Imithi yokugoma: Abangane noma Izitha?

Ngokusho kweCenter for Disease Control, imithi yokugoma iyimikhiqizo ekhuthaza amasosha omzimba ukuthi akhiqize ukuzivikela ezifweni ezithile, ekugcineni avikele umuntu kuleso sifo. Imithi yokugoma kuthiwa isindisa izigidi zezimpilo, kodwa ingabe ingalimaza ngendlela engenakulungiseka abamukeli?

Zibuze: Ingabe uzizwa uphephile ngokusebenzisa imithi yokugoma? Ingabe imithi yokugoma iyinzuzo empilweni yomuntu, noma isivimbeli? Uma bekunezingozi zempilo eza kanye nemigomo ungayinika ingane yakho? Uma sicabanga ngempilo yabantu bethu, ingabe uhulumeni kufanele agunyaze imithi yokugoma?

ICenters for Disease Control (CDC) incoma ukuthi kutholwe imithamo engama-28 yemithi yokugoma eyi-10, yezingane ezineminyaka engu-0 kuya kweyisithupha, kodwa inani lemithi yokugoma edingekayo ngengane kuya ngokuthi ingane ihlala kusiphi isimo. I-Montana idinga imigomo emithathu, kuyilapho i-Connecticut idinga kakhulu, 10. Ezifundeni eziningi, umzali angagwema ukugoma ingane yakhe ngokuthi kuphambene nezinkolelo zabo zenkolo noma zefilosofi. Nokho, kusukela ku-30^th kaJulayi, 2015, esifundazweni saseCalifornia, lokho kukhetha akusekona okwabazali - kungokwesifundazwe.

Ehlobo lika-2015, umbusi waseCalifornia wagunyaza umthethosivivinywa weSenate Bill (SB) 277 - umthethosivivinywa wezempilo womphakathi othi ekuvulweni kwawo:

"Umthetho okhona uvimbela isiphathimandla esiphethe isikole noma esinye isikhungo ukuba samukele noma yimuphi umuntu ngaphandle kwemibandela njengomfundi wanoma yisiphi isikole samabanga aphansi sikahulumeni noma esizimele, isikhungo sokunakekela izingane, inkulisa, isikole senkulisa, ikhaya lokunakekela izingane, noma isikhungo sokuthuthukiswa, ngaphandle uma ngaphambi kokuthi angeniswe kuleso sikhungo ubegonyelwe ngokuphelele izifo ezehlukene, okuhlanganisa isimungumungwane, umvukuzane, kanye ne-pertussis, kuncike kunoma iyiphi imibandela yobudala.

Ngokusho kwe-CDC, isizathu sokuthi ingane yakho igonywe iwukuvikela ezifweni eziningi izingane ezingenwa kuzo. Lezi zifo zihlanganisa i-diphtheria, i-tetanus, i-pertussis, i-Haemophilus influenzae (Hib), uvendle, nesifo se-pneumococcal, futhi ngokuvamile zelashwa ngemijovo ye-DTaP noma i-MMR. Nokho, imithi yokugoma ayinconyelwe izingane kuphela, kodwa futhi nakubantu abadala kanye nabasebenzi bezempilo.

Ucwaningo lwenziwe yi-Public Health Agency of Canada/Canadian Institutes of Health Research Influenza Research Network (PCIRN) ukukala umbono wokukhetha phakathi kokuthola umuthi wokugomela umkhuhlane waminyaka yonke, noma ukuphoqwa ukuthi ugqoke imaskhi njengesimo sokuqashwa. Lolu cwaningo, inhloso yalo bekuwukugxila embonweni womphakathi waku-inthanethi walolu khetho, luthole ukuthi cishe uhhafu wabahlanganyeli ubemelene nakho.

"Cishe isigamu (48%) sabaphawuli bazwakalisa imizwa engemihle ngomuthi wokugomela umkhuhlane, u-28% wawunethemba, u-20% wawungathathi hlangothi, kanti u-4% uzwakalise imibono exubile. Kuhlaziywe imibono engu-1163 eyenziwe ngabahlaziyi abangu-648 abaphendula izihloko ezingu-36. Izindikimba ezidumile kuhlanganisa nokukhathazeka ngenkululeko yokuzikhethela, ukusebenza kahle komgomo, ukuphepha kwesiguli, nokungamethembi uhulumeni, impilo yomphakathi kanye nemboni yezemithi."

Lolu cwaningo lubonise ochwepheshe abaningi bezokunakekelwa kwempilo abahambisani nokugoma, ngenxa yokungathenjwa. Abanye abakwethembi ukuphumelela kokwelashwa kanti abanye ababathembi labo abasebenzisa le migomo, bethi inkululeko yokuzikhethela kufanele idlule inhloso kahulumeni yokufaka okuthile emzimbeni womuntu.

Kulezi zimo, uma uchwepheshe wezokunakekelwa kwempilo engawutholi umgomo noma engagqoki imaski, ukuqashwa kwakhe kunganqanyulwa ngenxa yokungathobeli kwabo umthetho. Ukwesaba okwandayo kwabaningi kumayelana ne-SB 277, kanye neqiniso lokuthi singase singasenayo inkululeko yokuzikhethela uma sifuna ukugoma izingane zethu noma cha.

Nokho, kungani ukhathazeka noma wesabe imithi yokugoma? Balapha ukuze basize izingane zethu ziphile impilo enempilo, akunjalo? Lowo ngumbuzo wesigidi samadola - osuphendulwe yi-CDC, phakathi kokubhekisiswa.

Kunezithako eziningi emithini yokugoma egunyaziwe ezingathusa umphakathi, okuhlanganisa i-formaldehyde, i-mercury, i-MSG, i-bovine cow serum, namakhemikhali avutha kakhulu njenge-aluminium phosphate. Lezi zithako zingase zidwebe ifulegi elibomvu phakathi kwabazali abaningi, kodwa ingxabano enkulu ephikisana nemithi yokugoma amashumi ezinkulungwane zabazali abenze izimangalo zokuthi, ngemva kokuba ingane yabo igonyiwe, baye baveza izimpawu ezinkulu zokuziphatha kwe-autistic.

Yize umphakathi utshelwa ukuthi ukholelwe ukuthi imigomo ilapha ukuze kuzuze isintu kuphela ngenkathi kwakhiwa ikusasa elinempilo, kube nezimo esikhathini esidlule lapho imigomo iye yadala izinkinga zempilo kulabo abayitholile.

Ngo-1987, umgomo we-MMR ogama lakhe lingu-Trivivix wasetshenziswa futhi wakhiqizwa eCanada nguSmithKline Beecham. Lo mgomo ubangele i-meningitis kubamukeli bawo. Imiphumela yawo engemihle yaqashelwa ngokushesha, futhi umgomo wahoxiswa eCanada. Kodwa-ke, ngenyanga efanayo yahoxiswa e-Ontario, i-Trivivix yanikezwa ilayisense e-UK ngaphansi kwegama elisha, i-Pluserix. I-Pluserix yasetshenziswa iminyaka emine futhi yabangela i-meningitis futhi. Kwadingeka futhi ukuthi ihoxiswe ngo-1992 ngenxa yokukhala komphakathi kanye nokuntula ukwethemba abenzi benqubomgomo yokugoma. Esikhundleni sokucekela phansi lo mgomo owawuthiya impilo yezingane ezingu-1,000 XNUMX, i-Pluserix yathunyelwa ngomkhumbi emazweni asathuthuka njengeBrazil, lapho yasetshenziswa khona emkhankasweni wokugoma ngobuningi, okwenza umqedazwe we-meningitis.

Yize imithi yokugoma ilimaze abanye babamukeli bayo esikhathini esedlule, akusafanele kube nobufakazi obuphathekayo obenziwa umphakathi yi-CDC obufakazela ukuxhumana phakathi kwemithi yokugoma kanye ne-autism.

“Kwezokwelapha, kube nezifundo eziningi ezifakazela ukuthi imigomo ayibangeli i-autism. Inkinga engihlale nginayo lapho izinkulungwane nezinkulungwane zabazali bonke bexoxa indaba efanayo: ‘Ingane yami ithole umgomo, ngokuvamile umuthi wokugomela i-MMR. Kwase kuthi ngalobobusuku, noma ngakusasa, kwaqubuka umkhuhlane; kwathi lapho bephuma emkhuhlaneni balahlekelwa ukukhuluma noma ikhono lokuhamba,’” kusho uDel Bigtree, intatheli yezokwelapha.

Esikwaziyo nge-autism ukuthi ikhula ngesivinini ezinganeni. Ngawo-1970, ukukhubazeka kwe-autistic kwakutholakala ku-1 ezinganeni ezingu-10,000. Ngo-2016, ngokusho kwe-CDC, ingatholakala ku-1 ezinganeni ezingama-68. Abesilisa bangenwa kalula yi-autism ngesilinganiso esingu-3:1. I-autism yabesilisa ingatholakala esikalini esingu-1 kwabangama-42, kuyilapho intombazane engu-1 kwayi-189 kutholakala ukuthi ine-autism. Ngo-2014, kwakunamacala ayi-1,082,353 atholakala e-autism e-United States.

I-Autism ibangela ukukhubazeka okuningi enganeni, okunye kwakho okuhlanganisa ukungakwazi ukugcina ulwazi, ukuziphatha okuphindaphindayo, ukuntuleka kokusondelana, ukuzilimaza, ukuklabalasa okukhulu, nokungakwazi ukukala imizwa, phakathi kohide lwezinye izimpawu. Uma noma yikuphi kwalokhu kuziphatha kuvela enganeni yakho, kutuswa ukuthi uthole usizo lwezokwelapha. Kube nezinkulungwane zezigameko lapho abazali beqaphela ezinye zalezi zimpawu ezenzeka enganeni yabo ngemva kokuthola imigomo ye-MMR noma ye-DTaP.

“Okufike kwaba mnandi kakhulu ukubona imindeni eminingi ebibika ukuthi ingane yayo inohlobo oluhlehlisayo lokuziphatha kwenzeka ngemuva nje kokugonywa. Omunye walaba bazali ubengikhombisa izithombe zezingane zabo ebezikhula ngendlela ejwayelekile kwaze kwaba yizinyanga eziyi-18, kwathi kungazelelwe, ngemuva kokugonywa, zase zihlehla ngendlela emangalisayo," kusho uDoreen Granpeesheh Ph.D., umsunguli we-BCBA weCentre For. I-Autism kanye Nezinkinga Ezihlobene Nazo. "Izingane ezazinenkulumo noma kuphi eduze namagama angu-50-100 zazilahlekelwe ngokuphelele amagama azo. Izingane ezazisondelene kakhulu futhi zisebenzelana nabazali bazo ngokuphazima kweso zaze zahlukaniswa, zingasaphenduli egameni lazo. Konke lokhu kwenzeka ngemuva nje kokugomela i-MMR.”

Imibuzo ezungeze ubudlelwano phakathi kwemithi yokugoma kanye ne-autism iye yaphakanyiswa emphakathini wesayensi, kanye namazinga aphezulu ezombusazwe. Ngo-2002, uKhongolose wase-U.S. u-Dan Burton wabandakanyeka engxoxweni eshisayo phambi kweCongress, ngenxa yokungabi bikho obala kokutholwe yimiphumela yezinkampani ezenza imithi mayelana nemithi yokugoma. Burton uphakamise umbuzo obalulekile: sizobhekana kanjani nale nkinga esikhathini esizayo?

"Bekuyingane eyodwa kwabayi-1 10,000, manje sekunengane eyodwa kwezingaphezu kuka-1 ezilinyazwayo kuleli eziphethwe yi-autism. Manje lezo zingane zizokhula. Ngeke zife... uzophila aze abe neminyaka engama-250, 50. Manje ucabanga ukuthi ubani ozobanakekela?Kuzoba yithina sonke, abakhokhi bentela.Kuzobiza ... amathriliyoni amadola. 'zivumele izinkampani ezithaka imithi kanye nohulumeni wethu bavale le nxushunxushu namuhla ngoba ngeke iphele," kusho uBurton.

Izikhulu ze-CDC eziphakeme ziye zabuzwa mayelana nokuxhumana okungenzeka phakathi kwemithi yokugoma kanye ne-autism, futhi abanye baye bavuma ukuthi kungenzeka bathole ukuziphatha kwe-autistic ngenxa yemigomo ye-MMR noma ye-DTaP:

“Manje, sonke siyazi ukuthi imithi yokugoma ngezinye izikhathi ingabangela umkhuhlane ezinganeni. Ngakho-ke uma ingane igonyiwe, inomkhuhlane, inezinye izinkinga ezivela emithini yokugoma, futhi uma uhlotshaniswa nenkinga ye-mitochondrial, ingadala umonakalo othile. Ezinye zezimpawu zingaba izimpawu ezinezimpawu ze-autism,” kusho owayengumqondisi we-CDC, uJulie Gerberding M.D., ngesikhathi kunenhlolokhono ye-CNN. 

U-Gerberding akuyena yedwa umsebenzi we-CDC ongakhuluma mayelana nokuxhumana okungenzeka phakathi kwemithi yokugoma kanye ne-autism. U-William W. Thompson, indoda esikhule yaba uhlobo lwenganekwane ngemva kokuba i-CDC, iphinde yadalula izimfihlo mayelana nokutholwe yisayensi emithini yokugoma. UThompson, iSenior Scientist and Epidemiologist kwa-CDC, waqasha ummeli ngo-Okthoba 2002 lapho ethola ukuthi okwashicilelwa yi-CDC maqondana nokuphepha komgomo kwakungelona iqiniso. Ngo-Agasti ka-2014, u-Thompson waya esidlangalaleni ngalesi sitatimende:

“Igama lami nginguWilliam Thompson. NginguSayensi Omkhulu Wezikhungo Zokulawula Nokuvimbela Izifo, lapho ngisebenze khona kusukela ngo-1998. Ngiyadabuka ngokuthi mina nozakwethu sishiye ulwazi olubalulekile ngokwezibalo ku-athikili yethu yango-2004 eyanyatheliswa kujenali ye-Pediatrics. Idatha eyeqiwe yaphakamisa ukuthi abesilisa base-Afrika baseMelika abathola umgomo we-MMR ngaphambi kweminyaka yobudala engama-36 babesengozini enkulu ye-autism. Izinqumo zenziwe mayelana nokuthi yikuphi okutholakele okufanele kubikwe ngemuva kokuqoqwa kwedatha, futhi ngikholwa ukuthi umthetho olandelwayo wokugcina awulandelwanga. "

U-Thompson uthole ukuthi abesilisa base-Afrika baseMelika ababegonywe ngaphambi kweminyaka emithathu babe namathuba angama-340% okuthola ukuziphatha kwe-autistic. Nakuba ingozi inkulu kubantu base-Afrika baseMelika, ingozi ye-autism ikhuphuka kakhulu kunoma iyiphi ingane ethola imithi yokugoma ngaphambi kweminyaka engu-3.

"O Nkulunkulu wami, angikholwa ukuthi senze esikwenzile, kodwa sikwenzile," kusho uThompson etshela intatheli, mayelana nokuvuma kwakhe izono. "Leli iphuzu eliphansi kunawo wonke emsebenzini wami, engihambisana nalelo phepha. Nginamahloni manje uma ngihlangana nemindeni yezingane ezine-autism ngoba ngibe yingxenye yenkinga.”