A cikin 2015, cutar kwalara daga Arewa maso Gabashin Brazil ta fashe cikin labarai, tare da goyan bayan faɗakarwar lafiyar jama'a da ba ta da ƙarfi cewa Zika - flavivirus da aka yarda shekaru da yawa ba shi da lahani - a yanzu ba zato ba tsammani ke da alhakin microcephaly na haihuwa (jarirai masu ƙanƙan kai, ƙarancin hankali). Kwararru masu alaƙa da WHO a Latin Amurka sun ba da shawarar cewa mata su bar haihuwa har abada - maiyuwa har sai an ƙirƙira rigakafin Zika (har yanzu ba a gane ba). Babban firgici ya faru.
Babu ko guda ɗaya na cututtukan likitancin ɗan adam da a baya aka danganta da Zika - tagwaye kusa da kwayar cutar dengue (wanda ita kanta ke kawo cutar “zazzaɓin kasusuwa” na Kudancin Amurka miliyan, kowace shekara) - kuma ba tare da wani haɗin gwiwa na microcephaly ba. Cibiyar binciken likitancin Brazil ta yi maganin da'awar Zika- (da kuma daga baya microcephaly-) tare da shakku na farko - amma sau biyu ya rinjayi kafofin watsa labarai masu cin gashin kansu - na karshensu. ya shiga cikin firgici na kasa baki daya.
Tashe-tashen hankula daga Zika-microcephaly sun haɗa da wuce gona da iri na lafiyar jama'a: shawarwarin tafiya; Sojojin Brazil a kan tituna; tsoro mara gogewa; umarnin gaggawa da aka gabatar don zubar da ciki; rashin har abada na fiye da 100,000 "fatalwa" yara 'yan Brazil (jarirai ba a cikin ciki a lokacin firgita).
- "Oh, yana da iyaka akan yanayin tsoro ga mata masu ciki. Matan arziƙi sun ƙaura zuwa kudu. Ga mata:
- suna damuwa ko za su iya yin ciki;
- yi amfani da ƙarin (yadudduka na tufafi), da fatan kada a shafa;
- (maganin maganin kwari) wanda… na iya haifar da wata matsala."
– Dr. Sandra da Silva Mattos
An yi sa'a, cutar ta Zika ta ɓarke a fili ba tare da sanin ya kamata ba; bai taɓa cika hasashen masu sharhi na ƙarin ba miliyan microcephalic haihuwa kowace shekara, duniya. Duk da haka, bacewarsa gabaɗaya bai haifar da wani masanin kimiyya guda ɗaya yana tambayar sahihancin abin da ke cikin tushe (wataƙila ƙarya): cewa karɓar Zika mai ɗaukar hoto Aedes aegypti Cizon sauro a farkon ciki na iya lalata rayuwar da ake so a ciki.
Zika, wanda aka gano a Uganda a cikin 1947, ya ba da garantin a zahiri kawai biredi ta dozin na ilimi articles a cikin shekaru 60, babu wanda ya tabbatar da wani hatsarin ɗan adam. A cikin 2007, an sami ɗan ƙaramin “kugi” kamar yadda wasu cututtukan dengue a cikin Pacific suka yi wa lakabi da CDC (bayan gaskiya kuma ba tare da alaƙar asibiti ba) da Zika.
Zika in Bahia
A cikin 2015, cutar Zika ba ta taɓa fitowa a cikin Amurka ba. Ba a samu gwajin cutar Zika na yau da kullun ba har sai watanni da yawa bayan sanarwar barkewar cutar ta Brazil. Yawancin likitoci da sauran jama'a ba su taɓa jin labarin ba. Duk da haka, duk da (ko watakila saboda) rashin mahimmancin Zika, ya zama kyautar da ba za a iya samu ba a cikin farautar kayan aikin likita. Zuwa ga likitocin farauta, a priori, don ƙwayar cuta ta shafi canjin zamantakewa Zika yana wakiltar yumbu - ta hanyar buri da tsinkayen da aka ƙera zuwa cikakkiyar tsoro mai aiki.
A cikin 2014, likitocin Carlos Brito (na Recife) da Kleber Luz (na Natal) sun kafa ƙungiyar WhatsApp tare da ainihin manufar sanar da sabuwar ƙwayar cuta a cikin Brazil; gano wanda zai magance rashin adalcin al'ummar Brazil ta hanyar kawo kudi da kulawa ga yankunan Arewa maso Gabas na Brazil. Sun kira shi "CHIKV, Ofishin Jakadancin"- yana nufin duka manufarsu"chikungunya" (aka "CHIKV", kwayar cutar Afirka da ke iya yin kutsawa cikin Feira de Santana, Bahia-Brazil a lokacin.), da fim din 1986, The Ofishin Jakadancin – inda jaruman likitocin da ke adawa da kafa kasar suka sadaukar da kai wajen yakar wahalhalun da Turawan mulkin mallaka suka yi wa ‘yan asalin kasar. A ƙarshe, sun koma Zika - wanda ya yi amfani da ainihin manufar haifar da rikici don haɓaka ƙarin kudade har ma da girma.
Dokta Luz ya yi rashin nasara a tseren don zama na farko da aka "gano" Zika a Brazil, amma ba don rashin ƙoƙari ba. Ya ba wa Dr. Claudia Duarte dos Santos maganin cutar dengue, yana roƙonta: “Zika ce. Nemo Zika!"Ba ta iya ba kuma ta kasa - don haka nasa"Ofishin Jakadancin" an riga an tsara shi a cikin Afrilu 2015 ta masu bincike Drs. Silvia Sardi da Gubio Soares Campos ("S&SC") a Bahia maimakon.
Drs. S&SC, mai yiwuwa CHIKV- mambobi da kansu, kamar yadda aka danganta Zika ga marasa lafiya dengue masu laushi da sauran masu ciwo da kurji. S&SC sunyi haka ba tare da tabbatar da asibiti akan kowane takamaiman majiyyaci ba. Na'urar gwajin Zika PCR da S&SC suka yi amfani da ita a cikin dakin binciken su shine ragowar masu bincike na Senegal, wanda “FDA” na Brazil ko wasu masu bincike ba su tabbatar da ingancinsu ba. Zika da dengue a zahiri da genomically kusan iri ɗaya ne, don haka suna da ƙarfi a cikin lab.
An sami koma baya ga da'awar S&SC daga masu bincike na cibiyoyi waɗanda suka nuna lahani a cikin iƙirarin S&SC na Zika. S&SC ba su amsa ba tare da haƙurin ƙwararrun ƙwararrun da suka dace na raba bayanansu, kayansu da hanyoyinsu don ingantacciyar bitar takwarorinsu ba, amma ta hanyar watsa da'awarsu mara tushe kai tsaye ga shahararrun manema labarai. Wannan a zahiri ya haifar da tatsuniyar halittar Zika wacce ta ɗauki rayuwarta, ba tare da bita ba, kuma ta haifar da girgizar firgici.
Dokta Soares Campos ya ba da hujjar abin da ya yi: “Mun yanke shawarar cewa za mu ƙara amfanar jama’a, maimakon mu yi gaggawar rubuta takardar kimiyya mu buga ta"- kamar dai an sami wani abin gaggawa na lafiyar jama'a, yayin da yake yin watsi da dalilinsa, yana mai cewa "Zika bai kai tsanani kamar dengue ko chikungunya ba. Maganin shine Tylenol."Rashin duk wani haɗari na lafiya, me yasa ya rushe tsarin kimiyya?
Ma'aikatar lafiya ta jihar Bahia (SESAB) ta yi karo da jama'a kuma ta saba wa S&SC tare da sanarwar cewa "gano cutar Zika a Bahia na iya zama kuskure."SESAB ta kifar da rabin sakamakon S&SC wanda ya bar kashi 12% na samfuran jinin marasa lafiya 24 da ke nuna Zika (a zahiri mutane hudu a cikin birni na 300,000) - kuma kowane ko duka waɗannan huɗun na iya kasancewa ko dai an yi kuskuren gano cutar dengue, ko kuma ba komai.
Ana iya yin muhawara ko Dr. Soares Campos ya iya "amfanar jama'a"fiye da kansa- ya ba da ci gaban ƙwararrunsa daga Bahia zuwa Buenos Aires kamar yadda mai yin shelar kansa,"An gano cutar Zika a Brazil." Matarsa, Dokta Silvia, ta ce, "Mun tashi daga zama manyan mutane biyu zuwa taurarin watsa labarai." A halin yanzu, da'awar SESAB ta fadi a gefe - ba mamaki kamar "Qarya ta tashi, kuma gaskiya ta zo ta rame a bayanta."
Microcephaly a cikin Recife
Gabaɗaya gabaɗaya, 'yan watanni bayan haka, likitocin neuro-pediatricians a Recife sun ayyana microcephaly a matsayin "annoba" a cikin ƙarancin ƙa'idar hukuma ko kwatanta da bayanan asali. Ƙididdiga dalilansu a matsayin masu daraja, da imani akwai ƙarin irin waɗannan jariran a cikin unguwannin su - duk da haka, hanyoyinsu da maganganunsu sun kasance masu haɗari da gaggawa. Gudanar da tattaunawar likitocin nasu ta WhatsApp da ziyartar asibitocin gwamnati guda goma, Drs. Vanessa da Ana van der Linden sun tattara kusan kararraki 20 da suka bayyana.
A cikin 2015, Brazil tana da hanyar da ba ta dace ba don tantance wane jariri ke da microcephaly da wanda ba shi da shi. Brazil ta ayyana microcephaly idan kewayen kan jariri ya kasance daidaitattun ma'auni guda biyu a ƙasa da ma'ana - wanda ya haifar da ganewar microcephaly na kusan ɗaya cikin haihuwa arba'in, ba tare da la'akari da alaƙar asibiti ba. Wannan ya sauko sau 17 fiye da yanke hukuncin da WHO ta yanke na ma'auni guda uku da ke ƙasa da ma'ana, wanda ke nufin cewa microcephaly wani abu ne mai wuyar ganowa. kasashen da suka bi ka'idar WHO.
Babu makawa, ƙayyadaddun ma'auni na Brazil sun haifar da yawan jarirai masu ƙananan kai, amma waɗanda suke da hankali a hankali, a matsayin microcephalic. Wannan ya kara rura wutar fahimtar likitocin Recife. Kai tsaye sakamakon sanarwar da likitocin Recife suka yi na bullar cutar microcephaly, an daidaita ma'aunin rashin daidaituwa na Brazil sau biyu don ya zama mai tsauri, kuma a ƙarshe ya yi daidai da ƙa'idodin ƙasa da ƙasa.
Yawan jama'ar Metropolitan Recife na miliyan 4 yana samar da ~ 40,000 haihuwa a kowace shekara (~ 100 kullum), daga abin da ma'auni na da ya bayyana 2.5% a matsayin "microcephaly," kusan irin waɗannan haihuwa biyu a kowace rana. Zaman asibiti na yau da kullun na jariri a Brazil shine kwanaki biyu, amma ya fi tsayi don wannan ganewar asali, saboda haka kusan irin waɗannan lokuta goma na iya zama a cikin asibiti kullum a cikin Recife. Wannan yana haɓaka tare da lura da likitocin neuropediatric kuma yana bayyana ƙararrawar su:
Dokta Ana van der Linden ta ce, "Muna da unguwanni 3 (na ~ 7 gadaje kowanne)... kusan cika da yara masu microcephaly."Debora Diniz ya ci gaba,"Da farko likitocin sun yi tsammanin asibitin zai karbi jarirai goma [amma ya samu ninki biyu; saboda haka…] Drs. Ana da Vanessa van der Linden dukkansu sun tabbata cewa sabuwar cuta mai saurin yaduwa tana kan kwance. "
Haɗin Zika-Microcephaly
A wannan lokaci, "makircin yana kauri." Don kimanta yanayin microcephaly na Recife da premonition na neuro-pediatricians, Ma'aikatar Lafiya ta Brazil ta yanke shawara kan Dr. Brito, musamman an riga an saka hannun jari a cikin ra'ayi na sabuwar kwayar cutar Zika mai haɗari:
"Dokta Brito ya yi ƙoƙari ya shawo kan takwarorinsa masu ilimin cututtuka cewa microcephaly ba ta samo asali ne daga wani rahoto na baya ba ko kuma wasu kwayoyin halitta. Ya yi imanin cewa suna shaida. wani canji a tsarin cututtukan cututtuka, kuma dalilin shine cutar Zika. "
Tare da ƙarshe a hannu, duk abin da ake buƙata shine shaida.
Dr. Brito ya mai da hankali (kawai) akan uwaye 26 na jariran microcephalic: tambayar kowace ta sake tunani game da kurji, zazzabi ko ciwon watanni 6-8 kafin. A gare shi, amsa mai gamsarwa ta cancanci wannan shari'ar a matsayin "Zika" - ko da ba a yi gwajin jini da aka yi wa iyaye mata ko jarirai ba, kuma ba a sami rukunin kulawa na uwayen jarirai na yau da kullun da aka ba da takardar "rash, zazzabi, ciwon kai". Wannan tsarin ya saba wa kowane tushe na ilimin cututtukan cututtuka.
Dabarun Dr. Brito, gabaɗaya, ba su dace da hanyar kimiyya ba, wanda ya haɗa da
- "zaɓi son rai" (tambayoyi kawai microcephalics' ba uwayen jarirai na al'ada ba)
- "rashin makanta" (kawar da shinge mai shinge tsakanin mai bincike da batun; amsoshi masu tasiri da aka bayar don farantawa mai tambaya mai iko);
- “Rashin ganin ido” (shading na mai binciken yana ba da amsoshi game da tsinkayar kansa); kuma,
- "tunawa son rai" (zaton daidaito na tunanin iyaye masu nisa)
Ƙarshen bayanin da Dr. Brito ya yi ba tare da wata hujja ba game da wani labari na haɗin kai na Zika-microcephaly, wanda ya kasance sakamakon da aka riga aka ƙaddara, an fallasa shi kai tsaye ga manema labarai, yana juyar da bitar takwarorinsu da kwafi ko tabbatarwa na cibiyoyi na zamani - yana da matukar tasiri ga tsarin S&SC.
Binciken Zika na S&SC ya jawo hankalin kafofin watsa labarai, amma rashin lafiyar jama'a ba da daɗewa ba ya mutu. A gefe guda kuma, 'yan jarida na Brito Zika-microcephaly, sun ba da sanarwar haɗari da ke gabatowa kuma cikin sauri ya shiga cikin yanki, sannan na ƙasa, da firgita na duniya - na ƙarshe ya ƙara ƙaruwa saboda daidaituwar damuwar balaguron balaguron balaguro game da wasannin Olympics na Rio. kasa da 5% na ainihin da'awar zamanin firgici. Likitocin Brazil sun yi wa jarirai yawa fiye da kima - daga wasu haɗe-haɗe na firgita, wuce gona da iri, da rashin daidaitattun ƙa'idodin microcephaly na Brazil a lokacin. Microcephaly (kamar yadda aka yi iƙirari) ya mayar da hankali a ciki kuma ya yi daidai da wuri da lokacin firgicin da aka haifar da labarai (a cikin Recife da Arewa maso Gabas ta Brazil) maimakon tare da kewayon vector-saro na kansa.
Sabanin haka, Laifukan dengue sun yi daidai da yanayin sauro iri ɗaya, Aedes aegypti.:
A takaice, taswirar cutar dengue ta zo tare da Rarraba sauro Aedes aegypti; yayin da zika-microcephaly da'awar sun fi karfi inda mutane suka fi magana game da Zika-microcephaly.
A shekara mai zuwa lokacin da aka tabbatar da ka'idodin microcephaly, kuma ana iya tabbatar da cutar ta Zika ta hanyar gwaje-gwajen dakin gwaje-gwaje masu kyau, babu wani ƙarin haɓakar microcephaly da aka gani a ko'ina cikin Brazil gami da "Ground Zero" na Recife.
Masana kimiyya sun ruɗe
Babu Aedes aegypti sauro ko kwayar cutar da ke dauke da ita sun san iyakokin kasa; amma duk da haka ba a taɓa samun fashewar adadin microcephaly a Colombia ba.
"Zika ta bar wani yanayi mai cike da ruɗani da rashin daidaituwa na lalacewa a duk faɗin Amurka. Ga babban abin mamakin masana kimiyya, annobar ba ta haifar da nakasar tayin da aka firgita da ita ba lokacin da hotunan jarirai suka fara fitowa daga Brazil.
Ya kamata mu yi mamakin hakan Masana kimiyya na Zika sun “rikitar da su” da wannan matsalar? Ƙara cikin shakku da zato kimiyya ya cancanci (kuma babu shakka wannan labarin zai ƙara girma) kuma "rikicin" ya ɓace.
Ko da a cikin Recife kanta, an sami ɗimbin bambance-bambancen rates na abin da ya faru na microcephaly, tare da wasu unguwanni bisa tsari na girma fiye da sauran. Ƙungiyoyin masu arziki ba su nuna microcephaly ba duk da cewa babu wani dalili na farko da ya sa aka yi taka tsantsan game da sauro. Babu shakka, masu hannu da shuni suna da mafi kyawun gidajen sauro da kuma bushewar tituna – amma kuma suna kula da tsafta, a matsakaita, dangane da ƙungiyoyin da suka riga sun kasance na microcephaly.
Microcephaly - ban da nau'in "na farko" mai tsanani, mai wuyar gaske, wanda ba a taɓa samun ainihin dalilin mutum ba. A maimakon haka ƙididdigewa ne na zahiri da ƙididdiga na likitanci wanda aka siffanta shi da sanadin a matsayin “multifactorial,” watau an haɗa shi da sauƙi. ɗimbin wakilai masu yiwuwa (mafi yawansu [an jadada] sun zo daidai da talauci).
Raunin lalacewa; Cututtuka: "TORCHES" (toxoplasmosis, rubella, cytomegalovirus, herpes varicella, syphilis) da HIV; Rashin kulawa da ciwon suga na uwa; Rashi; Mahaifa hypothyroidism; Karancin folate na uwa; Rashin abinci mai gina jiki na uwa; Barasa-yawan amfani; Teratogens: hydantoin, radiation; phenylketonuria na mahaifa; Rashin isasshen wuri; Mutuwar tagwaye monozygous; Ischemic ko Hemorrhagic bugun jini
Kwatanta wannan da kwayar cutar rubella da ma'aikacinta nakasar neurologic ("rubella syndrome") wanda ya ƙunshi ƙayyadaddun alaƙa-sakamako. Cutar rubella a lokacin farkon watanni uku na uwa mai saukin kamuwa da gaske ko da yaushe (80% -100%) yana haifar da ciwo; Akasin haka, sifofin al'ada na ciwo ba su da wani dalili. Zika, da zarar ƙura ta lafa, an ɗauka cewa ta kawo (a tsawonta) kawai ~ 4% microcephaly-rates daga cututtukan farko na farkon watanni.
Haɗuwa da ƙarancin lalacewa na Zika tare da ƙarancin ƙarancin microcephaly, rashin gabatarwa iri ɗaya, da sauran abubuwan da suka rigaya sun kasance ~ ishirin da sauran abubuwan haɗin gwiwa suna hana shaidar ƙididdiga ta dalilin. Ka yi tunanin kallon wani fili, kana zaton ka gane dalilin da ya sa wasu karin ganyen ganye uku.
Wani asusun kasa na Brazil ya fara bayar da tallafi ga uwayen jariran Zika-microcephalic. Ko da tare da wannan sabon abin ƙarfafawa na kuɗi a cikin jirgin, ƙwayoyin microcephaly masu alaƙa da Zika sun ɓace!
A cikin 2016 da 2017 tare da zuwan ainihin gwajin Zika na asibiti; daidaitattun matakan microcephaly; kuma mafi girman wayar da kan jama'a, microcephaly da aka danganta da Zika ya ɓace nan da nan a matsayin sabon abu. Bai sake faruwa a wuri mai zafi a Arewa maso Gabashin Brazil ba ko kuma a ko'ina a duniya. Zika ya bayyana, alal misali, a cikin 2018 a Rajasthan Indiya - amma ba tare da microcephaly ba.
Nazari Uku Suna Ƙarfafa Shakkun Zika
Na farko:
Dr. da Silva Mattos"Microcephaly a arewa maso gabashin Brazil: nazari na baya-bayan nan akan jarirai da aka haifa tsakanin 2012 da 2015"A baya-bayan nan ya cika bayanan kwatankwacin shekarun da ba a samu ba ga likitocin Recife neuropediatrician. Sake gina bayanai yana sanya shakku cewa an sami karuwar gaske a cikin microcephaly a cikin 2015, shekarar fashewa. Sakamakon yana da ban mamaki:
A Jihar Paraíba (Makwabciyar Recife/Pernambuco na kusa da arewa), ƙimar microcephaly na shekarar firgita ta Zika ta bayyana kanta a matsayin ainihin daidai da sabon tushen da aka gano (2013 da 2014).
Na Biyu:
A tsakiyar barkewar cutar Zika a ƙarshen 2015, Brazil ta kafa "Rukunin Binciken Cutar Cutar Microcephaly"(MERG) wanda ke da nufin yin kwafi a kimiyyance tsarin jarrabawar Drs. van der Linden da Brito: mai da hankali kan birni guda, Recife - amma bayan shekara guda. wannan binciken ya kasance:
- babu tsoro, babu bincike fiye da kima, kuma babu ambaliya a yankin tare da uwaye masu firgita;
- gwaje-gwajen dakin gwaje-gwaje don Zika (da dengue);
- ƙungiyar kulawa;
- ma'aunin microcephaly guda ɗaya (ko da yake har yanzu ba daidai ba ne, sau 17 ma sako-sako);
- ƙungiyoyin bincike da aka tsara da yanke hukunci;
- babu latsa leaks.
Ragowar raunin sune waɗannan:
- babu daidaituwa na girman kai tare da ainihin iyawar fahimta;
- da kuma ci gaba da rashin yiwuwar bambance Zika daga dengue.
A cikin nasu kalaman: “Tabbatar da dakin gwaje-gwaje na kamuwa da cutar ZIKV a lokacin daukar ciki yana da ƙalubale saboda haɗin kai tare da sauran ƙwayoyin flavivirus, musamman dengue. Gwajin neutralization, wanda shine ma'aunin zinare don nuna bambanci tsakanin waɗannan ƙwayoyin cuta, yana ɗaukar lokaci, ana yin shi a cikin dakunan gwaje-gwaje kaɗan kuma baya bayyana lokacin da kamuwa da cuta ya faru.. "
Tsakanin waɗannan ƙungiyoyi biyu (na 89 uwaye na microcephalics, "CASES" - da kuma 173 uwaye na al'ada-girma jarirai, "CONTROS"), da alama babu wani babban bambanci a baya rates na Zika-antibodies ko dengue bayyanar. Wannan yana rage Zika a matsayin ma'anar sinadari a cikin microcephaly.
Na Uku:
An bincike a tsakiyar Brazil, da nisa daga firgita da kafofin watsa labaru suka haifar, ya nuna microcephaly (bayan bayyanar Zika) a irin wannan ƙananan ƙimar kamar yadda ya dace da tushen duniya, pre-Zika.
Bugu da ƙari, shekaru biyu na shuru a gaban labarai na Zika ko ta yaya ya mayar da cutar sau 3.5 ƙasa da haɗari. Shin wannan yana da kyau, yana nuna ainihin haɗarin kamuwa da cuta shine babban firgici mai son kai?
Babu ɗayan waɗannan binciken guda uku da ya jaddada (kamar yadda a nan) abubuwan da suka shafi bayanan su ke kawo shakku ga ka'idar Zika-microcephaly. Babu wanda aka watsa ko'ina ga jama'a, kuma ba a tsara shi a cikin makarantar kimiyya don tilasta sake yin la'akari da yawan firgita da mutane ke yadawa cikin fararen riguna.
Uzuri, uzuri, uzuri
"Akwai tsohuwar karin magana, 'Idan gaskiyar ba ta dace da ka'idar ba, canza ka'idar.' Amma sau da yawa yana da sauƙi don kiyaye ka'idar da canza gaskiyar."Albert Einstein
Masu goyon bayan Zika-microcephaly, a cikin fuskar gaskiyar da ke karkatar da hasashen da suke yi, sun yi kadan daga cikinsu. Ga wasu daga cikin gyare-gyaren da aka tsara:
- Zika yanzu, a maimakon haka, yana haifar da rikice-rikicen neurologic, mai lakabin “CZS,” Ciwon Zika na Haihuwa.
- Fitowar shekara daya ya kawo nan take Zika garken garken garken ga daukacin al'ummar Brazil.
- Brazil tana da haɗari musamman "mutant iri. "
- Ƙoƙarin lafiyar jama'a ya juya Zika ta hanyar wayar da kan jama'a da gujewa.
- Dr. Ernesto Marques, masanin ilimin cututtuka, Jami'ar Pittsburgh
- Shugaban Epidemiology a Makarantar Yale na Kiwon Lafiyar Jama'a, Dokta Albert Ko ya ba da shawara:
- "Shin Indiyawan (Asiya) da Thais ba su da sauƙi, ko ba mu gano shi ba?
- "Tabbata na akwai watsawa, amma ba a buga littattafan ba, ba a gano shi ba."
- "Shin ciwon Zika na haihuwa ana kuskuren ganewa kamar wani abu kamar toxoplasmosis?"
- Ya kasance m "cofactor" na "kafin bayyanar da dengue (ƙarfafa) haɗarin lahani na haihuwa daga Zika?"
- "Rashin ganewar asali shine hasashe mai ma'ana. Amma ba a bayyane yake cewa wannan bayanin ya shafi duka labarin ba. Wataƙila Zika ba ta aiki ita kaɗai."
- “Wataƙila wani kamuwa da cuta ya haɗu da Zika don sa cutar ta yi muni da ƙara haɗarin lahani na haihuwa."
- Christopher Dye na WHO ya ce:
- "Da alama mun ga lokuta da yawa na cutar Zika a cikin 2016. Amma babu microcephaly. Bambancin (tsakanin 2015 da 2016) yana da ban mamaki. Da farko dai, jami'an kiwon lafiya za su iya yin kima sosai da adadin cutar Zika a Brazil. Don haka ana iya kuskuren chikungunya da Zika cikin sauƙi"… [wanda NPR, ga darajarta, ta amsa da sauri:"Amma chikungunya baya haifar da microcephaly. "]
- "Ana kiyasin samun barkewar cutar Zika ~ kowace shekara 10. Yayin da ƙungiyar haihuwar Zika-naive ke da shekaru, za su zama jama'a masu rauni. " Dr. Anna Durbin
Duk abubuwan da ke sama sun kai “kare ya ci aikin gida na.Babu daya daga cikin wadannan da ke da ruwa da gaske idan aka yi la'akari da cewa kowace kasa mai zafi kuma ta guje wa alaƙar Zika-microcephaly, duk da rashin rigakafin garken garken ga Zika gabaɗaya ko kuma wani nau'i na "mutant" musamman.
Goyon bayan kimiyya ga CZS yana da rauni, kamar yadda binciken da NEJM ta buga sau da yawa ana ambatonsa. Rabin matan 345 da aka yi nazari a cikin 2016 sun gwada ingancin Zika a lokacin daukar ciki - amma a ƙarshe sun samar da shari'a ɗaya kawai na microcephaly maras dacewa ba tare da alaƙa da haɗin kai ba, ƙuntatawa ga tayi. Masu binciken, watakila sun ji takaici, sannan suka mayar da hankalinsu ga faffadan binciken cututtukan da ba na musamman ba - kuma sun ba da wannan ƙin yarda (na masu lura da cin zarafi): "Yakamata a fassara sakamakon mu da taka tsantsan tunda suna nuna kimar neurologic guda ɗaya da aka yi… da (kafin) sanin matsayin ciwon ZIKV na mahaifa."
Kudaden bincike, da zarar an kunna “kunna,” ana niyya don kiyaye su “a kunne” da masu binciken da kansu. Babu wanda ya yarda da kurakurai. Babu shakka, ba za a sami koma baya ba, ba za a sake fasalin ba, duk da ɗimbin RASHIN ƙarin bayanan tallafi. A gaskiya ma, akasin haka na iya faruwa: sau biyu ƙasa.
Cutar da ta ɓace don Cutar da ta ɓace
Martanin gwamnati ga Covid-19 ya ba da samfuri na daidaita iko ta hanyar jujjuyawar lafiyar jama'a na yawancin ƙa'idodinta na farko: misali nanata alluran rigakafi koda bayan fitowar kwayar cutar da ta dace daga wurin. Haɗin gwiwar ƙungiyoyin kamfanonin harhada magunguna tare da ikon lafiyar jama'a na ba da izini da kuma ba da umarnin rigakafi, yayin da kawar da alhakinta tabbas yana da fa'ida ga waɗannan masu ruwa da tsaki. Ƙaddamar da NIAID na gaba tare da rigakafin cutar Zika duk da shekarunta na shekaru 6 yana nuna irin wannan jaraba.
Majalisar dokokin Amurka ta amince da Mr. Bukatar tallafin Zika na dala biliyan 1 na Obama a cikin Satumba 2016 (a lokacin, Zika-microcephaly ya riga ya nuna alamun zama ƙaura - kuma Majalisa ya kamata ya san mafi kyau). Kimanin kashi 40%, dala miliyan 400, an ware don samar da maganin cutar Zika. A cikin wucin gadi, an sami rigakafin cutar dengue, don haka fasahar ta wanzu don samar da daya don Zika.
Matsalolin jinkirta shine kusan Catch-22. Don tabbatar da ingancin maganin, ƙwayar cuta dole ne ta kasance tana yawo (kuma tana da haɗari tun da farko, ta yadda za a ba da garantin ƙoƙari da tasirin sakamako). Lokacin da kwayar cutar ba ta aiwatar da aikin da aka yi niyya na yaduwa da haɗari ba, akwai babu wanda zai gwada maganin kuma babu dalilin samun wanda zai fara da.
Yayin da Zika ta lalace a duk duniya, kuma hukumomin da'a na gwamnatin Amurka sun hana allura da cutar da mutane da Zika don neman rigakafin, menene NIAID za ta yi da har yanzu dala miliyan 100 da masu bincike da yawa don ci gaba da aiki?
A cikin 2018, masu bincike sun yi ƙoƙarin kauce wa "matsalar" rashin Zika ta hanyar inganta gwajin ƙalubalen ɗan adam na Zika. Wannan yana nufin kamuwa da mutane masu lafiya na Brazil tare da kwayar cutar da ta daina kamuwa da mutane. Dokta Anna Durbin ta Johns Hopkins ta bayyana cewa sigar Brazil ta FDA ta ƙi [bar Amurka don] gudanar da irin wadannan gwaje-gwajen [a kasar Brazil]. Don haka, ta tashi don gudanar da irin wannan gwaji a jihar.
A halin yanzu, ana yiwa masu sa kai da ake biya a Baltimore allurar Zika - kuma babu shakka nan ba da jimawa ba za mu sami rigakafin Zika. Shin wannan zai haifar da wajabcin rigakafin Zika a duk wurare masu zafi - kuma, idan haka ne, ku bono? Anan ya ta'allaka ne da duk wani mai ra'ayin makircin da ake zaton zai kawo cikas ga sake dubawa da soke ka'idar. Zika-microcephaly yana wakiltar "gaggawa" da aka yarda da ita a duniya; ko da yake wanda (babban fa'ida) ga magunguna/kiwon lafiyar jama'a ba a fitar da shi ba tukuna. Soke ka'idar yana kawar da hanyar magunguna don samun riba da kuma mimbari na lafiyar jama'a.
Juyar da Zika
Wataƙila Zika ba ita ce mafi girma ba kuma, amma har yanzu ana ba da gargaɗi game da fallasa a waje ga iyaye mata masu zuwa a Amurka da sauran wurare a duniya. Ya kamata a cire shi azaman ra'ayi.
WHO, CDC, ƙwararrun kiwon lafiya da masu ilimin cututtuka na iya yin tasiri a lokacin ingantattun abubuwan gaggawa, amma ƙasa da haka a cikin yarda ko kuskuren gyara kai, bayan-gaskiya. Za a iya ayyana umarni, amma cikakkiyar karɓuwarsu na buƙatar amintacciyar amintacciyar amincewa. A zahiri an yi dubban labarai da aka rubuta akan Zika, bayan 2015, kuma babu ɗaya, sai nawa. Binciken Zika-Microcephaly's 'Crash' a cikin The American Journal of Medicine, tambayoyi masu tushe ko jimillar rashi na ainihin bayanan kimiyya.
“KIMIYYA” ana iya bayyana shi duka a matsayin tsarin ilimi, DA ingantaccen tsarin tattarawa da tabbatar da wannan ilimin. Don haka "kimiyya mai tambaya" shine "kimiyya." Kimiyya ba shi da “kotu” hukuma don tantance hukunce-hukunce; maimakon (aƙalla, a cikin duniyar pre-Covid-19) tattaunawa ta kyauta kuma a bayyane galibi ta hanyar labaran mujallu. Kimiyya a ƙarshe ba za ta yi kyau ba ko kuma a amince da ita idan ta ƙunshi wasu fannoni na matsayin firist fiye da ƙaƙƙarfan muhawara, kyauta.
Daga fara ba zato ba tsammani zuwa ƙarewar da ba a sani ba, labarin Zika-microcephaly yana cike da al'amuran da ba a bi ko mutunta hanyar kimiyya ba. Sashe biyu na “kimiyya ta hanyar leak ɗin latsawa” yana tunawa da ɓarnar “ƙarancin sanyi”. Aƙalla a cikin wannan misali, manema labarai sun murmure kuma sun sake duba su.
Leaks na kafofin watsa labarai na zato ya haifar da firgita kuma sun lalata lokaci da ikon tattara isassun bayanai don yanke hukunci akan hasashen Zika-microcephaly. Masu haɗin Zika-microcephaly ba su yi ba "ka kara amfanar jama'a" ta hanyar gujewa cavalierly "Nan da nan rubuta takardar kimiyya da buga shi." Zaɓuɓɓukan girman kai na naƙasassu na gwaji na lokaci ɗaya, a cikin ayyana annoba.
Saga na Zika-microcephaly ya haɗu da hoton soyayya na jama'a na marasa tsoro, likitoci da masu bincike waɗanda ke jagorantar manufa, tare da gaskiyar rikice-rikicen bayanai da ruguza kimiyya. Labarin Zika yana jin daɗin fim ɗin 1996 Twister, wanda ke ɗaukaka irin waɗannan masu binciken fannin. A wannan yanayin duk da haka, masu fafutuka na Brazil a ƙarshe za su cutar da su fiye da taimako: ƙirƙirar nasu '' guguwa '' na alama wanda lalacewa ta hanyar rashin fahimta ya wuce na cutar ta sauro.
Juyar da Zika ya zama jinkiri ga ɗaruruwan miliyoyin matasa mata da iyalai a duk faɗin wurare masu zafi, waɗanda ke buƙatar shari'ar Zika-microcephaly kar a manta da su ko a rubuta su, amma a sake yanke hukunci a bainar jama'a - amma wannan lokacin tare da ƙa'idodin kimiyya masu dacewa a wurin, da ikon yin tambaya. Sabbin Tufafi na Sarkin sarakuna.
Ba a taɓa samun wani lokaci a cikin tarihin ɗan adam inda manyan masu sauraron duniya ke da kalmomin "virus," "cututtuka," "WHO," da "Fauci" gaba da tsakiya a cikin zukatansu. Cututtukan guda biyu sun bambanta sosai, amma nazari da sake nazarin Zika-microcephaly yana ba da cikakkiyar cikakkiyar "sha'anin kasuwanci" na abin da zai iya kuma ya aikata ba daidai ba lokacin da nazarin kimiyya ya kasance gajere.
Anan akwai manyan zato na Zika guda huɗu, waɗanda duk suna buƙatar riƙe gaskiya don haɗin Zika-microcephaly ya kasance na gaske.
- Wannan wasu lokuta, waɗanda ba a gwada su gaba ɗaya waɗanda ke da alaƙa da dengue, suna nunawa a cikin wuraren da ba a taɓa gani ba a maimakon haka kuma tabbas (wanda ba a taɓa gani ba-a-Brazil) Zika.
- Cewa wannan Zika, wanda ba shi da lahani ga ɗan adam a baya, yana da wani gefen duhu wanda ba a lura da shi ba na microcephaly na haihuwa wanda tagwayensa, dengue, ba su taɓa nunawa ba, kuma kamar yadda sauri ya ɓace.
- Wannan da'awar ƙarin microcephaly (ba tare da kwatankwacin bayanan da aka rigaya ba) a wani yanki na Brazil (Recife, yayin firgita) yana nuna haɓakar haɓakar ƙasa baki ɗaya (a duk faɗin ƙasar Aedes aegypti).
- Kuma wancan labari gaba daya, wanda ba a tantance a kimiyance ba, dakin gwaje-gwajen rashin iya misaltawa (Zika) ya haifar da daya (microcephaly).
"A fahimtata cewa ba za a yi lissafi ba.” - Chevy Chase
Ba a buƙatar da yawa a nan; ka'idar yiwuwa mai sauƙi ya isa. Idan, alal misali, mun sanya yuwuwar kowane ɗayan waɗannan zato masu zaman kansu a kashi 30%, to, yuwuwar duk huɗun daidai suke ~ 1%. Daga karshe babban abin mamaki ba bacewar Zika-microcephaly ba ne, amma saurin karbuwarsa a matsayin akidar kimiyya; tare da ƙaramin mamaki cewa an bar shi ga wannan babban likita na "bare" don rubuta waɗannan batutuwa.
A halin yanzu masu ilimin Zika a cikin makarantar kimiyya na iya samun ta'aziyya a cikin kwarin gwiwa na Hercule Poirot mai binciken almara: "Koyaushe ina da gaskiya. Yana da matukar wuya ya ba ni mamaki. Kuma yanzu yana kama da na yi kuskure, kuma hakan yana tayar min da hankali. Amma bai kamata in damu ba, domin na yi gaskiya. Dole ne in yi gaskiya domin ban taba kuskure ba.”
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Dokta Randall Bock ya sauke karatu daga Jami'ar Yale tare da BS a cikin ilmin sunadarai da kimiyyar lissafi; Jami'ar Rochester, tare da MD. Ya kuma binciki abin ban mamaki 'kwanciyar hankali' da ya biyo bayan cutar ta Zika-Microcephaly ta Brazil ta 2016 da firgita, a ƙarshe ya rubuta "Juyar da Zika."
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