvura kw’amaraso igihe akomeretse(coagulation) cyangwa iyo yenda guhabwa umwijima mushya kugirango indwara itazagaruka..Iyo bibaye ngomba gukoresha imiti rero hari impamvu cyangwa intego zigera muri ebyiri:

  • Kugira ngo udukoko twayo dushire mu mubiri itaragera kure
  • Kugirango umwijima utangirika kandi ukore neza.

Ikigo cyitwa FDA gishinzwe iby’imiti ubu cyemera ikoreshwa ry’imiti 3 ariyo

  • Pegylated interferon alfa(PEG-IFN-a):urwanya virusi ukanafasha ubudahangarwa
  • Entecavir (ETV):urwanya virusi
  • Tenofovir disoproxil fumarate (TDF)

Hari n’indi miti itaremerwa neza ariko yerekana ko ikora neza rero hamwe barayikoresha nka lamivudine,telbivudine na adenofovirMuri iki gihe rero cy’uburwayi bwa vuba biba byiza gukoresha indi miti Uretse uriya wa PEG-IFN-a kuko ngo ugira ingaruka nyinshi. Iyo bapimye bagasanga nta dukoko tukiboneka mu maraso imuti barayihagarika.

Indwara karande (Hepatite B chronique)

Iki gihe cyo umurwayi avurwa kugirango indwara ye idahindukamo urushwima(cirrhose) cyangwa ikangiza umwijima ku buryo bukabije ikaba yanahindukamo kanseri y’umwijima.

Mu Rwanda uko minisiteri y’ubuzima isaba kuvura HBV:

Batangirira ku miti 2 ihurije hamwe ( amagarama 300 ya Lamivudine hamwe n’amagarama 300 ya tenofovir) iyi miti uyinywa ari ibinini ubinywa 1 ku munsi igihe kingana n’ibyumweru 48 kugeza kuri 52. irwanya virusi ndetse nta bindi byinshi wangiza, ntuhenda cyane ariko haba hari ibyago by’uko HBV yazagaruka. Iyo byanze rero nibwo hakoreshwa PEG-IFN-a utangwa mu nshinge mu gihe cy’ibyumweru 16, uyu muti ukangura ubudahangarwa bw’umubiri ukanarwanya virus. Uyu muti urahenda cyane, kandi ngo ukangiza n’ibindi bice by’umubiri. Ariko ngo niwo wizewe cyane ku buryo nta byago byinshi by’uko HBV yagaruka.

UKO YIRINDWA

Gukingirwa

Urukingo rwa Hepatite B ruraboneka mu Rwanda mu bitaro byose. Gusa kugeza ubu urukeneye ajyayo akishyura bakamukingira.Guverinoma y’u Rwanda yo yabanjje gukingira abantu bafite ibyago byinshi byo kwandura no kwanduza:abakora mu buvuzi ndetse n’abana bakivuka bose barabakingira gusa bitangiye vuba,. Kugeza ubu ntabwo leta irabona ubushobozi bwishyurira abantu bose urukingo Urukingo rutangwa mu nshinge eshatu hagati hagiye hacamo ukwezi. Ku mwana ukivuka bamukingira ku byumweru 6, 10 na 14.

Ubundi bwirinzi

Ubundi buryo bwo kwirinda bujyana n’uko indwara y’umwijima yo mu bwoko bwa Hepatite B yandura hirindwa aho ariho hose wahurira n’amatembabuzi y’umuntu wanduye.Imibonano mpuzabitsina: icyiza ni ukwifata n’ubudahemuka kuko ngo Hepatite B n’iyo wakoresha agakingirizo ntuba ubyizeye 100% ko uyirize. Igihe byanze rero agakingirizo karakoreshwaUmubyeyi wese akimara kumenya ko atwite ni ukujya kwipi misha iyi ndwara kugirango kwa muganga bamufashe uburyo bwo kutayanduza umwana we.Igihe umuntu yayanduye mwirinda gusangira ibikoresho bikomeretsa.Kwa muganga nabo basabwe gupima neza amaraso cg ingingo bigiye guhabwa umuntu ngo batayimwanduza.gusa nawe niba bagiye kubiguha wakwibuka kubaza niba byapimwe. Umuntu wese ubona bimwe mu bimenyetso byavuzwe haruguru asabwa kwihutira kugana ibitaro bimwegereye kugirango afashwe kuvurwa kandi arinde na bagenzi be.

 

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