So wo ba no yafunu mu yɛ no yaw kɛse? Ebetumi ayɛ Hemolytic Uremic Syndrome (HUS)!

So wo ba kumaa no anya akisikuru a ne yafunu mu yɛ no yaw nna kakraa bi ni? Ebia wubehu mogya mpo wɔ mu. Ɛyɛ ade a ɛfata sɛ wo, sɛ ɔwofo no, sɛ ɛba saa a, wobɛhaw wo ho kɛse. Sɛ wowɔ sɛnkyerɛnne ahorow te sɛ eyinom a, ebetumi ayɛ nea ɛsen yafunu a ɛyɛ wo yaw kɛkɛ. Ɛnnɛ yɛbɛka tebea bi a ebetumi ayɛ aniberesɛm, nanso sɛ wohu ntɛm a, wotumi sa no yiye ho asɛm. Ɛno ne (Hemolytic Uremic Syndrome) , anaa (HUS) tiawa.

Dɛn ne Hemolytic Uremic Syndrome (HUS) a ɛma mogya tu? Momma yɛnte ase tiawa.

Okay, afei momma yɛnhwɛ nea eyi (HUS) yɛ. Sɛ yɛbɛka no tiawa a, ɛyɛ tebea a mogya ntini nketenkete a ɛwɔ yɛn asaabo mu no siw . Fa no sɛ nsu paipu siw na nsu no gyae sen. Saa akwanside yi ma nneɛma atitiriw abiɛsa si:

1. Wo mogya mu nkwammoaa kɔkɔɔ no sɛe: Wɔ nnuruyɛ mu no, wɔfrɛ eyi hemolytic anemia . Mogya mu nkwammoaa kɔkɔɔ ne nea ɛde mframa pa kɔ yɛn nipadua mu nyinaa. Enti sɛ wɔsɛe wɔn a, mframa pa dodow a nipadua no hia no so tew.

2. Ntini mu nkwammoaa dodow a ɛwɔ mogya no mu so tew: Wɔfrɛ tebea yi thrombocytopenia . Nkwammoaa a ɛma mogya tu yɛ nkwammoaa nketenkete a ɛboa ma yɛn mogya tu bere a yɛretu mogya no. Sɛ eyinom so tew a, ɛbɛyɛ den sɛ wobegyae mogya a ɛretu no, na akuru betumi aba nipadua no nyinaa so.

3. Asaabo a ɛsɛe: Eyi ne ade a asiane wom sen biara. Sɛ asaabo no ntumi nyɛ adwuma yiye a, entumi nyi nneɛma fĩ a ɛboaboa ano wɔ nipadua no mu no mfi hɔ. Wɔsan frɛ eyi (Acute Kidney Injury - AKI) .

Ɛwom sɛ HUS betumi aka obiara de, nanso mpɛn pii no, ɔyare mmoawa bi , titiriw Escherichia coli , a wɔtaa frɛ no E. coli , na ɛde ba. Saa mmoawa yi na ɛde akisikuru ba, titiriw akisikuru a mogya wom. Nanso, syndrome yɛ sɛnkyerɛnne ahorow a wɔaboaboa ano, na HUS nso betumi aba esiane nneɛma afoforo a ɛnyɛ E. coli nti.

Ɛnyɛ asaabo nko na saa tebea yi (HUS) betumi aka, na mmom ɛtɔ mmere bi a akwaa afoforo te sɛ koma ne amemene. Nanso, ɛtaa ka asaabo no.

Nea ɛho hia sen biara: Sɛ wo anaa wo ba no ho yɛ wo yaw a mogya wom anaasɛ ne dwensɔtwaa bɛboro nnansa a, hwɛ hu sɛ wobɛkɔ oduruyɛfo nkyɛn. Sɛ wɔansa HUS yare a, ebetumi ayɛ den na ɛde ne nkwa mpo ato asiane mu.

So HUS ahorow ahorow wɔ hɔ?

Yiw, (HUS) ahorow atitiriw pii wɔ hɔ. Momma yensua wɔn ho ade kakra:

1. "Typical" (HUS): Eyi ne ɔkwan a wɔtaa de di dwuma . Mpɛn pii no, ɔyare mmoawa bi a ɛka yɛn dwensɔtwaa ketewaa ne yɛn akyi berɛmo no na ɛde ba.

2. "Atypical" (HUS) (aHUS): Eyi yɛ nea ɛntaa nsi kakra.Mpɛn pii no, eyi fi awosu mu nneɛma, a ɛkyerɛ sɛ wonya fi awofo hɔ ma mmofra.

3. "Secondary" (HUS): Saa ɔkwan yi ba wɔ abusuabɔ mu ne aduruyɛ mu tebea afoforo. Sɛ nhwɛso no, ebetumi afi nnuru bi, ɔyare mmoawa afoforo, anaa nyinsɛn mu aba.

Momma yensua pii fa "Atypical" (HUS) (aHUS) ho.

(aHUS) yɛ tebea a ɛntaa nsi koraa. Ebetumi nso de sɛnkyerɛnne koro no ara aba sɛnea na ɛte kan no:

• Mogya mu nkwammoaa kɔkɔɔ dodow a ɛso tew.
• Ntini mu nkwammoaa a ɛma mogya tu no dodow so tew.
• Asaabo a entumi nyɛ adwuma mpofirim (asaabo a entumi nyɛ adwuma yiye) .
• Mogya mmoroso (hypertension) anaasɛ mogya mmoroso a wontumi nni so.

Saa tebea yi (aHUS) taa yɛ awosu mu yare . Ɛne sɛ, nsakrae (nsakrae) bi a ɛba yɛn awosu mu nkwaadɔm mu na ɛde ba. Nanso, sɛ awosu mu tebea yi wɔ hɔ mpo a, ɔyare mmoawa, nyarewa, anaa nneɛma a atwa yɛn ho ahyia bi na ɛkanyan no.

(HUS) abu so dɛn?

Nnipa a wonya akisikuru a mmoawa (E. coli) no de ba no mu 5% kosi 15% benya HUS . Ɔkwan a wɔfrɛ no (aHUS) no ho yɛ na koraa. Ɛba nnipa bɛyɛ ɔpepem biako biara mu.

Dɛn ne (HUS) ho sɛnkyerɛnne atitiriw?

Ɛho hia paa sɛ wuhu saa sɛnkyerɛnne ahorow yi.

Nsɛnkyerɛnne a edi kan a wotumi hu:

• Atiridiinini: Mpɛn pii no, mogya ka ho.
• Yafunu mu yaw.
• Akisikuru ne ɔfe.
• Tipaeɛ .
• Awɔw ne atiridiinini.

Nneɛma afoforo a wotumi hu:

• Ɛnyɛ den sɛ wobɛbɔ akuru.
• Wora a ɛyɛ mmerɛw (pale): Hwene no mu ne ano mpo betumi ayɛ fitaa.
• Kesereneeyɛ.
• Gye no ɔhyɛ so.
• Tebea horow a ɛte sɛ ɔyare a ɛma obi hwe ase.
• Koma a ɛbɔ ntɛmntɛm (arrhythmia).

Sɛ (HUS) tebea no mu yɛ den a, mogya mu nkwammoaa kɔkɔɔ a asɛe no betumi ama mogya ayɛ mmerɛw na asɛe akwaa te sɛ asaabo. Afei asaabo no ntumi yiyi nneɛma a wɔsɛe no yiye. Eyi ne nea yɛfrɛ no (Acute Kidney Injury - AKI) . Ne ho sɛnkyerɛnne ahorow ni:

• Mogya a ɛwɔ nsu mu (hematuria).
• Awuduru dodow a ɛkɔ soro wɔ mogya no mu: Eyi betumi ama obi ho ayɛ no yaw na wanya yare.
• Mogya mmoroso.
• Ɔhome a ɛyɛ den (dyspnea).
• Edema: Ebetumi ahonhon, titiriw wɔ nan ne nansoaa mu.
• Nsu a ɛba no so tew (oliguria).

Dɛn ne nneɛma atitiriw a ɛde (HUS) ba?

HUS dodow no ara fi E. coli mmoawa ahorow bi. Saa mmoawa yi ma awuduru bi a wɔfrɛ no Shiga awuduru . Saa awuduru yi sɛe yɛn dwensɔtwaa ketewaa no mu nneɛma na ɛma obi nya akisikuru. Saa awuduru yi nso kɔ mogya mu, na ɛsɛe mogya mu nkwammoaa kɔkɔɔ na ɛsɛe asaabo no.

Ɛda adi sɛ wubenya E. coli yare no afi:

• Nam a wɔannoa no yiye: titiriw nantwinam, nantwinam a wɔayam.
• Nufusu ne nnuaba mu anonne a wɔmfa pasteurized: Pasteurization yɛ ɔhyew a ɛyɛ brɛoo a ekum nneɛma a epira te sɛ mmoawa.
• Nnuaba ne nhabannuru a wɔanhohoro na ɛho agu fĩ.

Wɔsan frɛ E. coli ahorow a ɛma awuduru yi Shiga E. coli a ɛma awuduru (STEC) . STEC a ɛtaa ba Amerika Atifi fam ne E. coli O157:H7 .

Ɛntaa mma sɛ nnuru ne nneɛma bi nso betumi de "secondary (HUS)" aba. Nhwɛso ahorow:

• Nnuru a wɔde ko tia kokoram (Nnuru a wɔde sa kokoram): te sɛ (bleomycin), (cisplatin), (gemcitabine).
• Nnuru a ɛma nipadua no tumi ko tia nyarewa: te sɛ (cyclosporine), (tacrolimus).
• Quinine: Aduru a wɔde sa asramma.
• Nnuru bi : (oxymorphone), (ecstasy), (cocaine).

So (HUS) yɛ ɔyare mmoawa?

Dabi, HUS nyɛ nea wɔde yare mmoawa ba.

Nanso, wobetumi de E. coli mmoawa akɔ nnipa mu. Saa mmoawa yi betumi afa aduan anaa anonne a efĩ wom so, anaasɛ obi anaa aboa bi a ɔwɔ akisikuru a E. coli ayɛ no nsu a ɛbɛka no so. Enti, ɛho hia sɛ yɛhwɛ yiye paa wɔ ahotew ho.

Hena na ɛda adi kɛse sɛ obenya nkɔso (HUS)?

Ɛwom sɛ obiara betumi anya HUS de, nanso nnipa a wodi so yi wɔ asiane kɛse mu:

• Wɔ mmofra nkumaa a wonnii mfe 5 fam.
• Wɔn a wɔn nipadua mu tumi a ɛko tia nyarewa no yɛ mmerɛw (a wɔn nipadua no tumi ko tia nyarewa no) fam.
• Sɛ obi a ɔwɔ w’abusua mu anya HUS pɛn (titiriw aHUS).
• Sɛ wunya E. coli yare a: Titiriw fi nneɛma te sɛ nam a wɔannoa no yiye ne nufusu a wɔmfa pasteurized nhyɛ mu.
• Sɛ obi ne obi a ɔwɔ akisikuru a (E. coli) de ba no di nkitaho tẽẽ.

Wobɛyɛ dɛn ahu sɛ wowɔ (HUS)? (Nyare a Wɔahu) .

Sɛ wokɔ oduruyɛfo nkyɛn a, ɔbɛyɛ saa nneɛma yi:

• Bisa w'aduruyɛ ho abakɔsɛm .
• Bisa w'abusua aduruyɛ ho abakɔsɛm .
• Wɔyɛ nipadua mu nhwehwɛmu .

Sɛ saa nneɛma yi ma adwenem naayɛ sɔre wɔ HUS tebea bi ho a, oduruyɛfo no bɛhyɛ sɛ wɔnyɛ nhwehwɛmu pii bio.

Sɔhwɛ ahorow bɛn na wɔyɛ?

• Nsuo mu nhwehwɛmu: Wɔfa wo nsuo bi na wɔhwɛ sɛ protein anaa mogya anaa.
• Mogya mu nhwehwɛmu: Wɔfa mogya de hwɛ nneɛma te sɛ mogya mu nkwammoaa kɔkɔɔ dodow, mogya mu nkwammoaa dodow, ne sɛnea w’asaabo ne wo mmerɛbo reyɛ adwuma yiye.
• Nsu mu nhwehwɛmu: Wɔfa nsu mu nsu mu nhwɛsode na wɔhwɛ sɛ mmoawa a wɔde HUS ba te sɛ E. coli O157 wɔ hɔ anaa.
• Awosu mu nhwehwɛmu: Ɛtɔ mmere bi a, wobetumi de wo mogya bi akɔma wɔakɔyɛ awosu mu nhwehwɛmu. Eyi betumi aboa ma woahu sɛ ebia wowɔ awosu mu tebea bi te sɛ aHUS ne ayaresa a eye ma wo.
• Asaabo mu nhwehwɛmu: Eyi hwehwɛ sɛ wɔfa asaabo no fã ketewaa bi na wɔde afiri a wɔde hwɛ nneɛma nketenkete hwɛ mu hwɛ sɛnea asaabo no asɛe kɛse ne nea ɛde bae. Ɛnyɛ obiara na ohia eyi.

Ɔkwan bɛn so na sɔhwɛ ahorow betumi akyerɛ sɛ wowɔ HUS?

• Efi nsu mu nhwehwɛmu mu: Sɛ mogya anaa protein wɔ nsu no mu a.
• Mogya mu nhwehwɛmu: Sɛ mogya mu nkwammoaa kɔkɔɔ ne mogya mu nkwammoaa kɔkɔɔ dodow sua, anaasɛ sɛ gyinapɛn ahorow a ɛkyerɛ sɛ asaabo no yɛ adwuma (te sɛ creatinine) kɔ soro a.
• Nsu mu nhwehwɛmu: Sɛ wohu mmoawa te sɛ (E. coli O157).
• Asaabo mu nhwehwɛmu: Wobetumi ahu sɛnea asaabo no asɛe pɔtee.

Ɔkwan bɛn so na wɔsa (HUS) yare?

Sɛ wohu sɛ wowɔ HUS a, ɛho behia sɛ wɔde wo kɔ ayaresabea na wɔsa wo yare. Ayaresa a wobetumi apaw bi ne:

• Nsu a wɔde fa ntini mu (IV) ne/anaasɛ nsu a wɔde ma wɔ nsu mu (aduan a wɔde ma wɔ awotwaa mu): Eyi boa ma wosiw nsu a ɛho nhia ano na ɛma wonya aduannuru a ɛho hia.
• Nnuru a Wɔde Yɛ:
• Wɔbɔ mmɔden sɛ wɔbɛtew asaabo a ɛsɛe no so denam nnuru a ɛma mogya mmoroso (nnuru a wɔde ko tia mogya mmoroso) a wɔde ma so .
• Wobetumi ama nnipa a wɔwɔ aHUS nnuru pɔtee te sɛ eculizumab anaa ravulizumab . Ansa na wubefi nnuru yi ase no, ɛho hia sɛ wobɔ wo ho ban fi meningococcal ne pneumococcal nyarewa ho, efisɛ saa nnuru yi ma asiane a ɛwɔ hɔ sɛ wubenya saa nyarewa no yɛ kɛse.
• Ebia ebehia sɛ wonom nnuru a ekum ɔyare mmoawa anyɛ yiye koraa no adapɛn abien.
• Mogya a wɔde ma: Mogya mu nkwammoaa kɔkɔɔ ne mogya mu nkwammoaa kɔkɔɔ a wɔde bɛma obi a ɔwɔ (HUS) no ho hia yiye. Mogya mu nkwammoaa kɔkɔɔ brɛ mogya a ɛtɔ kɔ nipadua mu ho sɛnkyerɛnne te sɛ ahome a ɛyɛ tiaa ne koma a ɛbɔ ntɛmntɛm no ase. Nkwammoaa a ɛma mogya tu no boa ma mogya no tu yiye, na ɛtew mogya a ɛtɔ ne akisikuru so.

Sɛ asaabo no sɛe kɛse a, ebia ɛho behia sɛ wɔde dialysis siesie mogya no kosi sɛ asaabo no bɛsan ayɛ yiye. Sɛ asaabo no di nkogu koraa esiane HUS nti a, ebia ɛho behia sɛ wɔde asaabo foforo ma .

So wobetumi asa HUS yare koraa?

Yiw, nnipa pii ho tɔ wɔn wɔ HUS mu a ɛnsɛe wɔn akwahosan daa.

Nanso, nnipa binom, titiriw mmofra nkumaa, betumi anya asaabo mu yare a enni sabea (CKD) a emu nyɛ den wɔ 20% kosi 50% mu. Asaabo mu yare a ɛba awiei (ESK) betumi aba wɔ 3% kosi 5% mu. Nhwehwɛmu kyerɛ sɛ CKD ka mpanyimfo bɛyɛ 45%.

Nnipa bɛboro 85% a wonya HUS no san wɔn asaabo dwumadi koraa. Nanso, sɛ wɔn ho tɔ wɔn koraa mpo a, hokwan ketewaa bi wɔ hɔ sɛ daakye wobenya mogya mmoroso anaa asaabo mu haw afoforo.

So wobetumi asiw HUS ano?

Nneɛma bi a wubetumi ayɛ de aboa ma wɔasiw E. coli yare mmoawa, ade titiriw a ɛde HUS ba no ano ni. Eyinom ho hia wo ne w’abusua paa:

• Kwati asuguare wɔ mmeae a efĩ (atare, nsubɔnten), titiriw sɛ wususuw sɛ mmoawa pii wɔ nsu no mu a.
• Sɛ wowɔ atiridiinini a, nkɔ asuguare.
• Kwati sɛ wobɛnom anonne a wɔmfa pasteurized (a wɔmfa nnuru nhyɛ mu) (nufusu, nnuaba mu nsu).
• Bere nyinaa tew adididan mu nnwinnade (nnade, kyɛnsee, nkankyee) ne mmeae a wosiesie nnuan (apon, kyerɛwpon, nkuku) ho yiye.
• Noa nkesua ne nam a wɔayam no yiye ma anyɛ yiye koraa no emu hyew yɛ digrii Celsius 71 (digrii Fahrenheit 160), na noa nkokɔ ma emu hyew yɛ digrii Celsius 74 (digrii Fahrenheit 165).
• Sɛ woreprapra nam so a, fa gu microwave anaa frigye mu. Mfa nsukyenee nhyɛ mu wɔ baabi a wosiesie aduan anaa nsu a ɛyɛ hyew mu.
• Ma nnuan a wɔannoa ne nea wɔanoa no ntetew mu.
• Fa samina ne nsu a ɛyɛ hyew hohoro wo nsa yiye ansa na woadi, bere a wode aguaree adi dwuma awie, bere a woasesa mmofra ntama nketewa awie, ne bere a wode wo nsa aka afuw mu mmoa awie no.

Susuw ho hwɛ, sɛ wudi anammɔn a ɛnyɛ den yi akyi a, wubetumi abɔ wo ho ban afi tebea a emu yɛ den te sɛ eyi ho.

Sɛ wowɔ (HUS) a, dɛn na wubetumi ahwɛ kwan?

Sɛ wohu yare no yiye na wɔsa wɔn yare a, nnipa dodow no ara a wɔwɔ HUS no ho tɔ wɔn koraa a ɛnsɛe wɔn akwahosan daa. Nanso, asiane wɔ hɔ sɛ obi benya mogya mmoroso anaa tebea afoforo a ɛbɛka asaabo no daakye.

HUS a emu yɛ den, titiriw sɛ ɛka akwaa afoforo te sɛ amemene no a, sɛ wɔansa a, ebetumi akum obi.

Dɛn ne hokwan ahorow a ɛwɔ hɔ sɛ obi benya nkwa (HUS)?

Sɛ wɔhunu yareɛ no yie na wɔsa no yareɛ a, nnipa bɛboro 90% nya nkwa wɔ HUS. Enti ɛho hia sɛ woremmɔ hu na sɛ wowɔ sɛnkyerɛnne ahorow a, wohwehwɛ nnuruyɛfo afotu ntɛm.

Mɛyɛ dɛn ahwɛ me ho?

Sɛ wo anaa wo ba nya akisikuru a emu yɛ den a, ɛho hia yiye sɛ wobɔ mmɔden sɛ wobɛsan de nsu ama wo nipadua mu.Nsã a ɛma nsu san nya ahoɔden te sɛ Jeevani betumi aboa ma wɔde anyinam ahoɔden a ayera asi ananmu. Ebia ɛho behia sɛ wɔma nkokoaa ne mmofra nkumaa nufusu anaa nufusu a wɔde ma wɔn. Bisa oduruyɛfo bi ɔkwan a eye sen biara a wobɛfa so ama wo ba no anya nsu.

Bere bɛn na ɛsɛ sɛ mekɔ oduruyɛfo nkyɛn?

Sɛ wowɔ saa sɛnkyerɛnne ahorow yi a, kɔ oduruyɛfo nkyɛn ntɛm ara:

• Mogya a ɛma obi dwensɔtwaa.
• Ɔyare a ɛtra hɔ boro nnansa.
• Nipadua a ɛho ahonhon.
• Wora a ɛyɛ mmerɛw sɛ ɛbɛpirapira.
• Ɔbrɛ a emu yɛ den.

Nsɛm bɛn na ɛsɛ sɛ mibisa oduruyɛfo no?

Wubetumi abisa oduruyɛfo no nsɛm yi:

• Wobɛyɛ dɛn asi so dua sɛ mewɔ Hemolytic Uremic Syndrome?
• Ɛyɛɛ dɛn na minyaa Hemolytic Uremic Syndrome?
• Sɛ minni Hemolytic Uremic Syndrome a, aduruyɛ mu tebea foforo bɛn na metumi anya?
• Ayaresa ahorow bɛn na wokamfo kyerɛ?
• So m’asaabo bɛsɛe koraa?
• So menya mogya mmoroso anaa asaabo mu haw afoforo daakye?

Dɛn ne Hemolytic Uremic Syndrome abiɛsa no?

Triad yɛ sɛnkyerɛnne atitiriw abiɛsa a wɔaka abom a ɛkyerɛ sɛ obi wɔ aduruyɛ mu tebea pɔtee bi.

Nea ɛka Hemolytic Uremic Syndrome triad no ho ne:

1. Wo mogya mu nkwammoaa kɔkɔɔ a ɛsɛe (microangiopathic hemolytic anemia) .

2. Ntini mu nkwammoaa a ɛwɔ wo mogya mu a ɛso tew nkakrankakra (thrombocytopenia) .

3. Asaabo mu opira a emu yɛ den.

Sɛ mewɔ atiridiinini a, so ɛno kyerɛ sɛ mewɔ Hemolytic Uremic Syndrome?

Esiane sɛ wowɔ atiridiinini nti, ɛnkyerɛ sɛ wowɔ Hemolytic Uremic Syndrome. Nanso, sɛ wowɔ mogya mu dwensɔtwaa, anaasɛ wo dwensɔtwaa no mu yɛ den (kosi sɛ nsu bɛtɔ wo yare anaasɛ ɛkyɛ bɛboro nnansa) a, akyinnye biara nni ho sɛ ɛsɛ sɛ wokɔ oduruyɛfo nkyɛn.

Nsonsonoe bɛn na ɛda (Hemolytic Uremic Syndrome) ne (Thrombotic Thrombocytopenic Purpura - TTP) ntam?

Hemolytic Uremic Syndrome (HUS) ne Thrombotic Thrombocytopenic Purpura (TTP) yɛ tebea abien a ɛte saa ara. Wɔ TTP mu no, mogya a ɛtɔ gu mogya ntini nketenkete mu. Ɛwom sɛ kan no na nnuruyɛfo boaboa HUS ne TTP ano de, nanso mprempren wobu no sɛ tebea horow a ɛsono emu biara.

Nea etwa to no, nneɛma a ɛsɛ sɛ wokae (Take-Home Message) .

Mpɛn pii no, akisikuru yɛ tebea a ɛtra hɔ bere tiaa bi, nanso ɛnyɛ dɛ. Mpɛn pii no, ɛyɛ yiye wɔ da koro anaa nnanu mu. Nanso, sɛ mogya tu wo dwensɔtwaa, anaasɛ wo dwensɔ bɛboro nnansa, ne sɛ wobrɛ, wo ho ayɛ wo hyew, anaasɛ wo nsu kakraa bi bere a wokɔ aguaree no ka ho a, bere aso sɛ wokɔ oduruyɛfo nkyɛn ntɛm ara.

Tebea bi a wɔfrɛ no Hemolytic Uremic Syndrome betumi asɛe w’asaabo kɛse na aka akwaa afoforo.Dodow a wunya eyi ho ayaresa ntɛm no, dodow no ara na ɛnyɛ den sɛ wobɛsɛe w’asaabo bere tenten. Enti, hwɛ yare no ho sɛnkyerɛnne no yiye, ma wo ho tew yiye, na sɛ wowɔ biribi a ɛhaw wo a, hwehwɛ aduruyɛfo afotu. W’akwahosan ho hia wo paa!

` Hemolytic Uremic Syndrome, HUS, Asaabo mu Yare, Atiridiinini, E. coli, Mogya mu Nkwammoaa Kɔkɔɔ, Nkwammoaa a Ɛma mogya Mu Nkwammoaa, Mmofra Akwahosan