Bayanin gabaɗaya
Kyanda cuta ce mai yaduwa da kwayar cutar paramyxovirus ke haifarwa. Tana yaduwa ta hanyar iska kuma tana iya haifar da matsaloli masu tsanani musamman ga yara.
Alamomi
Alamomi | Yawan faruwa | Tsanani | Farawa |
|---|---|---|---|
| Jan ido | 92% | Dan kadan | Farkon cuta |
| Tari | 95% | Dan kadan | Farkon cuta |
| Zazzabi mai tsanani | 98% | Mai tsanani | Farkon cuta |
| Rashin jin daɗi | 85% | Dan kadan | Farkon cuta |
| Zubar hanci | 90% | Dan kadan | Farkon cuta |
| Ciwon kai | 50% | Dan kadan | Farkon cuta |
| Saurin fushi | 60% | Dan kadan | Farkon cuta |
| Yawan zubar hawaye | 60% | Dan kadan | Farkon cuta |
| Rashin son ci | 70% | Dan kadan | Farkon cuta |
| Rashin jure haske | 50% | Dan kadan | Farkon cuta |
| Ciwon tsoka | 35% | Dan kadan | Farkon cuta |
| Ciwon maƙogwaro | 40% | Dan kadan | Farkon cuta |
| Ƙurji na maculopapular | 99% | Dan kadan | Kololuwar cuta |
| Kumburin ƙwayoyin lymph | 50% | Dan kadan | Kololuwar cuta |
| Ciwon ciki | 20% | Dan kadan | Kololuwar cuta |
| Zawo | 8% | Dan kadan | Kololuwar cuta |
| Amai | 15% | Dan kadan | Kololuwar cuta |
| Gajiya | 80% | Dan kadan | Kowane lokaci |
Hanyoyin yaduwa
Bayanin gabaɗaya
Kyanda cuta ce mai saurin yaduwa da kwayar cutar kyanda (dangin Paramyxoviridae) ke haddasa ta. R₀ na 12–18, wanda ke sa ta zama daya daga cikin cututtukan da suka fi yaduwa a duniya. Tana yaduwa ta hanyar digon numfashi da iska — kwayar cutar tana ci gaba da yaduwa a cikin iska har zuwa sa'a 2. An kiyasta mutuwar mutane 128,000 a 2021, musamman a cikin yaran da ba a yi musu allurar rigakafi ba ko kuma masu rashin abinci mai gina jiki a kasashen da ke da karancin kudaden shiga. Allurar rigakafi ta MMR mai kashi biyu ta rage mutuwar kyanda da fiye da 73% tun daga shekarar 2000.
Bayanin gabaɗaya
Kyanda (Measles) cuta ce mai tsananin yaduwa da kwayar cutar kyanda (Measles morbillivirus) daga dangin Paramyxoviridae ke haddasa ta. Tana daga cikin cututtukan da suka fi yaduwa a duniya, inda adadin yaduwa na asali (R0) ya kai tsakanin 12 zuwa 18. Tana yaduwa ta hanyar digogin numfashi da hayakin da ake fitarwa idan aka yi atishawa ko tari, kuma kwayar cutar za ta iya rataya a cikin iska har sa'a biyu bayan mai cutar ya bar wuri.
Lokacin da mutum zai iya yada cutar ya faro ne daga kwanaki 4 kafin kuraje su bayyana har zuwa kwanaki 4 bayan sun bayyana. Duk da cewa an samu maganin rigakafi (vaccine) mai inganci tun shekarar 1963, kyanda har yanzu tana daga cikin manyan abubuwan da ke kashe yara wadanda za a iya hana su ta hanyar allurar rigakafi a duniya. Hukumar Lafiya ta Duniya (WHO) ta kiyasta kusan miliyan 10.3 na kamuwa da cutar da mutuwar mutane kusan 107,500 a shekarar 2023.
A Najeriya, kyanda tana daga cikin manyan cututtukan da ke kashe yara musamman a yankin Arewa. Kalubalantar rigakafin yara na yau da kullum (Routine Immunisation — RI) a yankunan Arewacin Najeriya ya sa barkewar cutar ta zama ruwan dare. Hukumar Kula da Cututtuka ta Najeriya (NCDC) tana samun rahotannin dubban shari'o'in da ake zargi a kowace shekara. Shirin Rigakafin Kasa (NPI) da NPHCDA sun hada allurar MMR/MR a cikin jadawalin rigakafin yara. Domin kawar da kyanda, ana bukatar isasshen rigakafi na kashi 95% ko fiye da allurai biyu na MMR.
Kyanda cuta ce da dole a bayar da rahoton ta ga hukumomi a Najeriya da dukan kasashen Yammacin Afirka. Jadawalin rigakafin yara na Najeriya (NPHCDA) ya hada da allura ta farko ta kyanda/MR a wata 9 da kuma allura ta biyu a wata 15.
Alamomin gaggawa
Nemi kulawar gaggawa nan take idan wadannan suka bayyana:
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Wahalar numfashi ko saurin numfashi
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Ciwon kai mai tsanani ko taurin wuya ko sauyin wayewar kai (kumburin kwakwalwa)
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Farfadiya (seizures)
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Rashin iya sha ko amai mara yankewa
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Alamun rashin ruwa mai tsanani (idanu masu nutsewa, rashin yin fitsari, gajiya mai tsanani)
Ka kira lambar gaggawa ko ka tafi asibiti mafi kusa nan take.
Cikakkun alamomi
Alamomi da alamu mafi yawa
Lokacin kwanciyar cuta (Incubation period): Kwanaki 10–14
Matakin farko/Prodromal (kwanaki 2–4):
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Zazzabi mai tsanani (zai iya kaiwa 40°C)
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Tari mai ci gaba, mura (ciwon hanci), da kumburewar idanu (conjunctivitis) — alamu uku na gargajiya
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Tabo'in Koplik (Koplik's spots) — fararen tabo masu shudin launi a cikin bakin kusa da hakora — alamar da ta kebance kyanda, tana bayyana kwana 1–2 kafin kuraje
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Tsananin haske a idanu (photophobia), gajiya, rashin son abinci
Matakin kuraje (kwanaki 4–7):
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Kuraje masu ja da fari (maculopapular rash) suna farawa a bayan kunnuwa da kan goshi, sannan suna bazu daga kai zuwa jiki har zuwa kafafu cikin kwanaki 3–4
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Zazzabi yakan kai matsayinsa mafi girma a lokacin da kuraje suka fara bayyanawa
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Kumburin glandin lymph a ko'ina; wani lokaci kumburin saifa (spleen)
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Kuraje suna bacewa ta hanyar da suka bayyana tare da fitar fatar jiki kamar kitse
Matakin warwarewa (mako 1–3):
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Zazzabi yakan ragu bayan kwanaki 3–4 daga bayyanar kuraje
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"Mantawar garkuwar jiki" (immune amnesia) — kwayar cutar tana lalata sel din ajiyan garkuwar jiki da suka rigaya suna jiki, tana kawar da kashi 11–73% na tarin kwayoyin garkuwa (antibodies) (Mina et al., Science 2019)
Sanin alamomi shine mataki na farko don amsa cikin sauri.
Tafiyar cuta
Matakan cutar kyanda:
- Lokacin ɓoye cuta: Kwanaki 10–14 (tsakanin kwanaki 7–21) daga kamuwa zuwa bayyanar kuraje.
- Matakin farko (kwanaki 2–4): Zazzaɓi mai tsanani (sau da yawa >40°C), tari, majina (ruwan hanci), kumburin ido (conjunctivitis) ("C uku"). Tabo na Koplik (farar tabo a cikin baki) sun bayyana kwanaki 1–2 kafin kuraje.
- Matakin kuraje (kwanaki 5–6): Kuraje masu launin ja sun fara a fuska, sun bazu zuwa jiki da gaɓoɓi cikin kwanaki 3. Zazzaɓi yakan kai kololuwa yayin bayyanar kuraje, sannan ya ragu.
- Matakin warkarwa: Kuraje sun ɓace bisa tsarin bayyanarsu (fuska da farko), sau da yawa tare da ɓarkewar fata. Jimlar lokacin rashin lafiya: kwanaki 7–10.
Yaɗuwa: Daga kwanaki 4 kafin zuwa kwanaki 4 bayan bayyanar kuraje. Mafi yawan yaɗuwa a matakin farko. Adadin yaɗuwa na asali (R₀): 12–18 (ɗaya daga cikin cututtukan ɗan adam mafi saurin yaɗuwa).
Binciken cuta
Yadda ake gano wannan cutar
Gwajin asibiti (Clinical diagnosis): Zazzabi mai tsanani + alamu uku (tari, mura, kumburewar idanu) + kuraje masu ja da fari masu saukowa daga kai a cikin mutum da ba a yi masa allura ba yana nuna kyanda sosai. Tabo'in Koplik sun kebance kyanda.
Tabbatar da dakin gwaje-gwaje (Laboratory confirmation — dole ne):
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IgM antibodies na kyanda (ELISA): Tana zama tabbatacciya daga rana ta 3 bayan kuraje. Inganci >90%.
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RT-PCR: Daga swab din hanci/makogwaro ko fitsari — gwajin da ya fi dacewa, yana gano nau'in kwayar halitta (genotype).
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IgG na lokuta biyu: Karuwa sau ≥4 a cikin samfurori biyu.
Rahoto: Cuta ce da dole a bayar da rahoton ta nan take a Najeriya (NCDC Integrated Disease Surveillance and Response — IDSR).
Magani
Hanyoyin magani da ake da su
Magani — tallafin jiki ne kawai (babu maganin kwayar cuta kai tsaye):
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Karin Vitamin A (shawarar WHO): IU 200,000 a baki na kwanaki 2 a jere (yara ≥12 wata). Yana rage mutuwa har zuwa kashi 50%. A Najeriya inda rashin abinci mai gina jiki ya yadu, wannan yana da muhimmanci matuka.
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Magungunan rage zazzabi (paracetamol ko ibuprofen) — a guji aspirin a yara (Reye syndrome)
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Shan ruwa isasshe da abinci mai gina jiki
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Magungunan rigakafin kwayoyin cuta (antibiotics) don cututtukan bacteria da suka biyo baya (kamar ciwon kunne, ciwon huhu)
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Kwantar da marasa lafiya a asibiti don matsalolin da suka yi tsanani (kumburin kwakwalwa, ciwon huhu, rashin ruwa mai tsanani)
Lura: A Arewacin Najeriya, inda rashin abinci mai gina jiki ya yadu musamman a tsakanin yara, kyanda tana da hatsari sosai — kashi na mutuwa na iya kaiwa 5% ko fiye.
Yawancin lokuta ana magance su yadda ya kamata tare da gano cutar da wuri.
Cikakkun bayanin rigakafi
Yadda za ka kare kanka
Allurar rigakafi — matakin da ya fi tasiri:
Allurar MMR (Measles, Mumps, Rubella) tana ba da kariya fiye da 97% bayan allurai biyu.
Jadawalin rigakafin yara na Najeriya (NPHCDA):
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Allura ta 1 na MR/Measles: A wata 9
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Allura ta 2 na MR/Measles: A wata 15
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Kamfen din rigakafin da ake yi a wasu lokutan (Supplementary Immunisation Activities — SIAs)
Kalubale a Najeriya:
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Yawan rigakafin allura ta farko a Najeriya: ~60–65% (kasa da matsakaicin duniya)
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Arewacin Najeriya: wasu jihohi sun yi kasa da 50%
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Dalilai: rashin isassun kayan aikin lafiya, matsalar tsaro, rashin wayar da kai, da wasu imani na addini/al'ada
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NPHCDA da abokan hulda suna aiki don inganta rigakafin yau da kullum (RI)
Rigakafi bayan an fuskanci cutar:
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Allurar MMR cikin sa'o'i 72 bayan fuskanci cutar
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Immunoglobulin cikin kwanaki 6 ga masu hadarin gaske
Bakin garkuwar al'umma (Herd immunity): ~95% da allurai biyu
Shirye-shirye shine mafi kyawun kariya.
Shawarar tafiya
Hadarin ga masu tafiya:
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Ka tabbatar an yi maka allurai biyu na MMR kafin kowace tafiya zuwa kasashen waje
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Hadari mai girma: Afirka ta kudu da Sahara (musamman Najeriya da sauran kasashen Yammacin Afirka), Kudancin da Kudu maso Gabashin Asiya
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Masu tafiya zuwa Arewacin Najeriya: hadari na musamman saboda karancin rigakafi
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Jarirai masu tafiya zuwa wuraren hadari: ana iya yi wa allurar MMR daga wata 6 ("allura ta sifili")
Yaya yawancinta?
Ƙididdiga da bayanan yanki
WHO ta kiyasta ~10.3 miliyan na kamuwa da cuta da ~107,500 na mutuwa a 2023. Najeriya tana daga cikin kasashen da suka fi fama da kyanda a duniya — NCDC tana samun rahotannin dubban shari'o'in da ake zargi a kowace shekara, musamman a lokacin rani (Janairu-Mayu). Yankin Arewacin Najeriya (Kano, Kaduna, Katsina, Jigawa, Zamfara, Sokoto) yana da kashi mafi girma saboda karancin yawan rigakafi. Sauran kasashen Yammacin Afirka (Niger, Chadi, Kamaru) ma suna fama da barkewar cutar akai-akai.
Dalilan haɗari
Wanene ke cikin haɗarin mafi girma
Kamuwa: Rashin allurar rigakafi (>90% hadarin kamuwa idan an samu cudanya), tafiye-tafiye na kasa da kasa, zama tare, rashin isasshen allurar rigakafi a cikin al'umma. Cuta mai tsanani: Shekaru <5 ko >20, rashin abinci mai gina jiki (musamman karancin bitamin A), raunin garkuwar jiki, ciki.
Cikakkun bayanan matsaloli
Rikitarwa da za ta iya faruwa
Matsaloli — sun fi yawa kuma sun fi hatsari a jarirai, masu rashin abinci mai gina jiki, da masu raunin garkuwar jiki:
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Ciwon kunne na tsakiya (Otitis media): Matsalar da ta fi yawa (7–9%)
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Ciwon huhu (Pneumonia): Babbar sanadin mutuwa daga kyanda (5%)
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Kumburin kwakwalwa mai tsanani (Acute post-infectious encephalitis): 1 a cikin 1,000. Kashi na mutuwa 10–15%, raunin kwakwalwa na dindindin a kashi 25%.
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Subacute Sclerosing Panencephalitis (SSPE): Cutar kwakwalwa mai kisa da ke bayyanawa bayan shekaru 7–10 daga kamuwa.
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Makanta: Saboda rashin Vitamin A da kyanda ta tsananta — matsala ta musamman a Arewacin Najeriya
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"Mantawar garkuwar jiki" (Immune amnesia): Lalacewar sel din ajiyan garkuwar jiki na watanni ko shekaru
Mutuwa: Kasashe masu ci gaban masana'antu: 1–2/1,000. Kasashe masu tasowa: 3–5% (na iya kaiwa 30% a tsakanin yawan jama'a masu rashin abinci mai gina jiki). A Arewacin Najeriya, yawan rashin abinci mai gina jiki da rashin samun kulawa ta likita suna sa hadarin mutuwa ya yi yawa.
Murmurewa da hasashe
Sakamakon da ake tsammani da murmurewa
Hasashen warkarwa gabaɗaya: Mai kyau ga mutane masu ingantaccen abinci waɗanda ke da damar samun kulawar lafiya. Adadin mutuwa (CFR) bai wuce 0.1% ba a ƙasashe masu arziki amma ya kai 3–6% a wuraren da ba su da isassun kayan aiki, kuma ya haura zuwa 25% a cikin yara marasa abinci mai gina jiki da al'ummomin da aka raba da muhallansu.
Matsalolin da ke shafar hasashen warkarwa:
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Ciwon huhu (babban dalilin mutuwar kyanda): 1–6% na marasa lafiya.
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Kumburin ƙwaƙwalwa (encephalitis): ~1 a cikin 1,000; 15% mutuwa, 25% lalacewar jijiyoyin da ba za ta warke ba.
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Subacute sclerosing panencephalitis (SSPE): cutar lalacewar tsarin jijiyoyi mai kisa, tana bayyana bayan shekaru 7–10 bayan kamuwa. Yawan faruwa: ~1 a cikin 10,000 na marasa lafiyar kyanda (ya fi yawa idan aka kamu kafin shekara 2).
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Mantuwar rigakafi: kyanda na lalata 11–73% na ƙwayoyin rigakafin da ke jiki, wanda ke ƙara haɗarin kamuwa da wasu cututtuka na tsawon shekaru 2–3 bayan warkarwa.
Warkarwa: Mafi yawan marasa rikitarwa suna warke gaba ɗaya cikin kwanaki 7–10. Rigakafi na dindindin bayan kamuwa ta halitta.