Bayanin gabaɗaya
Zazzabi mai ruwan lemo (yellow fever) cuta ce mai haɗari da kwayar cutar yellow fever virus ke haifarwa, sauro Aedes ke yaɗa ta. Allurar rigakafi tana da tasiri na tsawon rai.
Alamomi
Alamomi | Yawan faruwa | Tsanani | Farawa |
|---|---|---|---|
| Ciwon baya | 75% | Matsakaici | Farkon cuta |
| Raguwar bugun zuciya | 35% | Dan kadan | Farkon cuta |
| Sanyi | 85% | Dan kadan | Farkon cuta |
| Zazzabi | 95% | Matsakaici | Farkon cuta |
| Ciwon kai | 90% | Matsakaici | Farkon cuta |
| Ciwon tsoka | 80% | Matsakaici | Farkon cuta |
| Jan ido | 35% | Dan kadan | Farkon cuta |
| Jiri | 40% | Dan kadan | Farkon cuta |
| Gajiya | 65% | Dan kadan | Farkon cuta |
| Rashin son ci | 50% | Dan kadan | Farkon cuta |
| Tashin zuciya | 70% | Dan kadan | Farkon cuta |
| Amai | 55% | Dan kadan | Farkon cuta |
| Ciwon ciki | 14% | Mai tsanani | Kololuwar cuta |
| Zubar jinin dausayi | 11% | Mai tsanani | Kololuwar cuta |
| Zubar jini | 10% | Hadari | Kololuwar cuta |
| Zazzabi mai tsanani | 12% | Hadari | Kololuwar cuta |
| Shanƙe | 17% | Mai tsanani | Kololuwar cuta |
| Ƙananan ɗigon jini | 9% | Mai tsanani | Kololuwar cuta |
| Rikicewa | 5% | Hadari | Kololuwar cuta |
| Duhuwar fitsari | 8% | Mai tsanani | Kololuwar cuta |
| Ƙarancin ruwa a jiki | 6% | Matsakaici | Kololuwar cuta |
| Raguwar matsin jini | 4% | Hadari | Kololuwar cuta |
| Ƙarancin fitsari | 7% | Mai tsanani | Kololuwar cuta |
| Farfaɗiya | 3% | Hadari | Kololuwar cuta |
| Girgiza | 4% | Hadari | Kololuwar cuta |
Hanyoyin yaduwa
Bayanin gabaɗaya
Zazzaɓin rawaya cuta ce mai tsanani ta zubar jini da ƙwayar cutar zazzaɓin rawaya (YFV, dangin Flaviviridae) ke haddasa ta. Sauro irin Aedes da Haemagogus ne ke yaɗa ƙwayar cutar. Sunan "zazzaɓin rawaya" ya fito ne daga rawaya da ke bayyana saboda lalacewar hanta. Tana yaɗuwa a yankunan zafi na Afirka da Kudancin Amurka. Allurar YF-17D tana ba da kariya kusan 100% da allura ɗaya kuma tana ba da rigakafi na rayuwa.
Bayanin gabaɗaya
Zazzabin rawaya (yellow fever) cuta ce da kwayar cutar YFV (Flaviviridae) ke haifarwa. Ana yaduwa ta hanyar cizon sauro nau'in Aedes da Haemagogus. Najeriya tana daya daga cikin kasashe 34 na Afirka da cutar ke yaduwa a ciki (endemic) — an samu babbar barkewar cutar a shekarar 2017-2018 (jihohin Kwara, Kogi, Zamfara, da sauransu) tare da mutuwar mutane da dama. Ita ce kadai cutar da ake bukata shaida ta alurar rigakafi (International Certificate of Vaccination or Prophylaxis, ICVP — 'Yellow Card') wajen shiga da fita kasashe a karkashin IHR 2005. Dukkan matafiya zuwa Najeriya DOLE su samu allurar rigakafin zazzabin rawaya. A yankin Yammacin Afirka, cutar tana yaduwa a dazuzzuka (sylvatic cycle — tsakanin birai da sauro), a yankin karkara (savannah cycle), da kuma a birane (urban cycle — mafi hatsari, inda Aedes aegypti ke yaduwa a biranen). Cutar tana da matsala biyu: yawancin mutane ba sa nuna alamomi (80%), amma wadanda suka shiga mataki na biyu (toxic phase) suna da hadarin mutuwa na kashi 20-60%. Allurar rigakafi ta 17D ita ce mafi kyawun makami — allura guda daya tana ba da kariya na tsawon rayuwa (WHO ta canza shawararta a shekarar 2016 — ba sai an yi booster ba). Najeriya ta gudanar da manyan yakin allurar rigakafi a shekarun 2018-2023 don kare miliyoyin mutane, musamman a jihohin da suka fi fuskantar cutar.
Alamomin gaggawa
GAGGAWA: zazzabi + rawaya (jaundice) + zubar jini bayan zama a yankin da cutar ke yaduwa → je asibiti NAN DA NAN. Amai na jini (black vomit). Rashin fitsari. Suma. Ci gaba da lalacewa bayan lokacin jin sauki na dan lokaci — wannan alama ce mai hatsari sosai.
Cikakkun alamomi
Alamomi da alamu mafi yawa
Mataki na 1 (acute phase, kwanaki 3-4): zazzabi kwatsam, ciwon kai, ciwon tsoka, ciwon baya, amai, rashin cin abinci. Fasali na musamman: bugun zuciya a hankali duk da zazzabi (relative bradycardia — alamar Faget). Mataki na hutawa: wasu marasa lafiya suna jin sauki na dan lokaci (kwanaki 1-2). Mataki na 2 (toxic phase — kashi 15-25% na marasa lafiya): rawaya mai tsanani (jaundice — saboda haka sunan 'zazzabin rawaya'), zubar jini daga baki, hanci, da idanu ('amai bakin jini' / black vomit), gazawar koda (oliguria zuwa anuria), suma, da mutuwa. Mutuwa tana faruwa ne a cikin kwanaki 7-10 bayan fara alamomi.
Sanin alamomi shine mataki na farko don amsa cikin sauri.
Tafiyar cuta
Matakan cutar rawaya:
- Lokacin ɓoye cuta: Kwanaki 3–6.
- Lokacin kamuwa (kwanaki 3–4): Zazzaɓi mai tsanani ba zato ba tsammani (39–40°C), ciwon kai, ciwon tsokoki, ciwon baya, tashin zuciya, amai. Alamar Faget (bugun zuciya mai jinkiri duk da zazzaɓi). Ƙwayoyin cuta suna cikin jini — sauro na iya kamuwa.
- Lokacin hutu (sa'o'i 24–48): Zazzaɓi da alamomi sun dan ragu na ɗan lokaci. Mafi yawan marasa lafiya suna warke a wannan matakin.
- Lokacin guba ("matakin guba", 15% na marasa lafiya): Zazzaɓi ya dawo tare da rawaya (gazawar hanta), zubar da jini (amai na jini — "vomito negro," zubar da jini daga ɓangarorin jiki), gazawar ƙoda (ƙarancin fitsari, ƙaruwar creatinine), DIC.
- Warkarwa ko mutuwa (kwanaki 7–10 daga farawa): Mutuwa yawanci tana faruwa kwanaki 7–10 bayan farawa, galibi daga gazawar gaɓoɓi da yawa. Waɗanda suka tsira suna warke a hankali cikin makonni 2–4.
Binciken cuta
Yadda ake gano wannan cutar
Gwajin jini: IgM ELISA (antibody) — yana nuna a kwanan nan ne aka kamu; ana iya cakuda tsakanin sa da sauran Flaviviruses (dengue, Zika). RT-PCR — mafi daidai, yana gano kwayar cutar a cikin kwanaki 5 na farko. PRNT (Plaque Reduction Neutralisation Test) — don tabbatar da cutar. Gwajin hanta: ALT/AST mai tsayi sosai. Bilirubin mai tsayi (jaundice). Gwajin jini na gama gari: karancin farin jini (leucopaenia), karancin platelets.
Magani
Hanyoyin magani da ake da su
Babu maganin kashe kwayar cutar (no antiviral). Magani na tallafawa (supportive care) kawai: ba da ruwa ta jijiya (IV fluids), maganin rage zazzabi (paracetamol — KADA a bai wa mai cutar aspirin ko ibuprofen saboda hadarin zubar jini), kula da gazawar koda (dialysis idan ya cancanta), jini (blood transfusion) idan zubar jini ya yi yawa. Kulawa ta musamman a ICU ga marasa lafiya masu tsanani.
Yawancin lokuta ana magance su yadda ya kamata tare da gano cutar da wuri.
Cikakkun bayanin rigakafi
Yadda za ka kare kanka
Allurar rigakafi ta 17D: DOLE ga dukkan mutane masu shekara 9 wata zuwa sama a Najeriya. Allura guda daya tana ba da kariya na tsawon rayuwa (WHO 2016). Shaida ta alurar rigakafi (ICVP/Yellow Card) DOLE a samu kafin tafiya zuwa ko daga Najeriya — allurar za ta yi aiki ne bayan kwanaki 10 daga shan ta. Wanda ba zai iya shan allurar ba (masu rashin karfin garkuwar jiki, mata masu juna biyu, yara 'yan kasa da watanni 6, masu rashin jituwa da kwan kwado/eggs): likita zai ba da wasikar keban (medical waiver). Kare kai daga cizon sauro: gidan sauro, DEET, tufafi masu rufe jiki. Najeriya: EYN (Eliminate Yellow Fever Epidemics) — shirin rigakafi na kasa.
Shirye-shirye shine mafi kyawun kariya.
Shawarar tafiya
DOLE: Allurar rigakafin zazzabin rawaya ga dukkan matafiya zuwa Najeriya da Yammacin Afirka — a sha allurar aƙalla kwanaki 10 kafin tafiya. A samu Yellow Card (ICVP) kuma a adana ta sosai — ana iya neman ta a kan iyaka. Matafiya daga Najeriya zuwa wasu kasashe (musamman Asiya da Tsakiyar Gabas): wasu kasashe suna bukata Yellow Card daga dukkan masu zuwa daga Najeriya. Bayan tafiya: idan ka/ki ji zazzabi da rawaya (jaundice) cikin mako 2 bayan dawowa — je asibiti nan da nan kuma fada cewa ka/ki je yankin zazzabin rawaya.
Yaya yawancinta?
Ƙididdiga da bayanan yanki
Najeriya: daya daga cikin kasashe 34 na Afirka da cutar ke yaduwa. Babbar barkewa a 2017-2018 (>4,000 masu shakku, >200 tabbatattun shari'o'i, mutuwa >45 a jihohin Kwara, Kogi, Zamfara, Edo, Borno). Duk shekara ana samun rahotannin kamuwa a jihohin tsakiyar Najeriya da arewa. Jigawa, Bauchi, Borno, Gombe: an samu kamuwa a 2020-2024. NCDC tana sa ido kan cutar a kowace shekara.
Dalilan haɗari
Wanene ke cikin haɗarin mafi girma
Rashin allurar rigakafi, zama/tafiya zuwa yankunan da cutar ke yaɗuwa (Afirka ta yamma/tsakiya, Kudancin Amurka), fallasa ga cizon sauron Aedes, ayyukan waje a cikin dazuzzuka (yanayin sylvatic), shekaru >60 (ƙarin haɗarin mummunan tasirin allurar YEL-AVD).
Cikakkun bayanan matsaloli
Rikitarwa da za ta iya faruwa
Kashi 15-25% na masu cuta mai tsanani na mutuwa. Gazawar hanta da koda, zubar jini mai tsanani (DIC), coma.
Murmurewa da hasashe
Sakamakon da ake tsammani da murmurewa
Cutar mai sauƙi/matsakaici (~85% na marasa lafiya masu alamomi): Cutar tana warke da kanta, cikakkiyar warkarwa cikin kwanaki 3–4.
Mummunar cuta (~15% na marasa lafiya masu alamomi, "matakin guba"):
-
CFR 20–50% da zarar matakin guba ya fara.
-
Mummunar cutar hanta, gazawar ƙoda, zubar da jini, gazawar gaɓoɓi da yawa.
-
Babu takamaiman maganin ƙwayoyin cuta — kulawar tallafi ne kawai.
Gabaɗaya: Mafi yawan kamuwa ba su da alamomi ko masu sauƙi ne. Daga cikin waɗanda suka nuna alamomi, ~15% suna ci gaba zuwa mummunar cuta. Adadin mutuwa na gabaɗaya: ~3–7.5%.
Warkarwa: Waɗanda suka tsira suna samun rigakafi na dindindin. Babu yanayin ɗauke da cuta na dindindin.
