Omanyi ku butoffaali obumyufu obuli mu musaayi gwo. Zitera okuba ezeetooloovu, ezigonvu, ng’obupiira obutono obwa kapiira. Kino kizisobozesa okutambula amangu mu misuwa emitonotono mu mubiri gwo ne zitwala omukka gwa oxygen mu bitundu by’omubiri gwo byonna. Naye mu bantu abamu, obutoffaali buno obumyufu bufuuka bwa sickle (C-shaped), ne bukaluba era ne bukwatagana. Kino kye tuyita obulwadde bwa sickle cell disease (SCD). Buno si bulwadde obusikira, wabula mbeera ya buzaale.
Ddala obulwadde bwa sickle cell disease (SCD) kye ki?
Mu ngeri ennyangu, obulwadde bwa sickle cell bulwadde bwa buzaale obukwata obutoffaali bwaffe obumyufu. Munda mu butoffaali buno obumyufu mulimu puloteyina eyitibwa hemoglobin . Omulimu gwayo omukulu kwe kusitula omukka gwa oxygen okuva mu mawuggwe n’agusaasaanya mu mubiri gwonna. Molekyulu ya hemoglobin y’omuntu omulamu eba yeetooloovu era nnyangu. Eno y’ensonga lwaki obutoffaali obumyufu bulabika bulungi nga bwetooloovu.
Naye mu muntu alina obulwadde bwa sickle cell, olw’obulema mu buzaale, enkula ya molekyu eno eya hemoglobin ekyuka. Olw’okuba hemoglobin eno etaali ya bulijjo, obutoffaali obumyufu bufuuka mu ngeri ya sickle, ne bukaluba era ne bukwatagana. Teebereza, kiki ekyandibaddewo singa ogezaako okusindika ebitundu by’omusaayi ebikalu, ebiringa ekiso nga biyita mu ttanka ennyimpi, mu kifo ky’okusindika emipiira egy’ekyekulungirivu egitambulirako? Zaali zikuŋŋaana ne zisibira mu ttanka, si bwe kiri? Mu ngeri y’emu, obutoffaali buno obufaanana ng’ekiwujjo busibira mu misuwa gyaffe emigonvu, ne bulemesa omusaayi okutambula. Kino kye kireeta ebizibu eby'enjawulo ng'obulumi obw'amaanyi n'okukendeeza ku musaayi .
Bubonero ki obutera okulabika ku bulwadde buno?
Abalongo abazaalibwa n’obulwadde bwa sickle cell batera okutandika okulaga obubonero nga bawezezza emyezi nga 5. Obubonero buno busobola okwawukana okusinziira ku muntu. Era ziyinza okukyuka ng’ekiseera kigenda kiyitawo.
| Obubonero | Ennyinyonnyola ennyangu |
|---|---|
| Okukendeera kw’omusaayi | Sickle cells zibeera nnyangu nnyo. Wadde ng’obutoffaali obumyufu obwa bulijjo buwangaala ennaku nga 120, obutoffaali buno bufa mu nnaku 10-20. Kino kireetera omubiri okubulwa obutoffaali obumyufu, ekikuleetera okuwulira ng’okooye era ng’okooye buli kiseera. |
| Ebizibu by’Obulumi | Kano ke kabonero akakulu era akasinga obubi mu bulwadde buno. Obutoffaali obuyitibwa sickle cells bwe bukuŋŋaanyizibwa ne buziba emisuwa emigonvu mu kifuba, mu lubuto, ebitundu by’omubiri n’amagumba, kireeta obulumi obutagumiikiriza. Singa obulumi buno buba bwa maanyi, oyinza okwetaaga okuweebwa ekitanda mu ddwaaliro n’ogenda mu ETU (Emergency Treatment Unit) . |
| Okuzimba emikono n’ebigere | Emisuwa emigonvu egigasa omusaayi mu ngalo n’ebigere bwe gizibikira, ebitundu ebyo bitandika okuzimba. |
| Okukwatibwa yinfekisoni enfunda eziwera | Obutoffaali buno obuyitibwa sickle cells oluusi bwonoona ebitundu by’omubiri ng’ennywanto. Ensigo kitundu kikulu nnyo mu baserikale b’omubiri gwaffe. Bwe kyonoonese, obulabe bw’okukwatibwa yinfekisoni bweyongera. |
| Okufuuka okwa kyenvu kw’amaaso n’olususu | Obutoffaali obuyitibwa sickle cells obwonooneddwa bwe bumenyeka, olususu n’enjeru z’amaaso biyinza okufuuka ebya kyenvu (nga jaundice). |
| Obuzibu mu kulaba | Singa obutoffaali buno buzibikira mu misuwa egigabira eriiso omusaayi, retina y’eriiso eyinza okwonooneka era n’okufuna obuzibu mu kulaba. |
| Okulwawo okukula | Abaana abalina embeera eno bayinza okukula mpola okusinga abaana abalala, era n’okutuuka mu myaka gy’obuvubuka kuyinza okulwawo. |
Lwaki obulwadde buno bubaawo? Ani asinga okubeera mu bulabe?
Ekisinga okuvaako obulwadde buno bwe buzibu mu buzaale. Kiva ku bulema mu buzaale (hemoglobin-beta gene) ku chromosome yaffe 11, eyeenyigira mu kukola hemoglobin.
Ekisinga obukulu nti omwana okusobola okufuna obulwadde buno, alina okusikira obuzaale buno obulema okuva ku nnyina ne kitaawe.
Singa abazadde bombi baba basitula obuzaale buno obulema, ekitegeeza nti tebalina bulwadde buno wabula nga balina obuzaale obuleeta obulwadde buno mu mibiri gyabwe, omwana waabwe alina emikisa 1 ku buli 4 (25%) okuzaalibwa n’obulwadde buno.
Singa omuzadde omu yekka y’asikira obuzaale obwo, omwana afuuka omutambuze w’obulwadde buno. Ebiseera ebisinga tebalaga bubonero, naye basobola okuyisa obuzaale buno mu baana baabwe.
Mu nsi yonna, obulwadde buno businga kubeera mu bantu abava mu Africa, Middle East, Southern Europe, ne Asian Indian.
Ozuula otya obulwadde buno? (Okuzuula obulwadde)
Waliwo engeri ennyangu ennyo ey’okuzuula kino. Okukebera omusaayi okwangu kusobola okuzuula oba waliwo ekika kino ekya hemoglobin ekitali kituufu. Mu nsi nnyingi, buli mwana omuwere akeberebwa kino.
Singa ggwe oba omwana wo muzuuliddwa nti olina embeera eno, omusawo ayinza okukuwa amagezi okwongera okukeberebwa (nga sikaani ey’enjawulo okukebera oba olina obulabe bw’okusannyalala). Era, olw’okuba embeera ya buzaale, oyinza n’okusindikibwa ew’omubuulirizi w’obuzaale.
Ggwe oba munno bw’oba olina obulwadde bwa sickle cell oba nga alina obulwadde buno, osobola okukeberebwa amazzi g’omwana wo ng’oli lubuto okulaba oba alina obulwadde buno. Buuza omusawo wo okumanya ebisingawo.
Obujjanjabi bwe buruwa?
Waliwo ebigendererwa ebikulu bisatu eby’okujjanjaba obulwadde bwa sickle cell:
- Okuziyiza ebizibu by’obulumi
- Okufuga obubonero n’okuwa obuweerero
- Okuziyiza ebizibu ebirala
Kino waliwo obujjanjabi obw’enjawulo.
Eddagala
- Hydroxyurea: Eddagala lino bwe limira buli lunaku liyinza okukendeeza ku mirundi gy’okulumba n’okukendeeza ku bizibu ng’okukendeera kw’omusaayi n’okukwatibwa yinfekisoni. Abakyala ab’embuto balina okwewala okumira eddagala lino.
- Eddagala eriweweeza ku bulumi: Obulumi bwe bubaawo, eddagala eriweweeza ku bulumi omusawo ly’awandiika liyinza okuyamba okufuga obulumi.
- Eddagala eddala: Eddagala nga `Crizanlizumab` (empiso) ne `L-glutamine` (obuwunga) kati likozesebwa okukendeeza ku bulumi, n'eddagala nga `Voxelotor` erikendeeza ku kukendeera kw'omusaayi.
Enzijanjaba endala
- Okuteekebwamu Omusaayi: Okuwaayo omusaayi omulamu kiyinza okuziyiza ebizibu ng’okukendeeza ku musaayi n’okusannyalala.
- Stem Cell Transplant: Kino kikyusa obusigo bw’amagumba. Abaana n’abavubuka abamu abakulu balina obusobozi okuwona ddala obulwadde buno nga bayita mu kino. Naye, omugabi akwatagana obulungi (ebiseera ebisinga ow’oluganda ow’oku lusegere) alina okuzuulibwa ku kino.
Enkola z’obujjanjabi ezisembyeyo: Gene Therapy
Olw’okukulaakulana kwa ssaayansi w’obusawo, obujjanjabi obw’obuwanguzi ennyo era obusuubiza obulwadde buno kati buvuddeyo. `Casgevy` ne `Lyfgenia` ze nkola bbiri ez'obuzaale ezisembyeyo. Mu ngeri ennyangu, enkola zino zikozesa obutoffaali obusibuka mu busimu bw’amagumba bw’omulwadde yennyini, ‘obulongooseddwa’ nga bakozesa tekinologiya ow’obuzaale nga `CRISPR`, kwe kugamba, ne butereeza ekikyamu, ne bufuulibwa obutoffaali obulamu obukola obutoffaali obumyufu, oluvannyuma ne buddamu okuyingizibwa mu mubiri. Buno bujjanjabi bwa mulembe nnyo obusobola okuwonya obulwadde buno.
Kakwate ki akaliwo wakati w’obulwadde bwa sickle cell n’omusujja?
Eno mboozi ya kyewuunyo nnyo. Omusujja bulwadde bwa maanyi obusiigibwa ensiri. Bannasayansi balowooza nti obuzaale bw’obutoffaali obuyitibwa sickle cell gene bwakula okusobola okukuuma abantu obutakwatibwa musujja. Ekyo kisoboka kitya? Singa omuntu alina obulwadde bwa sickle cell (si bulwadde, gene yokka) afuna omusujja, teguba gwa maanyi nnyo. Kino kiri bwe kityo kubanga obutoffaali obumyufu obulinga ekiwujjo buziyiza ekiwuka ky’omusujja okukula obulungi munda mu mubiri. Eno y’ensonga lwaki abantu abalina obuzaale buno baawangaala mu bitundu omusujja mwe gwali, gamba nga Afirika.
Obubaka Obutwala Awaka
- Obulwadde bwa sickle cell si bulwadde busiigibwa, wabula bulwadde bwa buzaale obusikira abazadde.
- Ekizibu ekikulu wano kiri nti enkula y’obutoffaali obumyufu ekyuka ne zizibikira mu misuwa.
- Obulumi obw’amaanyi, okukoowa ennyo (anemia), n’okukwatibwa yinfekisoni bwe bubonero obukulu.
- Bw’ogoberera obujjanjabi obutuufu n’okubuulirirwa, osobola okufuga obubonero bwo n’obeera n’obulamu obwa bulijjo. Kikulu nnyo okubeera ng’okwatagana n’omusawo buli kiseera.
- Olw’obujjanjabi obw’omulembe nga gene therapy, kati waliwo essuubi eddungi nnyo eri obulwadde buno.
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