Ese mu muryango wawe hari umuntu ufite "Indwara ya Sickle Cell"? Reka tubimenye neza!

Uyu munsi tugiye kuvuga ku ndwara isanzwe ari nshya ku bantu benshi, ariko ishobora kuba ifitanye isano cyane n'imiryango imwe n'imwe. Yitwa Sickle Cell Disease (SCD). Ushobora kuba warigeze kumva iri zina mbere. Mu by'ukuri ni indwara ifitanye isano n'amaraso yacu, ni ukuvuga ifitanye isano n'amaraso, kandi ikaba ari indwara ivukanwa. Reka turebere hamwe icyo ari cyo, impamvu ibaho, n'ikindi cyakorwa kuri yo.

Indwara ya Sickle Cell ni iki? Reka tubisobanukirwe mu buryo bworoshye!

Mu magambo make, indwara ya sickle cell (SCD) ni indwara yibasira uturemangingo dutukura tw’amaraso mu mubiri wacu, dukomoka ku babyeyi ku bana. Iyi ni imwe mu ndwara zikunze kugaragara mu maraso ku isi. Noneho reba, mu turemangingo dutukura tw’amaraso yacu harimo poroteyine yitwa hemoglobin . Iyi hemoglobin ni ingenzi cyane. Kuko, ni iyi poroteyine itwara ogisijeni mu mubiri wacu wose. Imeze nk'imodoka ya ogisijeni. Uturemangingo dutukura tw’amaraso y’umuntu muzima akenshi tuba turi impande kandi tworoshye. Nk’udupira duto twa kabutike. Kubera iyo mpamvu, dushobora kwinjira mu mitsi mito y’amaraso mu mubiri (twita imitsi) tugaha ogisijeni ingingo zacu zose n’imitsi. Ariko, ikiba ku muntu urwaye sickle cell ni uko hari impinduka nto muri iyi hemoglobin. Iyi hemoglobin idasanzwe yitwa hemoglobin S. Ibi bituma uturemangingo dutukura tw’amaraso duhinduka nk’ukwezi, cyangwa imiterere y’igice cy’ukwezi, aho kuba uruziga kandi tworoshye. Si ibyo gusa, ahubwo uturemangingo turakomera cyane, ntitwinjirana byoroshye, kandi tugafatana. Tekereza, bigenda bite iyo uturemangingo dutukura tw’amaraso tunyura muri iyo mitsi mito y’amaraso? Turafatana! Hanyuma amaraso arahungabana. Bivuze ko ingingo zacu z'ingenzi n'imitsi ntibona umwuka uhagije wa ogisijeni. Niyo mpamvu hashobora kubaho ingorane zikomeye nko kubabara cyane, kwandura indwara zitandukanye, kwangirika kw'ingingo, no kudakora neza kw'imikorere yazo . Ikindi kintu ni uko izi selile zimeze nk'umuhoro zidapfa igihe kirekire nk'uturemangingo dutukura dusanzwe. Zipfa vuba. Hanyuma umubiri uhora ufite ikibazo cyo kubura uturemangingo dutukura. Ibi nibyo twita anemia . Indwara ya selile sickle ni indwara ibaho ubuzima bwose. Ariko ntugahangayike, hari uburyo bwo kuvura ibi. Ukoresheje ubu buryo bwo kuvura, ushobora kugabanya ibimenyetso no kongera igihe cyo kubaho.

Ese hari ubwoko butandukanye bw'indwara ya sickle cell?

Yego, hari ubwoko butandukanye bw'indwara ya sickle cell. Ubwo bwoko buterwa n'uturemangingo umuntu akura ku babyeyi be.

Hemoglobini SS (HbSS)

Iyi ni yo ndwara ikomeye cyane ya sickle cell. Abantu bagera kuri 65% bafite SCD bafite ubwo bwoko. Aba bantu baragwa gene ya hemoglobin S iva ku babyeyi bombi. Ibi bivuze ko hemoglobin yabo hafi ya yose cyangwa yose iba idasanzwe. Ibi bituma bagira ikibazo cy'amaraso adakira.

Hemoglobini SC (HbSC)

Ibi ni byoroheje cyangwa biri hagati.Ubwoko buri ku rwego rwo hejuru. Abantu bagera kuri 25% bafite SCD bafite ubu burwayi. Aba bantu baragwa gene ya hemoglobin S iva ku mubyeyi umwe, naho gene y'indi gene idasanzwe ya hemoglobin C iva ku wundi mubyeyi.

Hemoglobin (HbS) Beta Thalassemia

Aba bantu baragwa gene ya hemoglobin S iva ku mubyeyi umwe n'gene idasanzwe yitwa beta thalassemia iva ku wundi mubyeyi. Hariho kandi ubwoko bubiri bw'iyi gene:

• “Plus” (HbS beta +): Ubu bwoko bw’indwara bufata abantu bagera kuri 8% by’abarwayi ba SCD kandi akenshi buba bworoheje.
• “Zero” (HbS beta 0): Ubu bwoko bw’indwara bwibasira abantu bagera kuri 2% bafite SCD kandi bushobora kuba bukomeye nk’indwara ya hemoglobin SS (HbSS).

Izindi moko adasanzwe

Uretse ibi, hari n'ubundi bwoko budasanzwe nka hemoglobin SD (HbSD), hemoglobin SE (HbSE), na hemoglobin SO (HbSO) . Aba bantu baragwa gene imwe ya hemoglobin S n'indi gene idasanzwe yitwa D, E, cyangwa O.

Ni irihe tandukaniro riri hagati ya Sickle Cell Anemia n'indwara ya Sickle Cell Disease?

Aha niho abantu benshi bahurira n'urujijo. Indwara ya Sickle Cell (SCD) ni ijambo rusange rikoreshwa ku bwoko bwose butandukanye bw'indwara ya sickle cell twavuze haruguru. Ni nk'umutaka. Ubundi bwoko bwose bugwa muri uwo mutaka. Abaganga bakoresha ijambo "Sickle Cell Anemia" gusa ku bwoko bukomeye bwa SCD butera amaraso make . Ni ukuvuga ubwoko bwitwa hemoglobin SS (HbSS) na hemoglobin beta zero thalassemia. Urabyumva?

Ni irihe tandukaniro riri hagati y’imiterere y’uturemangingo tw’umutsima n’indwara?

Hari abantu bafite imiterere ya sickle cell gusa. Ibi bivuze ko bakura gene ya hemoglobin S iva ku mubyeyi umwe gusa . Undi mubyeyi akura gene nzima. Ubusanzwe, abantu bafite imiterere ya sickle cell ntibagaragaza ibimenyetso by'indwara ya sickle cell. Ariko, bashobora kwanduza iyi gene idasanzwe ku bana babo. Ibi bivuze ko ari bo batwara iyi gene. Ariko, ni gake cyane, ndetse n'abantu bafite imiterere ya sickle cell bashobora kugira ibibazo by'ubuzima iyo babuze amazi menshi cyangwa iyo bakoze imyitozo ngororamubiri ikomeye . Ubushakashatsi buracyakomeje kuri ibi.

Indwara ya sickle cell ikunze kugaragara mu rugero rungana iki?

Abashakashatsi bavuga ko abantu bagera ku 100.000 muri Leta Zunze Ubumwe za Amerika gusa barwaye indwara ya sickle cell. Ikunze kugaragara cyane mu bantu bafite inkomoko muri Afurika. Iboneka kandi mu Banyamerika bakomoka muri Hisipaniya, n'abakomoka mu Nyanja ya Mediterane, mu Burasirazuba bwo Hagati, mu Buhinde no muri Aziya. Hari kandi abantu bafite iyi ndwara muri Sri Lanka.

Ni iki gitera indwara y'uturemangingo tw'umusemburo?

Indwara ya sickle cell iterwa n'impinduka mu ngirabuzimafatizo muri gene yitwa HBB gene . Iyi gene ya HBB niyo ishinzwe gukora igice kimwe cya hemoglobin. Abantu bafite SCD baragwa ngirabuzimafatizo ebyiri za HBB zahinduwe zikora hemoglobin idasanzwe - imwe iva kuri buri mubyeyi. Ibi byitwa autosomal recessive inheritance. Ibi bivuze ko ababyeyi bombi b'umwana ufite SCD bafite kopi imwe ya gene yahinduwe (bivuze ko bashobora kugira imiterere ya sickle cell). Ariko, abo babyeyi akenshi ntibagaragaza ibimenyetso.

Ni nde ufite ibyago byinshi byo kurwara indwara ya sickle cell (SCD)?

Hari amatsinda y'abantu ashobora kwandura iyi ndwara cyane. Abo ni:

• Abantu bafite inkomoko muri Afurika (urugero: Abanyamerika b'Abanyafurika).
• Abanyamerika b'Abanya-Hisipaniya bo muri Amerika y'Epfo na Amerika yo Hagati.
• Abantu bakomoka mu nyanja ya Mediterane, mu Burasirazuba bwo Hagati, mu Buhinde no muri Aziya.

Ni ibihe bimenyetso by'indwara ya sickle cell?

Ibimenyetso by'indwara ya sickle cell bikunze gutangira kugaragara umwana afite amezi agera kuri 5 kugeza kuri 6. Ibi bimenyetso bishobora gutandukana bitewe n'umuntu ku giti cye. Hari abantu bagira ibimenyetso byoroheje, abandi bashobora kugira ingorane zikomeye. Ibimenyetso by'ingenzi bishobora kugaragara ni ibi bikurikira:

• Ububabare bukunze kubaho.
• Anemia : Ibi bishobora gutera umunaniro ukabije, ububabare, no gucika intege.
• Jaundice : Ibara ry'umuhondo ku ruhu n'umweru mu maso.
• Kubyimba kubabaza mu maboko no mu birenge.

Ni izihe ngorane ziterwa n'iyi ndwara?

Indwara ya sickle cell ishobora gufata ibice byinshi by'umubiri. Ingaruka zimwe zitangira mu buryo butunguranye (zikomeye), izindi zikamara igihe kirekire (zidakira). Izi ngorane zishobora gutangira hakiri kare kandi zikamara ubuzima bwose.

Ububabare

Iyi ni yo ngorane ikunze kugaragara cyane iterwa n'indwara ya sickle cell. Ubu bubabare bubaho iyo uturemangingo tumeze nk'umuhoro dufashe imitsi y'amaraso tugafunga inzira y'amaraso. Ushobora kugira ububabare butunguranye kandi bukomeye. Ibi byitwa kandi ububabare, sickle cell crisis, vaso-occlusive crisis (VOC), cyangwa vaso-occlusive episode (VOE) . Ubu bubabare bushobora kuba buke cyangwa bukomeye, kandi bushobora gutangira mu buryo butunguranye kandi bukamara igihe icyo ari cyo cyose. Ubu bubabare bukunze kuba mu gituza, mu mugongo, ku maguru no ku maboko. Hari abantu bashobora kugira ububabare budakira , bivuze ububabare bumara igihe kirenga amezi atandatu.

Anemia

Indwara ya Sickle cell itera kubura amaraso kuko uturemangingo dutukura dupfa vuba cyane. Kubura amaraso ni ukubura uturemangingo dutukura dufite ubuzima bwiza dushobora gutwara umwuka mu mubiri wose. Niyo mpamvuUmunaniro ukabije, umuhondo, kubura amahoro, isereri, no kubabara umutwe bishobora kubaho.

Indwara yo mu gituza ikabije

Iki ni ikibazo cyihutirwa cy’ubuvuzi gishyira ubuzima mu kaga . Kishobora kwangiza ibihaha, kigatera imbogamizi mu guhumeka, kandi kikagabanya umwuka wa ogisijeni mu bindi bice by’umubiri. Iki kibazo kibaho iyo uturemangingo tw’umusemburo tubuza amaraso na ogisijeni mu bihaha.

Udukoko tw'amaraso

Kubura amaraso mu mitsi yo mu bwoko bwa sickle cell byongera ibyago byo kubyimba kw'amaraso. Ibi byongera ibyago byo kubyimba kw'amaraso mu mitsi yo mu bwoko bwa deep vein thrombosis - DVT). DVT ishobora kandi gucika ikajya mu bihaha (pulmonary embolism - PE).

Igisebe cy'imitsi

Iyo uturemangingo tw’umusemburo dufashe umutsi ujyana amaraso mu bwonko, amaraso ajya mu bwonko arahagarara. Ubwonko ntibubona umwuka uhagije wo gukora. Ibi bishobora gutera indwara yo mu bwonko . Abantu bagera kuri 10% bafite SCD bazagira indwara yo mu bwonko. Abantu bafite ikibazo cyo kubura amaraso mu bwonko bafite ibyago byinshi byo kurwara indwara yo mu bwonko.

Ibibazo byo Kureba

Uturemangingo tw’imitsi dushobora kuziba imitsi y’amaraso mu maso. Ibi bikunze kubaho muri retina . Hari igihe nta bimenyetso bigaragara hanyuma kureba bigahita bibura, ndetse bigatera no guhuma burundu.

Ubuhanga bwo gushyira imbere ibintu mu mwanya wabyo

Priapism ni indwara aho uturemangingo tw’igitsina cy’umugabo tumeze nk’umuhoro dufunga, bigatuma habaho guhagarara ku buryo buhoraho kandi bubabaza ( priapism ). Uretse ububabare, priapism ishobora kwangiza burundu no kudakora neza kw’imibonano mpuzabitsina . Priapism imara amasaha arenga ane ni ikibazo cyihutirwa cy’ubuvuzi.

Kwangirika kw'ingingo no kunanirwa kwazo

Abantu barwaye indwara ya sickle cell bafite ibyago byo kugira ibibazo by'umutima, ibihaha, impyiko, n'izindi ngingo kuko batabona amaraso na ogisijeni bihagije. SCD ishobora gutuma ingingo nyinshi zinanirwa gukora neza .

Ese indwara cyangwa imiterere y'uturemangingo tw'umusemburo bigira ingaruka ku gutwita?

Abagore benshi barwaye indwara ya sickle cell batwite neza. Ariko ingaruka zayo ni nyinshi. SCD ishobora kongera ibyago byo kugira umuvuduko ukabije w'amaraso, kubyimba kw'amaraso, gukuramo inda, kubyara abana bafite ibiro bike, no kubyara imburagihe . Bityo rero ni ngombwa gukurikiza inama za muganga wawe.

Indwara y'uturemangingo tw'umusemburo ipimwa ite?

Muri Sri Lanka, kimwe no mu bihugu byinshi ku isi, buri mwana uvutse asuzumwa indwara ya sickle cell mu rwego rwo gupimwa umwana ukiri muto . Ibi bikubiyemo gufata amaraso make mu gatsinsino k'umwana no kuyapima. Ibi binasuzuma izindi ndwara nyinshi. Kugira ngo byemezwe ko umwana arwaye, muganga w'umwana azakora ikizamini cya hemoglobine electrophoresis . Nanone, indwara ya sickle cell irashobora kumenyekana mbere y'uko umwana avuka binyuze mu gupimwa mbere yo kubyara . Ibi bizamini birimo:Ibi birimo gupima virusi ya chorionic na amniocentesis .

Ese hari umuti wuzuye w’indwara ya sickle cell?

Yego, gutera umwongo w'amagufwa , uzwi kandi nka transplantation ya stem cell, bishobora gukiza indwara ya sickle cell. Ibi bikubiyemo gufata umwongo w'amagufwa muzima uvuye ku muntu muzima kandi uhuza neza na genetike (nk'umuvandimwe wawe) ukawushyira mu murwayi. Ariko, abantu bagera kuri 18% gusa barwaye SCD ni bo bashobora kubona ubwo buryo buhuye. Hariho kandi ingaruka n'ingorane kuri ubu buryo bwo gutera umwongo. Muganga wawe azabiganiraho nawe.

Ni ubuhe buryo bwo kuvura indwara ya sickle cell?

Kuvura indwara ya sickle cell birimo imiti, guterwa amaraso, gutera umwongo w'amagufwa, no kuvura uturemangingo . Ubuvuzi bushobora gutangirira kuri antibiyotike . Abana bavutse bafite SCD ikomeye bahabwa antibiyotike kabiri ku munsi mu gihe cy'imyaka 5 kugira ngo birinde kwandura.

Indi miti

Abantu benshi barwaye SCD bakoresha imiti kugira ngo bagabanye ubukana bw'indwara yabo no kuvura ibimenyetso. Bimwe muri byo birimo:

• Voxelotor: Ibi bishobora kubuza uturemangingo dutukura kuba nk'umuhoro no gufatana. Ibi bishobora kugabanya kwangirika kwa zimwe mu turemangingo dutukura tw'amaraso, kunoza uburyo amaraso atembera mu ngingo, no kugabanya ibyago byo kubura amaraso.
• Crizanlizumab: Uyu muti ufasha mu gukumira uturemangingo dutukura tw’amaraso dufite ishusho y’umuhoro gufata ku nkuta z’imitsi y’amaraso . Ibi bishobora kunoza urujya n’uruza rw’amaraso no kugabanya ububabare n’ububyimba.
• Hydroxyurea : Ibi bishobora kugabanya cyangwa gukumira ingorane nyinshi za SCD, nko kubabara kenshi, indwara y’igituza ikabije, no kubura amaraso menshi.
• L-glutamine: Iyi ni imiti igabanya ububabare. Ishobora kugabanya umubare w'ibitero by'ububabare ufite. Izindi miti igabanya ububabare irimo imiti igabanya ububabare itari iya steroide (NSAIDs) na opiates .

Guterwa amaraso

Muganga wawe ashobora kukugira inama yo guterwa amaraso kugira ngo avurwe kandi akurinde ingorane za SCD.

• Guterwa amaraso mu buryo bwihuse:Ibi bifasha kuvura ingorane zitera kubura amaraso cyane. Abaganga bashobora no kubikoresha mu bihe nk'imitsi yo mu bwonko, indwara y'igituza ikabije, ndetse no kunanirwa kw'ingingo.
• Gutera uturemangingo dutukura mu maraso: Ibi bishobora kongera umubare w'uturemangingo dutukura mu mubiri no gutanga uturemangingo dutukura dusanzwe tudasa n'umuhoro.

Gutera uturemangingo tw’umugongo (byitwa kandi gutera umwongo w’amagufwa)

SCD ishobora gukira hakoreshejwe uburyo bwo gutera uturemangingo tw’ingirabuzimafatizo. Ibi bisaba umutanga uhuye neza (nk'umuvandimwe wawe). Ubushakashatsi burimo gukorwa kugira ngo ababyeyi cyangwa abavandimwe bawe bahuje imiterere y’uturemangingo barusheho gutera uturemangingo. Muganga wawe azakubwira ingaruka n’ibyiza by’ubu buryo bw’ubuvuzi hashingiwe ku mimerere yawe yihariye.

Ubuvuzi bw'uturemangingo

Abashakashatsi barimo gukora ubushakashatsi ku buvuzi bw'uturemangingo kugira ngo bavure SCD. Ibi bikubiyemo gukosora gene idasanzwe ya hemoglobin cyangwa gushyira gene ya hemoglobin nzima mu turemangingo tw'umubiri w'umuntu. Amakuru ya mbere kuri ibi ni meza cyane. Icyizere ni uko ubuvuzi bw'uturemangingo buzaba uburyo busanzwe bwo kuvura SCD.

Ese ibi bishobora kwirindwa?

Indwara ya sickle cell ni indwara iterwa n’uturemangingo, bityo ntishobora kwirindwa . Niba utwite, ni byiza kuganira na muganga wawe ku bijyanye no gupima imiterere y’uturemangingo cyangwa ubujyanama ku miterere y’uturemangingo . Ibi bizagufasha wowe n’umukunzi wawe kumenya niba ufite iyo gene n’ibyago byawe byo kuyitera abana bawe.

Ni iki umuntu urwaye indwara ya sickle cell ashobora kwitega?

Abantu barwaye indwara ya sickle cell bashobora kubaho igihe gito ugereranyije n'abaturage muri rusange. Ariko, uburyo bushya bwo kuvura SCD bwazamuye cyane igihe cyo kubaho n'ireme ry'ubuzima . Iyo iyi ndwara yitabwaho neza, abantu barwaye sickle cell bashobora kubaho kugeza ku myaka 50.

Ni gute nakwita ku mwana wanjye mu gihe arwaye indwara ya sickle cell?

Niba umwana wawe arwaye indwara ya sickle cell, hari ibintu byinshi ushobora gukora kugira ngo umufashe:

• Buri gihe jyana umwana wawe kwa muganga.
• Ha umwana wawe inkingo zose zasabwe ku gihe.
• Fasha umwana wawe gukora siporo buri gihe no kurya indyo yuzuye umutima .
• Iyo habayeho ikibazo cy'ububabare, ha umwana wawe ibinyobwa byinshi n'umuti ugabanya ububabare utari steroide (NSAID) . Niba ububabare budashobora gukemurwa mu rugo, mujyana kwa muganga kugira ngo ahabwe imiti ikomeye igabanya ububabare.

Ni ryari ugomba kujya mu Kigo cyita ku Buvuzi bw’Ingoboka (ETU) ?

Indwara ya sickle cell ishobora gutera ingorane zitandukanye zishobora gushyira ubuzima mu kaga. Niba wowe cyangwa umwana wawe mufite kimwe muri ibi bimenyetso bikurikira, hamagara 911 cyangwa ujye mu cyumba cy’ubutabazi bw’ibanze kiri hafi yawe ako kanya:

• Ububabare bukomeye.
• Ibimenyetso by'amaraso akabije: umunaniro ukabije, isereri, no guhumeka nabi.
• Umuriro urenze dogere selisiyusi 38.5 (dogere selisiyusi 38.5).
• Ibibazo byo kutabona neza.
• Kugorwa no guhumeka.
• Gushyukwa kw'igitsina gabo kumara amasaha ane cyangwa arenga (priapism).
• Ibimenyetso by'indwara yo mu gituza ikabije: kubabara mu gituza, inkorora, umuriro.
• Ibimenyetso bya stroke: Gucika intege mu buryo butunguranye ku ruhande rumwe rw'umubiri, gucika intege cyangwa guta ubwenge.

Kuki indwara ya sickle cell itera ububabare?

Mu magambo make, uturemangingo dutukura tw’amaraso dufite ishusho y’umuhoro dusa n’inyuguti ya C, cyangwa ukwezi kw’icyiciro cya kabiri. Uko tugenda mu mitsi yawe y’amaraso, turafatana maze tukabuza amaraso gutembera. Icyo gihe ni bwo ububabare bubaho. Tekereza nk’umuvuduko w’imodoka mu muhanda.

Ese sickle cell ni indwara y’ubwiyongere bw’umubiri?

Oya. Nubwo indwara ya sickle cell ifite bimwe mu biranga indwara ziterwa n’ubwiyongere bw’umubiri , abaganga ntibafata SCD nk'indwara iterwa n’ubwiyongere bw’umubiri. Bafata SCD nk'indwara iterwa n'uturemangingo .

Indwara ya sickle cell ni indwara ibaho ubuzima bwose. Gutera uturemangingo tw’inyuma, bishobora gutanga umuti wuzuye, si ko buri gihe bishoboka, kandi ni ibintu biteje akaga. Ariko, gusuzuma no kuvurwa hakiri kare bishobora gufasha kugabanya ibimenyetso no kugabanya ibyago byo guhura n’ibibazo. Iyo uhawe ubuvuzi buri gihe, ushobora kubaho ubuzima bwuzuye kandi bukora.

Hanyuma, hari ibintu by'ingenzi ugomba kwibuka (Ubutumwa bwo kujyana mu rugo)

Sawa, twavuze byinshi ku ndwara ya sickle cell. Dore ibintu by'ingenzi ugomba kwibuka:

• Indwara ya selile y'umukara (SCD) ni indwara y'amaraso ivuka aho imiterere y'uturemangingo dutukura tw'amaraso ihinduka, bigatera ibibazo mu gutembera kw'amaraso.
• Impamvu nyamukuru ibi ni ubwoko budasanzwe bwa hemoglobine yitwa hemoglobine S.
• Ububabare, kubura amaraso, kwandura indwara, no kwangirika kw'ingingo ni ibintu bisanzwe.
• Kumenya hakiri kare no kuvura neza ni ingenzi cyane. Abana bavutse barasuzumwa.
• Nubwo gutera umwongo w'amagufwa bishobora kuba umuti, ntabwo bikwiriye buri wese. Hariho ubundi buryo bwo kuvura, nko imiti no guterwa amaraso.
• Ushobora kubaho neza n'iyi ndwara uhindura imibereho yawe, ukurikiza inama z'abaganga, kandi ukihutira kugira icyo ukora mu gihe cy'impanuka .

Niba wowe cyangwa umuntu uzi ufite ikibazo icyo ari cyo cyose kijyanye n'indwara ya sickle cell, menya neza ko wagana muganga kugira ngo akugire inama. Nta kintu cyo gutinya cyangwa ngo ugire isoni. Ikintu cy'ingenzi ni ukumenya amakuru! Indwara ya sickle cell, hemoglobin, uturemangingo dutukura tw'amaraso, kubura amaraso, indwara zikomoka ku ngirabuzimafatizo, ibibazo by'ububabare, kuvura sickle cell