Cizon Hanci, Cizon Kunci, Rubella

Wadanda ya kamata su samu alurar MMR:

Yara:

• Allura ta 1: Watanni 9-12 (a Nijeriya, MCV1 a watanni 9)

• Allura ta 2 (MCV2): Watanni 15-18 ko shekaru 4-6 — WHO ta ba da shawarar amma Nijeriya ba ta gabatar da wannan a NPI ba tukuna

Manya da ba su da kariya: Mutanen da ba su taba samun alurar Measles/MMR ba kuma ba su taba kamuwa da cututtukan ba.

Mata masu shirin daukar ciki: Ya kamata su tabbatar cewa suna da kariya daga Rubella kafin daukar ciki. Sai a jira akalla wata 1 bayan allura kafin daukar ciki.

Ma'aikatan kiwon lafiya: Dole ne su samu allura 2 na MMR ko kuma tabbacin kariya ta hanyar gwajin jini.

Matafiya: Duk wanda ke tafiya kasashen waje ya kamata ya tabbatar cewa yana da isassun allurar Measles/MMR.

A lokacin barkewar kyanda: NCDC na gudanar da yakin rigakafin gaggawa — musamman a sansanonin 'yan gudun hijira da yankunan da ba su da isassun allurar.

Ba a ba da alurar MMR ga wadannan mutane ba:

Mata masu juna biyu: MMR alura ce mai rai — ba a ba da ita a lokacin juna biyu. Sai a jira akalla wata 1 bayan allura kafin daukar ciki.

Masu matsanancin raunin garkuwar jiki: Masu cutar kanjamau tare da CD4 kasa da 200, masu shan chemotherapy, masu dashen gabobi da ke shan anti-rejection drugs.

Mutanen da suka samu jini ko immunoglobulin: Sai a jira watanni 3-11 (ya danganta da nau'in product) kafin shan MMR.

Matsanancin rashin lafiyar neomycin ko gelatin: Wadannan abubuwa ne da ke cikin alurar.

Yara kasa da watanni 6: Ba a ba da su alurar.

MUHIMMI — KARYA CE: Ba gaskiya ba ne cewa MMR na haifar da autism. Binciken kimiyya da aka yi a duniya — ciki har da binciken da ya hada yara fiye da miliyan 1.2 — ya tabbatar da cewa BABU wata alaka tsakanin MMR da autism. WHO, CDC, NCDC, da duk hukumomin kiwon lafiya na duniya sun tabbatar da haka.

Sakamako na alurar MMR:

Sakamako na yau da kullum (masu sauki):

• Zafin wurin allura (10%)

• Zazzabi mai sauki zuwa matsakaici, kwanaki 6-12 bayan allura (5-15%)

• Dan hawan fata (rash) — kwanaki 7-12 bayan allura (5%)

• Kumburin kwayar lymph (kasa da 5%)

• Ciwon gidauniyoyi na dan lokaci (kasa da 25% — daga rubella component)

Sakamako marasa yawa:

• Kumburin kumatu (mumps parotitis) mai sauki — 1-2%

• Thrombocytopenia (raguwar platelet) — 1 cikin 25,000; yawanci tana warwarewa

Sakamako masu tsanani (da wuya sosai):

• Febrile seizures — 1 cikin 3,000 (ba sa haifar da farfadiya ta dindindin)

• Anaphylaxis — 1 cikin miliyan

• Encephalitis — kasa da 1 cikin miliyan (kwatanta da 1 cikin 1,000 daga cutar kyanda da kanta)

Bayani: Hadarin daga cututtukan kyanda, mumps, da rubella sun fi hadarin alurar da nisa. A Nijeriya, kyanda na ci gaba da kashe yara — alurar na ceton rayuka.

Yadda ake ba da alurar MMR:

Hanyar ba da allura: Karkashin fata (subcutaneous injection), yawanci a saman hannun hagu.

Jadawali (WHO):

• MCV1: Watanni 9-12

• MCV2: Watanni 15-18 ko shekaru 4-6

NPI na Nijeriya (a halin yanzu):

• MCV1 (Measles monovalent): Watanni 9 — tare da Yellow Fever

• MCV2: Ba a gabatar da shi ba tukuna a jadawalin NPI

Adadin: 0.5 mL, karkashin fata.

Ajiye alurar:

• 2-8°C (ko -20°C ga ajiya na tsawon lokaci)

• Kare daga haske

• Bayan an hade ta da diluent, yi amfani cikin awanni 6

NPHCDA na aiki tare da WHO, UNICEF, da Gavi don:

• Gabatar da MMR a maimakon measles monovalent

• Gabatar da MCV2 a cikin jadawalin NPI

• Wadannan matakai za su kara kariya daga kyanda, mumps, da rubella a Nijeriya

Ingancin alurar MMR:

Bayan allura daya (MCV1):

• Measles: 85-95% kariya (idan aka ba da ita a watanni 9: 85%; a watanni 12: 95%)

• Mumps: 78-85% kariya

• Rubella: 95-100% kariya

Bayan allura biyu (MCV1 + MCV2):

• Measles: 97-99% kariya

• Mumps: 88-95% kariya

• Rubella: >99% kariya

Tsawon kariya:

• Measles da Rubella: Kariya na dawwama tsawon rayuwa a yawancin mutane

• Mumps: Kariya na iya raguwa bayan shekaru 10-15 a wasu mutane

A Nijeriya:

• Tare da MCV1 kawai a watanni 9, kariya daga kyanda ita ce kusan 85%

• Wannan na nufin cewa 15% na yara ba sa samun kariya — su ne wadanda ke ci gaba da yaduwar kyanda

• Gabatar da MCV2 zai kara kariya zuwa kusan 97% — wannan zai taimaka sosai wajen kawar da kyanda

WHO ta ce: Don kawar da kyanda, dole ne kariya ta kai 95% a al'umma. Nijeriya na bukatar MCV2 don cimma wannan matsayi.

Mu'amalar alurar MMR da wasu magunguna:

Wasu allurar masu rai: Idan ba a ba su a rana guda ba, sai a jira akalla kwanaki 28. A NPI na Nijeriya, ana ba da MCV1 tare da Yellow Fever a watanni 9 — wannan ya dace.

Immunoglobulin da jini: Sai a jira watanni 3-11 bayan karbar jini ko immunoglobulin kafin shan MMR. Amma idan an riga an ba da MMR, sai a jira makonni 2 kafin ba da immunoglobulin.

Tuberculin skin test (TST/Mantoux): MMR na iya rage reaction na TST na dan lokaci. Sai a yi TST a rana guda da MMR ko a jira makonni 4-6 bayan MMR.

Magunguna masu rage garkuwar jiki: Sai a daina su akalla makonni 4 (corticosteroids) ko watanni 3-6 (chemotherapy, biologic agents) kafin ba da MMR.

Pregnancy: CONTRAINDICATED — live vaccine.

MMR vaccine is a live attenuated vaccine and is contraindicated during pregnancy.

• Women should avoid conception for 4 weeks after MMR vaccination.

• Inadvertent vaccination during pregnancy is NOT an indication for termination — no cases of congenital rubella syndrome have been reported following inadvertent vaccination of pregnant women (CDC, WHO).

• Pre-conception: check rubella immunity (anti-rubella IgG) and vaccinate non-immune women before pregnancy.

• Post-partum: vaccinate rubella-seronegative women before hospital discharge.

Breastfeeding: Safe.

MMR vaccine is safe during breastfeeding. Rubella vaccine virus may be excreted in breast milk and transmitted to the infant, but this does not cause disease and is not a reason to defer vaccination. CDC and WHO recommend post-partum MMR for susceptible breastfeeding mothers.

Pediatric use:

• Routine schedule: Dose 1 at 12–15 months, Dose 2 at 4–6 years.

• Minimum age: 6 months (for international travel to measles-endemic areas — counts as dose 0; repeat standard 2-dose series from 12 months).

• HIV-positive children with CD4 ≥15% should receive MMR (recommendation from WHO and ACIP).

• Available as MMR (M-M-R II, Priorix) or MMRV (ProQuad — includes varicella; approved from 12 months to 12 years).

• MMRV at dose 1: slightly increased risk of febrile seizures (1 extra per 2,300–2,600 doses) compared to separate MMR + V.

Geriatric use:

• Adults born before 1957 are generally considered immune to measles and mumps (through natural infection).

• However, serological testing may be warranted for healthcare workers or travelers regardless of birth year.

• No upper age limit for MMR vaccination in susceptible adults.

• Immune response is adequate in healthy elderly adults. Live vaccine caution applies to severely immunocompromised elderly.

Matakan kariya:

Allura ta biyu (MCV2) na da muhimmanci: 5-15% na mutanen da suka samu allura daya ba sa samun cikakkiyar kariya. Allura ta biyu na kama yawancin wadanda ba su samu kariya daga allura ta farko ba — shi ya sa WHO ke ba da shawarar allura 2.

Rigakafin CRS (Congenital Rubella Syndrome):

• Mata masu shirin daukar ciki ya kamata su yi gwajin rubella immunity

• Idan ba su da kariya, sai su samu MMR kuma su jira wata 1 kafin daukar ciki

• CRS na haifar da nakasar ido, kunne, zuciya, da kwakwalwa a jarirai

A Nijeriya:

• NPHCDA na aiki don gabatar da MCV2 a cikin jadawalin NPI

• Yakin SIAs (Supplementary Immunization Activities) na Measles na taimakawa wajen kara kariya

• NCDC na sa ido kan cutar kyanda ta hanyar case-based surveillance

Bayan mu'amala da kwayar cutar kyanda: Ana iya ba da MMR cikin awanni 72 bayan mu'amala don hana ko rage tsanani cutar.