Sankarau (Meningitis)

Matakan cutar sanƙarau:

1. Lokacin ɓoye cuta: Kwanaki 2–10 (matsakaici kwanaki 3–4).
2. Matakin farko (sa'o'i): Alamomin numfashi na sama, zazzaɓi, ciwon kai — galibi ba ya bambanta da cutar ƙwayar cuta. Abu mai muhimmanci, wannan matakin na iya zama gajere ƙwarai.
3. Kumburin fatar ƙwaƙwalwa mai tsanani (sa'o'i zuwa kwanaki 1–2): Zazzaɓi mai tsanani, mummunar ciwon kai, taurin wuya, tsoron haske, amai. Alamomin Kernig da Brudzinski. Sauyin sani.
4. Gubar jini ta meningococcus (na iya faruwa tare ko ba tare da kumburin fatar ƙwaƙwalwa ba): Tabo na jini → shunayya → purpura fulminans. Ƙarancin matsin jini, saurin bugun zuciya, DIC. Na iya ci gaba daga alamar farko zuwa mutuwa cikin sa'o'i 12–24.
5. Warkarwa tare da magani: Ya kamata a ba da maganin ƙwayoyin cuta (ceftriaxone/cefotaxime) cikin sa'a 1 na zargin cutar. Dexamethasone a matsayin ƙarin magani.

Babban abu: Mummunar gubar jini ta meningococcus na iya ci gaba daga lafiya zuwa mutuwa cikin sa'o'i 12–24. Tabo na jini da ba sa ɓacewa idan aka matsa sune alamar haɗari da ke buƙatar gaggawar kulawar gaggawa.

Ana fara magani kafin sakamakon gwaji — kada a jira!

• Binciken asibiti: zazzabi + taurin wuya + kuraje masu jini a cikin mutum a yankin "bel din sankarau" a lokacin rani — isasshen zargin sankarau

• Blood culture + Lumbar puncture (LP) — nazarin ruwan kwakwalwa (CSF): glucose ↓, protein ↑, neutrophils ↑

• Gram stain: diplococci masu siffar kofi (Gram-negative)

• Latex agglutination — don gano serogroup

• PCR — ya fi dacewa, yana gano serogroup

• A Najeriya (NCDC protocol): a lokacin barkewar cuta, ana iya fara magani bisa alamun asibiti ba tare da LP ba idan ba a samu kayan aikin ba

• Bayar da rahoto nan take ga LGA, State Epidemiologist, da NCDC

Masu tafiya zuwa Arewacin Najeriya:

• A yi allurar ACWY musamman a lokacin rani (Disamba-Yuni)

• Hadari mafi girma a yankunan cunkoson jama'a

• Hajj/Umra: Allurar ACWY DOLE CE — sharadin visa

• Masu tafiya zuwa kasashen "bel din sankarau" (Niger, Chadi, Burkina Faso, Mali, da sauransu): allurar ACWY

Idan ka ga alamun zazzabi + ciwon kai + taurin wuya yayin tafiya a Najeriya: nemi likita NAN TAKE — ba a jira sai gobe ba.

Najeriya — daya daga cikin kasashen da suka fi shafuwa a duniya:

• Jihohin Arewa 10+ suna cikin "bel din sankarau" na Afirka

• Lokacin barkewar cuta: Disamba–Yuni (harmattan/lokacin rani) — iska mai bushewa tana cutar da membrane na hanci kuma tana sauƙaƙe kamuwa

• 1996: Mafi girmar barkewar sankarau a tarihin Najeriya (>100,000 shari'o'i, >11,000 mutuwa)

• 2009: Barkewar serogroup A (>50,000 shari'o'i)

• 2013-2014: MenAfriVac campaign — raguwar serogroup A >99%

• 2017: Barkewar serogroup C a Zamfara (>14,000 shari'o'i, >1,000 mutuwa)

• 2023-2024: Shari'o'in serogroups C/W suna ci gaba a jihohin Arewa

Serogroup shift: Bayan nasarar MenAfriVac wajen rage serogroup A, serogroups C, W, da X suka fara haifar da barkewar cuta — saboda haka allurar pentavalent (Men5cv) tana da matukar muhimmanci.

Tare da magani: CFR 8–15% (kumburin fatar ƙwaƙwalwa), 20–40% (gubar jini ta meningococcus).

Ba tare da magani ba: Kusan kashi 100% mutuwa.

Matsaloli a cikin waɗanda suka tsira:

• Rashin ji: 5–10%.

• Lalacewar jijiyoyi: 10–20% (lalacewar tunani, farfaɗiya, matsalolin motsi).

• Yanke gaɓoɓi (saboda purpura fulminans/DIC): 5–10% na waɗanda suka tsira daga gubar jini.

• Lalacewar ƙoda, zubar da jini a ƙwayar glandular (cutar Waterhouse-Friderichsen).

Abubuwan da ke nuna hasashen warkarwa: Shekaru ƙasa da 1 ko fiye da 60, saurin ci gaba, gubar jini ta meningococcus ba tare da kumburin fatar ƙwaƙwalwa ba, DIC, da suma suna nuna mummunan sakamako.

Warkarwa: Waɗanda suka tsira ba tare da babbar matsala ba yawanci suna warke gaba ɗaya cikin makonni 2–4.