Mmene Majeremusi Olimbanazoŵa Amadzukiriranso
MAVAIRASI, mabakiteriya, mapulotozowa, mafangayi, ndiponso majeremusi ena otere akhalapo chilengedwereni zamoyo padziko lapansi. Majeremusiŵa, omwe ndi zolengedwa zopangidwa moderereka kwambiri kuposa zolengedwa zonse, amatha kukhala bwinobwino m’malo osiyanasiyana, motero amatha kupezeka m’malo amene cholengedwa china chilichonse sichingakhalemo. Amapezeka m’malo amene mumatuluka ziphalaphala zotentha pansi pa nyanja ngakhalenso m’madzi ouma a m’chigawo chozizira kwambiri cha Arctic. Ndipo tsopano ayamba kudelera mankhwala oopsa kwambiri ophera majeremusiŵa.
Zaka 100 zapitazo, majeremusi ena ankadziŵika kuti amayambitsa matenda koma panalibe aliyense panthaŵiyo amene anali atamvapo za mankhwala olimbana ndi majeremusi m’thupi. Motero munthu akadwala matenda oopsa oyambitsidwa ndi majeremusi, madokotala ambiri ankasoŵa pogwira choncho ankangomulimbitsa mtima basi. Munthuyo ankayenera kungodalira mphamvu zoteteza thupi lake kuti ndizo zilimbane nawo matendawo pazokha. Ngati munthuyo analibe mphamvu zokwanira zoteteza thupi kumatenda, nthaŵi zambiri pankachitika zoopsa. Nthaŵi zambiri anthu ankatha kufa ngakhale ndi kachilonda kakang’onong’ono, ngati kaloŵa matenda.
Motero, zinthu zinasintha kwambiri pankhani ya zachipatala atatulukira mankhwala opha majeremusi m’thupi. Chifukwa choti odwala anayamba kupatsidwa mankhwala a mtundu wa sulfa kuzipatala, cha m’ma 1930 ndiponso mankhwala monga penisilini komanso streptomycin cha m’ma 1940, panadzatulukiridwa zinthu zambiri m’zaka makumi angapo pambuyo pake. Pofika cha m’ma 1990, panali magulu 15 a mankhwala otha kuchiritsa matendaŵa okwana pafupifupi 150 omwe amapangidwa posakaniza mankhwala ena.
Zothetseratu Majeremusiŵa Zinakanika
Pofika m’ma 1950 ndi m’ma 1960, anthu ena anayamba kusangalala kuti agonjetsa matenda oyambitsidwa ndi majeremusi. Mpaka analipo akatswiri ena a sayansi ya majeremusi amene ankakhulupirira kuti mtsogolo matenda ameneŵa adzangosanduka nthano zoopsa za kalekale. Mu 1969 wamkulu wa madokotala a ku United States ananena mawu pa maso pa Nyumba ya Malamulo ya m’dzikolo kuti posachedwapa n’kutheka kuti anthu “adzaiwalako za matenda oyambitsidwa ndi majeremusi.” Mu 1972, Macfarlane Burnet, yemwe analandirako mphotho yapamwamba yotchedwa Nobel analemba mogwirizana ndi David White mawu aŵa: “N’zoonekeratu kuti mtsogolomu matenda oyambitsidwa ndi majeremusi sadzamvekanso ayi.” Inde, anthu ena ankaona kuti n’zotheka kuti matenda otere adzatheratu.
Kukhulupirira kuti matenda oyambitsidwa ndi majeremusi ankaoneka kuti anali atatha kunachititsa anthu ochuluka kutayirira kwambiri. Nesi wina amene ankadziŵa bwino mmene majeremusi ankaopsera asanatulukire mankhwala ake ananena kuti manesi ena achinyamata anayamba kutayirira osakhalanso aukhondo. Iye akawakumbutsa kuti asambe m’manja ankangomuyankha kuti: “Mukudandaula chiyani kodi, pajatu masiku ano kunabwera mankhwala opha majeremusi.”
Komatu kudalira kwambiri mankhwala otere ndiponso kukonda kwambiri kuwagwiritsira ntchito kwadzetsa mavuto oopsa. Matenda oyambitsidwa ndi majeremusi akuvutitsabe. Komanso kuwonjezera apo, abwera mwamphamvu kwambiri moti ndiwo akupha kwambiri anthu padziko lonse! Zinthu zinanso zimene zachititsa matendaŵa kufala kwambiri ndizo nkhondo, kuchuluka kwa matenda opereŵera zakudya m’thupi m’mayiko osauka, kusoŵa kwa madzi abwino, uve, kuyendayenda m’mayiko akunja, ndiponso kusintha kwa zanyengo padziko lonse.
Mabakiteriya Anayamba Kusamva Mankhwala
Vuto la kusamva mankhwala kwa majeremusi wamba lasanduka lalikulu kwambiri mosagwirizana ndi mmene anthu ambiri anali kuyembekezera. Komano tikayang’ana m’mbuyo tingathe kuona kuti anthu akanayenera kuyembekezera kuti mtsogolo majeremusi adzayamba kusamva mankhwala. N’chifukwa chiyani akanayenera kutero? Taganizirani mwachitsanzo chabe vuto langati lomweli, limene linalipo mankhwala a tizilombo otchedwa DDT atangofika kumene cha m’ma 1945.a Panthaŵiyi oŵeta ng’ombe zamkaka anasangalala kwambiri tizilombo touluka titangotsala pang’ono kutheratu chifukwa chopopera mankhwala a DDT. Koma tizilombo tingapo tinatsalako ndipo tinaswa ana omwe anayamba kusamva mankhwala a DDT. Posakhalitsa tizilombo tosamva mankhwalati tinaswananso kwadzaoneni.
Ngakhale DDT asanayambe kugwiritsiridwa ntchito, ndiponso mankhwala a penisilini asanayambe kugulitsidwa mu 1944, mabakiteriya oopsa anali atayamba kale kusonyeza kuti ali chikwanekwane kudziteteza. Dr. Alexander Fleming, yemwe anatulukira mankhwala a penisilini, anadziŵa zimenezi. M’nyumba yochitiramo kafukufuku wa matenda iye anaona kuti mbadwo ulionse wa tizilomboti unkabadwa ndi khungu lolimbirapo lolepheretsa mankhwala amene iye anatulukirawo kuloŵa m’kati.
Zimenezi zinam’chititsa iyeyu, zaka 60 zapitazo, kuti achenjeze kuti mabakiteriya oopsa amene ali m’thupi mwa munthu angathe kuyamba kusamva mankhwala a penisilini. Motero ngati mankhwala onse a penisilini amene dokotala wam’patsa munthu kuti amwe atalephera kupha mabakiteriya oopsa ambiri ndithu, mibadwo yotsatira ya mabakiteriyawo, yomwe yazoloŵera mankhwalaŵa ingathe kuchulukana m’thupimo. Motero, matendaŵa angayambirenso koma sangachiritsidwenso ndi mankhwala a penisilini.
Buku lakuti The Antibiotic Paradox linanena kuti: “Zimene Fleming ananena zinakwaniritsidwa ndipo zinali zoopsa kuposa mmene iyeyo ankaganizira.” Zinakhala bwanji choncho? Akatswiri anatulukira kuti pali mitundu ina ya mabakiteriya imene imapanga timadzi m’thupi mwawo timene timachititsa kuti mankhwala a penisilini azikanika kuipha. Motero ngakhale wodwala atalandira mankhwala a penisilini ochuluka bwanji, siziphula kanthu n’komwe. Izitu zinali zopweteketsa mutu kwabasi!
Pofuna kugonjetsa matenda obwera ndi majeremusi, kunkabwera mankhwala atsopano kaŵirikaŵiri kungoyambira m’ma 1940 mpaka m’ma 1970, ndipo enanso ochepa anafika m’ma 1980 ndi m’ma 1990. Mankhwala ameneŵa ankatha kupha mabakiteriya amene sankafa ndi mitundu yoyamba ija ya mankhwala. Koma patangotha zaka zochepa chabe, panabwera mitundu ina ya mabakiteriya imene sinkafa ngakhale ndi mankhwala atsopanoŵa.
Anthu azindikira kuti tizilombo ta mabakiteriya timachita zinthu zodabwitsa kwambiri kuti tisamamve mankhwala. Mabakiteriya amatha kusintha kapangidwe ka khungu lawo kuti mankhwala alephere kuwaloŵa kapenanso kusintha kayendedwe ka zinthu m’thupi mwawo kuti mankhwala alephere kuwapha. Chinanso, mabakiteriya amatha kutulutsa mankhwalawo akangoti aloŵa m’thupi mwawomo, kapenanso amatha kungowagaya moti sathanso kugwira ntchito yake.
Poti mankhwala ophera majeremusi akugwiritsidwa ntchito kwambiri, nawo mabakiteriya olimbanazoŵa akuchuluka ndipo akufala. Kodi ndiye kuti mankhwalaŵa alibenso ntchito? Ayi, nthaŵi zambiri mankhwalaŵa amagwira ntchito. Ngati mankhwala ena otero atalephera kuchiza matenda enaake, nthaŵi zambiri pamakhala mankhwala ena amene amatha kutero. Inde kuyambira kale mabakiteriya osamva mankhwala akhala akuvutitsa, koma m’posachedwa pompa pamene achita kufika posautsa anthu motere.
Kusamva Mankhwala Osiyanasiyana
Kenaka asayansi anasokonezeka maganizo kwambiri atazindikira kuti mabakiteriya amatha kuyamba kufanana chilengedwe chawo pogaŵana mphamvu zinazake zosintha chibadwa cha chinthu. Poyamba ankaganiza kuti ndi mabakiteriya a mitundu yofanana okha amene amatha kugaŵana mphamvu zimenezi. Koma kenaka anadzapeza kuti mabakiteriya ena a mtundu winanso anali ndi mphamvu zachilengedwe zotha kulimbana ndi mankhwala. Pogaŵana mphamvu zimenezi, mabakiteriya a mitundu yosiyanasiyana ayamba kusamva mankhwala osiyanasiyana amene anthu ambiri amagwiritsira ntchito.
Ndiye kuwonjezera pa vutoli, atafufuza cha m’ma 1990, anapeza kuti mabakiteriya ena paokha, amatha kupeza mphamvu zachibadwa zowapangitsa kuti asamamve mankhwala enaake. Ngakhale mankhwala otere atakhala a mtundu umodzi wokha, mabakiteriya a mitundu inayake amadzayamba kusamva mankhwala osiyanasiyana, achilengedwe ndi ochita kupanga omwe.
Tsogolo Likudetsa Nkhaŵa
Ngakhale kuti mitundu yambiri ya mankhwala opha majeremusi m’thupi imathabe kuchiritsa anthu ambiri, kodi mankhwalaŵa adzakhala othandiza motani mtsogolo muno? Buku lakuti Antibiotic Paradox linati: “Tiiwaleko zakuti matenda aliwonse oyambitsidwa ndi mabakiteriya angathe kumadzatheratu kamodzi n’kamodzi munthu akangolandira mankhwala otere.” Bukuli linawonjezera kunena kuti: “Chifukwa choti m’madera ena a padzikoli mumapezeka mitundu yochepa chabe ya mankhwala otereŵa, pamakhala palibe mtundu uliwonse pa mankhwalawo umene ungathe kuchiza matenda enaake oyambitsidwa ndi mabakiteriya. . . . Anthu akudwala ndiponso kufa ndi matenda amene ena ananena zaka 50 zapitazo kuti adzakhala atatheratu padziko lonse.”
Si mabakiteriya okha amene ayamba kusamva mankhwala. Mavairasi ndiponso mafangayi komanso tizilombo tina todwalitsa tayambanso kulimba nazo mogometsa, moti n’kutheka kuti khama lonse limene anthu achita potulukira ndiponso kupanga mankhwala ophera tizilomboti lingathe kungopita pachabe.
Choncho kodi vutoli n’kutani nalo? Kodi n’zotheka kuthetsa kapena kuchepetsa vutoli? Kodi zingatheke bwanji kuti mankhwala omwe amatha kupha majeremusi apitirirebe kugwira ntchito yake mmene matendaŵa akuchulukiramu?
[Mawu a M’munsi]
a Mankhwala ophera tizilombo totere ngoopsa, komanso mankhwala ena alionse amene timamwa ngoopsa. Mankhwala a mitundu iŵiri onseŵa amatha kuthandiza munthu ndiponso amatha kum’pweteka. Inde, mankhwala opha majeremusi m’thupi amatha kupha majeremusi oopsa koma amathanso kupha majeremusi ofunika.
[Bokosi/Chithunzi patsamba 16]
Mankhwala Opha Majeremusi
Mankhwala amene mumalandira kuchipatala mukadwala matenda oyambitsidwa ndi majeremusi ali m’gulu la mankhwala amene makamaka amapha majeremusi okhawo amene amayambitsa matenda.
Majeremusi ndi tizilombo tating’ono kwambiri timene sitioneka popanda makina a maikulosikopu. Mankhwala opha majeremusi osiyanasiyana m’thupi makamaka amapha majeremusi oyambitsa matenda. Koma tsoka ilo, mankhwalaŵa amathanso kupha mabakiteriya ofunikira m’thupi.
M’chaka cha 1941, Selman Waksman, amene anatulukira nawo mankhwala otchedwa streptomycin, anawaika mankhwalaŵa m’gulu la mankhwala opangidwa kuchokera ku tizilombo tosaoneka ndi maso paokha. Mankhwala onse opha majeremusi m’thupi amachiritsa anthu chifukwa chakuti amatha kupha majeremusi popanda kum’dwalitsa munthuyo.
Kwenikweni, mankhwala onse otere penapake ngowonongabe m’thupi mwathu. Komano mmene mankhwalaŵa amawonongera majeremusi zimasiyana ndi mmene amawonongera thupi lathuli. Kusiyana kumeneku kukakhala kwakukulu ndiye kuti mankhwalawo ngabwino; koma kukhala kochepa ndiye kuti ngoopsa. Ndipotu pali mankhwala ambirimbiri amene anatulukiridwa koma ambiri ngoti sangagwiritsidwe ntchito kwa anthu kapena nyama chifukwa ngoopsa kwambiri.
Mankhwala oyamba achilengedwe amene anayamba kugwira ntchito yopha majeremusi m’thupi anali penisilini, amene anawapanga kuchokera ku zomera zotchedwa Penicillium notatum. Mu 1941, m’pamene penisilini anayamba kuperekedwa kwa anthu odwala kudzera m’mitsempha. Kenaka, pasanathe nthaŵi yaitali, mu 1943, anapeza mankhwala otchedwa streptomycin kuchokera ku mabakiteriya opezeka m’dothi otchedwa Streptomyces griseus. M’kupita kwa nthaŵi anadzapanga mankhwala ena ambirimbiri ophera majeremusi ndipo anali ochokera ku zinthu zosiyanasiyana zachilengedwe komanso zina zochita kupanga. Komabe majeremusi apeza njira zodziteteza kuti asamafe ndi mitundu yambiri ya mankhwalaŵa, achititsa kuti padziko lonse pakhale vuto la matenda osautsa.
[Chithunzi]
Zomera zimene amapangira penisilini zimene zikumera pansi pa mbaleyi zimachititsa kuti mabakiteriya asachulukane
[Mawu a Chithunzi]
Christine L. Case/Skyline College
[Bokosi/Zithunzi patsamba 17]
Mitundu ya Majeremusi
Mavairasi ndiwo majeremusi aang’ono kwambiri. Amayambitsa matenda ofala monga a chimfine, ndi zilonda za pakhosi. Mavairasi amayambitsanso matenda oopsa monga a poliyo, Ebola ndi Edzi.
Mabakiteriya ndi majeremusi okhala ndi selo imodzi yokha ndipo ngopangidwa moderereka kwambiri moti alibe phata lake komanso nthaŵi zambiri amakhala ndi kachigawo kamodzi kokha kokhala ndi zinthu zonse zokhudzana ndi chibadwa chawo. M’thupi mwathumu muli mabakiteriya ambirimbiri ndipo makamaka amakhala m’matumbo. Amatithandiza kugaya chakudya m’thupi mwathu ndipo ndiwo makamaka amapanga vitamini K, imene imathandiza kuti magazi azitha kuundana.
Ndi mitundu 300 yokha pa mitundu 4,600 ya mabakiteriya odziŵika imene imayambitsa matenda. Komabe mabakiteriya ndiwo amayambitsa matenda ochuluka kwambiri a zomera, zinyama, ndiponso anthu. Pakati pa anthu, mabakiteriya amayambitsa matenda monga chifuwa cha TB, matenda a m’mimba a kolera, chotupa cha kukhosi, matenda a anthrax, mano, mitundu inayake ya matenda a chibayo, ndiponso mitundu yosiyanasiyana ya matenda opatsirana pogonana.
Mapulotozowa nawonso ali ndi selo imodzi ngati mabakiteriya, koma amatha kukhala ndi maphata angapo. M’gulu la mapulozotowaŵa muli ena otchedwa amiba, thirayipanosomu komanso majeremusi amene amayambitsa malungo. Pafupifupi zamoyo zitatu pa zamoyo khumi zilizonse zotere ndi tizilombo tokhala m’kati mwa zamoyo zina ndipo tilipo ta mitundu yokwana 10,000, ngakhale kuti pamenepa pali mitundu yochepa chabe imene imadwalitsa anthu.
Mafangayi nawo amatha kuyambitsa matenda. Majeremusi ameneŵa ali ndi phata ndipo ali ndi timitsitsi toloŵanaloŵana. Matenda ofala kwambiri amene amayambitsidwa ndi majeremusiŵa ndi matenda amtundu wa chipere monga linyetsu kapena kuti nyansi, ndiponso mauka kapena kuti masungu. Matenda oopsa oyambitsidwa ndi mafangayi nthaŵi zambiri amagwira anthu okhawo amene mphamvu zoteteza thupi lawo ku matenda zafooka chifukwa chopereŵera zakudya m’thupi, matenda a kansa, mankhwala osokoneza bongo, kapena matenda obwera ndi mavairasi amene amachepetsa mphamvu zoteteza thupi ku matenda.
[Zithunzi]
Kachilombo ka Ebola
Mabakiteriya otchedwa “Staphylococcus aureus”
Mapulotozowa otchedwa “Giardia lamblia”
Mafangayi oyambitsa zipere
[Mawu a Chithunzi]
CDC/C. Goldsmith
CDC/Janice Carr
Taloledwa ndi Dr. Arturo Gonzáles Robles, CINVESTAV, I.P.N. México
© Bristol Biomedical Image Archive, University of Bristol
[Chithunzi patsamba 14]
Alexander Fleming, amene anatulukira penisilini