Hukumomin hukuma sun kasance kuma suna ci gaba da inganta su ta hanyar hukumomin hukuma a cikin ƙasata - Brazil - ta daidai da FDA ɗin mu (ANVISA) da kuma wasu gwamnonin jihohi da masu unguwannin birni. Yin rufe fuska ya zama tilas a cikin jirage a duk faɗin ƙasar har zuwa Maris 1st 2023, kuma a cikin jigilar jama'a a wasu biranen, gami da São Paulo, birni mafi girma a Latin Amurka, har yanzu ana buƙatar su. Ko da yake daga injina (gwajin gwaje-gwaje) da mashina masu fa'ida masu ma'ana su ne tsangwama masu ma'ana, ba a tabbatar da ingancinsu ba a cikin gwajin da aka sarrafa bazuwar (RCTs).
Shugaban Majalisar Kula da Magunguna ta Brazil ya bayyana wannan gaskiyar daidai wasika zuwa ANVISA, wanda da ƙarfin hali ya ce: “Yin amfani da abin rufe fuska a matsayin alama na nagarta ko a matsayin ma’auni na jin daɗin zaman jama’a ba za a taɓa sanyawa a kan mutanen da ba su da irin wannan akidu ko ɗabi’a, musamman idan babu hujjar kimiyya ko ma yiyuwar cutar da lafiyar majiyyaci, kamar yadda yake a halin da ake ciki.”
Bukatar cewa abin rufe fuska ta hanyar RCTs ba kawai tsari ba ne; Magunguna da hanyoyin kwantar da hankali ba a yarda da su ba tare da ɗaya ko fiye da RCTs tare da bayyanannun sakamako masu mahimmanci. An gwada tasirin abin rufe fuska don rage watsa kwayar cutar a cikin RCT da yawa kafin da kuma bayan fara cutar ta COVID-19.
Masu binciken Cochrane sun sake duba su kuma sun sabunta su a cikin wani Takarda mai shafi 300 da aka buga a ƙarshen Janairu 2023. Ga waɗanda ba su da masaniya da wannan ƙungiyar, Cochrane wata cibiyar sadarwa ce ta duniya ta masu haɗin gwiwa wacce manufarta ita ce yin nazari da taƙaita mafi kyawun shaida daga binciken ilimin halittu, ba tare da tsangwama daga sha'awar kasuwanci da kuɗi ba, kuma shine babban mai ba da shawara na duniya don kula da lafiya na tushen shaida. An amince da sake dubawa na Cochrane a duniya azaman maƙasudin bayanai masu inganci.
Shekaru 10 na koyar da kwas a kan kimiyya da pseudoscience don kammala digiri a Jami'ar São Paulo (USP). A duk lokacin da ɗalibi ya tambaye ni "Mene ne ingantaccen tushen bayanan asibiti da ilimin halittu?" Na amsa, ba tare da lumshe ido ba: Cochrane. Wannan ya yi daidai da kyau kafin bayyanar cutar ta COVID-19, kuma har yanzu daidai yake.
Komawa zuwa nazarin Cochrane. Takardar ta duba tasirin wasu ayyukan da ba na likitanci ba kan watsa kwayar cutar numfashi, daga cikinsu akwai abin rufe fuska na likitanci/na tiyata. Ƙarshen nazarin 13 RCTs, wanda aka gudanar tsakanin 2008 da 2022, shine cewa raguwar haɗarin da abin rufe fuska ke bayarwa, dangane da gwajin dakin gwaje-gwaje don mura/SARS-CoV-2 ya kasance 1.01. Tazarar amincewa, wanda ke nuna bambancin tsakanin binciken da aka yi nazari a cikin bita, shine 0.72 (28 kashi raguwar haɗari) zuwa 1.42 (42 kashi karuwa). A wasu kalmomi, don abin rufe fuska don yin tasiri, rage haɗarin ya kamata ya kasance ƙasa da 1.0. Don haka marubutan sun kammala bisa waɗannan bayanan (mafi kyawun shaidar kimiyya da ake da su) cewa an gano abin rufe fuska ba shi da wani tasiri akan watsa kwayar cuta.
A zahiri, an riga an nuna rashin ingancin abin rufe fuska a cikin wani Binciken Cochrane na baya wanda aka buga a watan Disamba 2020. Tun kafin wannan lokacin, duk wanda ya kalli adabin kimiyya a fage, da ya zarce haka.
Akwai da'awar da aka yi ta hanyar rufe masu ba da izini cewa kimiyyar abin rufe fuska ta samo asali a cikin shekaru uku da suka gabata kuma abin rufe fuska, abin rufe fuska na likita da abin rufe fuska ba su isa ba. Madadin haka, ya kamata mu yi amfani da na'urorin numfashi bisa ka'idojin P2/N95. Wannan dalili, duk da haka, yana da wasu kurakurai. Da farko, yawancin mutane suna amfani da abin rufe fuska ko abin rufe fuska, wanda ya fi araha fiye da na numfashi.
Bugu da ƙari, sake dubawa na Cochrane ya kuma kimanta 5 RCTs wanda ya kwatanta P2 / N95 respirators zuwa likitancin likita / tiyata. Rage haɗarin da aka haɗu ya kasance 1.10, tare da tazarar amincewa na 0.90 zuwa 1.34, ma'ana cewa masks na tiyata / likitanci sun yi mafi kyau fiye da masu numfashi na P2/N95, amma sakamakon bai kasance mai mahimmanci ba.
Bugu da ƙari, a cikin Disamba 2022, RCT wanda ke kwatanta tasirin abin rufe fuska na likita da masu numfashi na N95 An buga watsawar COVID-19. Wannan binciken, wanda aka gudanar a wuraren kiwon lafiya 29 a Kanada, Isra'ila, Pakistan da Masar, shine mafi girman RCT akan masu ba da numfashi na N95 da aka taɓa gudanarwa. Sakamakon haka shi ne babu wani gagarumin bambanci tsakanin kungiyoyin da suka yi amfani da N95 da wadanda suka yi amfani da abin rufe fuska. A takaice dai, N95 bai fi abin rufe fuska ba. Kuma tunda mun rigaya mun san cewa abin rufe fuska na likita ba sa hana yaduwar kwayar cutar….
Bayanan duniya na ainihi (wanda ake kira shedar muhalli) wani nau'i ne na bincike wanda ba shi da tsauri fiye da RCTs amma har yanzu yana da bayanai kuma yana samuwa. Misali, na nuna a cikin a takarda da aka buga a watan Afrilu 2022 Spain da Italiya, bi da bi, suna da ƙimar rufe fuska da kashi 95 cikin ɗari da kashi 91 cikin ɗari (kashi na mutanen da ke da'awar sanya abin rufe fuska koyaushe lokacin barin gida), watau mafi girman ƙimar riko da abin rufe fuska a duk Turai yayin lokacin hunturu na 2020-2021.
Daga cikin kasashen Turai 35 da aka yi nazari a wannan lokacin, Spain da Italiya sun kasance na 18 da 20, bi da bi, dangane da adadin COVID-19. A ka'idar, idan abin rufe fuska ya hana watsa kwayar cutar, ya kamata mutanen Spain da Italiya su sami mafi ƙarancin adadin COVID-19, amma ba haka ba ne abin da bayanan ke nunawa.
A matsayin wani misali, Japan, wacce aka santa da yawan amfani da abin rufe fuska kafin barkewar cutar, ta sami ƙaruwa sau 15 a cikin shari'o'in COVID-19 tsakanin 1 ga Janairu da Disamba 31, 2022 (daga miliyan 1.73 zuwa miliyan 29.23), kodayake Yawan amfani da abin rufe fuska bai taɓa yin kasa da kashi 85 cikin ɗari ba a ƙasar nan.
An ambaci babban matakin rufe fuska a Japan a farkon shekarar cutar a matsayin dalilin karancin COVID-19 a can. Amma nasarar da Japan ta samu na yaƙar COVID-19 ba ta daɗe ba, kuma ba ta da alaƙa da rufe fuska, kamar yadda “ƙwararrun masana” za su gano idan sun ɗan jira kaɗan. Ko da yake ba za a iya amfani da shaidar muhalli don haifar da dalili ba, yana nuna cewa a matakin yawan jama'a, abin rufe fuska ya gaza kuma.
Wani batu da wasu “masana” suka yi shi ne abin rufe fuska ga ƙwayoyin cuta na numfashi, kamar yadda kwaroron roba ke kamuwa da cututtukan da ake ɗauka ta hanyar jima'i (STDs). Koyaya, kwaroron roba da abin rufe fuska ba kwatankwacinsu bane, musamman saboda waɗannan PPEs guda biyu suna ba da matakan kariya daban-daban. Ba zai yiwu a gwada tasirin kwaroron roba kai tsaye kan rigakafin STD ba saboda la'akari da la'akari (musamman a lokuta na cututtukan da ba za a iya warkewa ba kamar AIDS).
Maimakon haka, an gudanar da RCTs kwatanta tasirin latex ko wasu nau'in kwaroron roba don hana ciki. Matsakaicin tasirin kwaroron roba na gargajiya, daga nazarin daban-daban 11, ya kasance 97.8 kashi (Rage haɗarin ninka sau 50). A gefe guda, RCT mafi dacewa ga amfani da abin rufe fuska, (cRCT na Bangladesh) ya nuna raguwar haɗarin kawai. 11.6 kashi (1.13-ninka). Hujjar cewa abin rufe fuska yana daidai da kwaroron roba ba ta da tabbas.
Shin akwai shaidar kimiyya cewa abin rufe fuska yana da tasiri wajen hana watsa kwayar cutar numfashi? Ee, akwai. Amma duk karatun su ne na lura (ko sake dubawa) na ƙarancin inganci idan aka kwatanta da RCTs. Gwamnati da kafofin watsa labarai sun yi amfani da waɗannan ƙananan karatun don sanya abin rufe fuska ga jama'a.
Wannan batu yana da mahimmanci don haka zan sake maimaita shi: an ƙaddamar da umarnin masking bisa ga ƙananan ƙananan karatu, a cikin kuɗin da aka fi dacewa da gwaje-gwajen da aka bazu, wanda ya nuna, gaba ɗaya, cewa ba su rage yaduwar kwayar cutar ba a cikin tsauraran gwaje-gwajen da aka sarrafa. A matsayinka na mai mulki, mafi kyawun ingancin binciken (misali, dubawa tare da gwaje-gwajen da bazuwar), rage tasirin abin rufe fuska. Bai kamata a ɗauki waɗannan gwaje-gwajen a matsayin shaida na sanadi ba kuma tabbas kada a sanar da manufofin lafiyar jama'a.
A gefe guda kuma, ingantattun hanyoyin, kamar kwaroron roba don hana ciki da STDs, da alluran rigakafi da maganin rigakafi don rigakafi da magance cututtuka, gabaɗaya suna ba da kyakkyawan sakamako. Ɗauki, alal misali, nazarin meta-nazari na Cochrane guda biyu waɗanda suka yi nazarin amfani da maganin rigakafi. A daya daga cikinsu, An gwada maganin rigakafi don tsananin ciwon huhu a cikin yara, tare da nasarar nasarar 80-90 bisa dari. Wani meta-bincike yayi nazari akan yadda ake amfani da maganin rigakafi akan cutar typhus na karkara tare da samun nasarar kashi 95-100 cikin XNUMX.
Mun kuma ga cewa kwaroron roba yana da ƙimar inganci na kashi 98 cikin ɗari.
Sabanin haka, ƙididdigar meta-bincike na Cochrane akan masks ya nuna tasirin sifili akan ƙwayar mura ko watsa SARS-CoV-2! Wannan shine dalilin da ya sa maganin rigakafi da kwaroron roba suna da tasiri mai tasiri kuma ba abin rufe fuska ba.
Ganin bayyanar da ke sama, me yasa har yanzu wasu hukumomin kiwon lafiya ke inganta sanya abin rufe fuska? Wasu ƴan hasashe: (1) shinge na zahiri yana ba da ma'anar aminci - ko da ni, wanda ya san abin rufe fuska ba na karewa, na ji mafi aminci sanya ɗaya; (2) hujjojin injina (gwajin gwaje-gwaje) ya nuna cewa abin rufe fuska yana tace ƙwayoyin cuta (ko da yake abin rufe fuska ko abin rufe fuska, wanda yawancin mutane ke sawa, kawai suna ba da gudummawa). Kashi 10 zuwa 12 na ingancin tacewa); (3) rashin isasshen ilimin shaidar kimiyya.
Duk da shaidar da aka bayar ta hanyar RCTs da aka buga da sake dubawa na tsari, wasu hukumomi suna ci gaba da da'awar cewa ya kamata a gudanar da ƙarin gwaje-gwaje na asibiti, amma ba yanzu ba… saboda gudanar da RCTs yayin bala'i zai zama rashin da'a.
Bisa ga wannan akida ta halin yanzu, ka'idar yin taka tsantsan tana nuna cewa muna amfani da abin rufe fuska, ko da ba tare da sanin ko suna aiki ko a'a ba. Koyaya, yakamata a tuna cewa an gudanar da RCTs biyu na abin rufe fuska yayin bala'in COVID-19.
Bugu da ƙari, duk gwaje-gwajen da aka yi bazuwar da aka gudanar har zuwa yau sun nuna a kai a kai cewa masks ba su da tasiri wajen rage watsa kwayar cuta; sabili da haka, ciki har da ƙungiyar kulawa (ba tare da abin rufe fuska ba), ko da a lokacin annoba, ba zai iya haifar da haɗari ga mahalarta nazarin ba.
An haɓaka abin rufe fuska azaman kayan aiki mai mahimmanci don rage ko ma dakatar da yaduwar SARS-CoV-2 yayin bala'in COVID-19. Doka ta ba da umarnin sanya abin rufe fuska a wuraren jama'a a kasashe da yawa.
Koyaya, tun kafin barkewar cutar, mafi kyawun shaidar da ake samu - gwaje-gwajen da aka sarrafa bazuwar - sun riga sun nuna cewa abin rufe fuska ba su da tasiri wajen ɗauke da kwayar cutar ta numfashi. Ƙarin RCTs da aka gudanar yayin bala'in sun goyi bayan wannan ƙarshe. Don haka, mafi kyawun shaidar da aka samu ba ta goyan bayan ko da shawarar sanya abin rufe fuska ba, balle a sanya su tilas.
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Beny Spira farfesa ne a sashen nazarin halittu a Jami'ar São Paulo, Brazil.
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