Lafiyar Yanki na Lancet - Turai
Editan Edita,
Nordstrӧm et al. sun yi nazarin tasirin dangi na kashi na huɗu na allurar Covid akan duk abin da ke haifar da mutuwa, tare da allurai uku, a cikin tsofaffi mazauna Sweden. Ɗaya daga cikin rukuninsu biyu ya ƙunshi mazauna gidajen kulawa 24,524. Marubutan sun kiyasta tasirin rigakafin kusan kashi 40 cikin 0.6 a cikin tsofaffi marasa ƙarfi (yawan adadin kusan XNUMX).
Kamar yadda zan nuna a nan, sakamako na gaskiya ya kasance wani wuri tsakanin ƙimar rabo na 1.2 da 2.4, wato, tasiri mara kyau. Kashi na huɗu ba shi da amfani a mafi kyau, kuma mai yiwuwa cutarwa ga wannan jama'a masu rauni.
Tsarin binciken ya kasance mai sauƙi. An daidaita masu karɓa na kashi uku zuwa masu karɓa na kashi huɗu akan nau'i-nau'i da yawa, kuma an bi ƙungiyar da ta dace don mutuwa daga kowane dalili. Marubutan sun tsallake makon farko bayan alurar riga kafi kuma sun kiyasta tasirin a cikin tazara biyu. Mafi kyawun sakamako (ingantacciyar tasiri na kashi 39 cikin ɗari) an samo shi ne daga lokacin biyo baya na kwanaki 7-60, wanda kashi uku cikin huɗu na mutuwar ya faru.
Marubutan sun san mabuɗin barazanar ga ingancin sakamakon su: saura ruɗani ta halayen lafiya marasa aunawa. Suna rubuta:
"Bugu da ƙari, duk da cewa masu karɓa na uku suna da halaye iri ɗaya kamar masu karɓa na huɗu, wasu masu karɓa na uku ba su sami kashi na huɗu ba saboda tabarbarewar lafiyar da ba a kama su ta asali ba. Idan haka ne, wannan zai ƙara haɗarin mutuwa kuma ya haifar da ƙima mai girma VE."
Wannan shine "kyakkyawan rigakafi" son zuciya, an rubuta akai-akai a cikin bayanai daban-daban daga ƙasashe daban-daban. Alurar riga kafi sun fi koshin lafiya, a matsakaita, fiye da waɗanda ba a yi musu allurar ba, kuma waɗanda suka karɓi adadin N+1 sun fi waɗanda suka karɓi adadin N. Wannan gaskiya ne a cikin bayanan UK don masu karɓar kashi na uku (a kan masu karɓa na kashi biyu) da masu karɓar kashi na huɗu (a kan masu karɓa na kashi uku).
Abin farin ciki, ana iya cire son zuciya, aƙalla da ƙima. Masu bincike daga Hungary da kuma Amurka (da kuma kaina) da kansa ya ba da shawarar irin wannan hanyar gyara don mutuwar Covid, ta amfani da bayanai kan mutuwar marasa Covid. Muna ƙididdige abin son zuciya - rabon mutuwar marasa lafiya a cikin ƙungiyar marasa lafiya tare da ƙungiyar mafi koshin lafiya - wanda ke nuna halaye daban-daban na asali. Bayan haka, muna haɓaka haɗarin haɗarin mutuwa na Covid ta hanyar nuna son kai.
Hankali mai sauƙi ne: muna daidaita haɗarin mutuwar Covid sama a cikin ƙungiyar mafi koshin lafiya, don ƙirƙirar ƙungiyoyi biyu waɗanda ke da kwatankwacin haɗarin mace-mace. Sauran bambancin mace-mace, a kowace hanya, yakamata a kimanta tasirin rigakafin. Gyaran yana ɗaukan mu fiye da daidaitawar da ba ta cika ta hanyar daidaitawa ko jujjuyawar juzu'i ba saboda yana da lissafin ma'auni masu dacewa marasa aunawa.
Babu bayanai game da mutuwar Covid da mutuwar Covid-19 a cikin binciken Nordstrӧm et al., amma ana iya amfani da wannan gyara ga duk mace-mace, ƙarshen binciken, kamar yadda bayani na gaba.
Cewa masu karɓa na kashi huɗu sun fi koshin lafiya ya bayyana a cikin jadawali na mace-mace, waɗanda suka rabu a farkon abin da aka biyo baya (Hoto a ƙasa). Wannan bayyanannen nuni ne na haɗarin mace-mace daban-daban saboda ba ma tsammanin wata fa'ida ta kashi na huɗu a cikin mako ɗaya na allura. Don haka, adadin mace-mace a ƙarshen makon farko ya kamata ya ƙididdige abubuwan son zuciya, waɗanda za a iya amfani da su don daidaita ma'auni, wanda aka samo daga baya, yanke-hagu, bibiya.
Ba ni da wani bayani kan adadin ko adadin wadanda suka mutu kafin rana ta bakwai (kimanin 150?), Na gani a gani na kimanta wannan rabon ya kai kusan 4 (girman adadi a hagu).
A hannun dama na tebur na 3 na marubuta (a ƙasa), Na ƙididdige madaidaicin ƙimar da aka gyara don duk abin da ya haifar da mutuwa a cikin kwanaki 7-60 na biyo baya, tare da ɗaukar nauyin ƙima na 4 (ƙididdigar gani), 3, da 2 (mafi yawan mazan jiya). Tasirin da aka gyara ya tashi daga 2.4 zuwa 1.2 akan kashi na hudu, sakamako mai cutarwa.
Irin wannan son zuciya mai ƙarfi ya bayyana a ciki nazarin mazauna gidajen jinya a Isra'ila a lokacin yakin neman rigakafin farko. Bayan gyare-gyare, ƙididdigar haɗarin haɗari (masu allurai biyu tare da ba a yi musu allurar rigakafi ba) ya kasance 1.6 a cikin kwanaki 30 na biyowa kuma ba ta da kwanaki 60 na biyo baya. Kamar yadda kuka sani, babu wasu gwaje-gwajen da bazuwar da ke da ƙarshen mace-mace. Nazarce-nazarcen lura da son zuciya duk abin da muke da shi ne.
Hukumomin kiwon lafiyar jama'a a Sweden da sauran wurare suna ba da shawarar wani mai haɓakawa ga masu rauni, mazauna gida a cikin faɗuwar mai zuwa. Na tabbata mun yarda cewa babu wanda yake so ya ba da shawarar allurar da ba ta da amfani a mafi kyau, kuma mai yiwuwa cutarwa.
Zan iya mika muku wannan wasiƙar, kamar yadda aka saba yi, kuma in buga a nan, idan an ƙi. Koyaya, na yi ƙoƙarin gabatar da wasiƙu sau uku kafin kuma ya yanke shawarar sauya odar wannan lokacin. Ba zato ba tsammani, nawa biyu An ƙaddamar da wasiƙar da aka ƙi zuwa ga Lancet, kuma batun da na yi a can game da saura ruɗani son rai an fallasa kwanan nan (da wasu) a ciki wasika ga editan jaridar New England Journal of Medicine.
Ina fatan za ku nemi amsar marubutan, ku buga wannan wasiƙar a cikin mujallar ku, kuma ku yi la'akari da janye takardar ta hanyar. Nordstrӧm et al.
gaske,
Eyal Shahar, MD, MPH
Farfesa Emeritus na Lafiyar Jama'a
https://www.u.arizona.edu/~shahar/
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Dokta Eyal Shahar farfesa ne a fannin kiwon lafiyar jama'a a fannin cututtukan cututtuka da kididdiga. Binciken nasa yana mayar da hankali ne akan ilimin cututtuka da kuma hanyoyin. A cikin 'yan shekarun nan, Dr. Shahar ya ba da gudummawa sosai ga hanyoyin bincike, musamman a fannin zane-zane da kuma son zuciya.
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