Masifunde Nge-Hepatitis D: Kuhlukile Kakhulu! | Nirogi Lanka

Kungenzeka ukuthi uke wezwa ngezimo ezahlukahlukene zesibindi, kodwa namuhla eNirogi Lanka, sifuna ukuxoxa ngesifo esiyingqayizivele nesibucayi kakhulu: i-Hepatitis D. Ake sibheke kabanzi ukuthi yini eyenza leli gciwane lihluke, ukuthi lithinta kanjani impilo yakho, kanye nezinyathelo ezibalulekile ongazithatha ukuze uzivikele.

Kuyini i-Hepatitis D?

Kalula nje, i-Hepatitis D igciwane elibangela ukuvuvukala kwesibindi. Kodwa-ke, okwenza leli gciwane libe lihlukile ngempela ukuthi igciwane le-Hepatitis D (HDV) alikwazi ukubangela ukutheleleka ngokwalo. Kuzwakala kumangalisa, akunjalo? Ukuze liphindaphindeke futhi libangele izifo emzimbeni wakho, igciwane kumele lihlale ndawonye negciwane le-Hepatitis B (HBV) . Lokhu kusho ukuthi ungalithola kuphela i-Hepatitis D uma usuvele uthelelekile nge-Hepatitis B, noma uma uthola womabili amagciwane ngesikhathi esisodwa. Alikwazi ukusinda noma ukubangela ukugula lodwa.

Ukutheleleka kwe-Hepatitis D ngokuvamile kuhlukaniswa ngezigaba ezimbili:

1. Ukutheleleka Okubukhali: Izimpawu zibonakala ngokushesha futhi zingase zihlale amasonto noma izinyanga eziningana. Kwezinye izimo, umzimba wakho ungase uqede ukutheleleka ngokwawo.

2. Ukutheleleka Okungapheli: Lolu uhlobo olubi kakhulu. Ukutheleleka okunamandla kungaqhubekela esimweni esingapheli, lapho izimpawu ziqhubeka khona isikhathi esingaphezu kwezinyanga eziyisithupha. Lokhu kungaholela ekulimaleni kwesibindi sakho isikhathi eside, okuhlala njalo.

Yiziphi izinhlobo ze-Hepatitis D?

Ake sibheke izindlela ezimbili eziyinhloko ongazithola ngazo i-Hepatitis D.

Kuyini i-Coinfection?

Ukutheleleka ngamagciwane kwenzeka uma utheleleke ngegciwane le-Hepatitis B (HBV) kanye negciwane le-Hepatitis D (HDV) ngesikhathi esifanayo . Cabanga ngakho njengokuhlasela ngasikhathi sinye kwamagciwane womabili. Kulezi zimo, izimpawu zivame ukufana nokutheleleka kwe-Hepatitis B okuvamile kodwa kungaba nzima kakhulu . Kodwa-ke, kunezindaba ezinhle: uma utheleleke ngakho kokubili ngesikhathi esisodwa, amathuba okuba ukutheleleka kube okungamahlalakhona ngokuvamile aphansi.

Kuyini i-Superinfection?

Ukutheleleka nge-superinfection kuhlukile, futhi kunengozi enkulu . Lokhu kwenzeka uma usuvele unegciwane le-Hepatitis B elikhona (mhlawumbe elingamahlalakhona) bese usanda kuvezwa yigciwane le-Hepatitis D. Kufana nokwengeza ungqimba olusha lokugula kolukhona. Uma kwenzeka ukutheleleka nge-superinfection, izimpawu zakho zangaphambilini ze-Hepatitis B zingase zivele ngokuzumayo noma zizizwe ziqine kakhulu . Ezimweni eziningi (cishe ama-90%), lolu hlobo lokutheleleka nge-superinfection luqhubekela esimweni esingamahlalakhona . Lokhu kusho ukuthi ukutheleleka kungahlala emzimbeni wakho isikhathi eside, okwandisa izinga lapho isibindi sakho singalimala khona.

Ziyini izimpawu ze-Hepatitis D?

Izimpawu ze-Hepatitis D zifana kakhulu nezinye izinhlobo ze-hepatitis. Abanye abantu bangase bangakhombisi nhlobo izimpawu. Kodwa-ke, uma kuvela izimpawu, ungase uhlangabezane nalokhu okulandelayo:

• Imfiva.
• Ubuhlungu besisu , ikakhulukazi ohlangothini oluphezulu kwesokudla lwesisu sakho (lapho isibindi sakho sitholakala khona).
• Isicanucanu nokuhlanza.
• Ukulahlekelwa yisifiso sokudla , lapho ungenaso isifiso sokudla.
• Umchamo onombala omnyama , ovame ukufana nombala wetiye.
• Ngakolunye uhlangothi, indle yakho ingaba nombala okhanyayo noma ofana nobumba .
• Ukuphuzi kwesikhumba namehlo — isimo esaziwa ngokuthi i-jaundice . Lokhu kwenzeka lapho isibindi sakho singakwazi ukucubungula i-bilirubin ngempumelelo.
• Ukukhathala okuqhubekayo noma ukukhathala.

Ukutheleleka kwe-Hepatitis D nakho kungabangela ukuthi noma yiziphi izimpawu ze-Hepatitis B ezikhona zibe zimbi kakhulu .

Yini ebangela i-Hepatitis D?

Imbangela yi- Hepatitis Delta Virus (HDV) . Kodwa-ke, njengoba kushiwo, ayikwazi ukusebenza yodwa. Ithembele ngokuphelele kwi-Hepatitis B virus (HBV) ukuze iphile futhi iphindaphindeke. Ngakho-ke, ukuze ube ne-Hepatitis D, kufanele ube ne-HBV virus emzimbeni wakho.

I-Hepatitis D idluliselwa kanjani?

I-Hepatitis D idluliselwa ngendlela efanayo ne-Hepatitis B: ngokuxhumana negazi noma olunye uketshezi lomzimba (isb. isidoda, uketshezi lwesitho sangasese sowesifazane) somuntu onegciwane. Izindlela ezibalulekile zokudlulisela zihlanganisa:

• Ukuxhumana ngokocansi okungavikelekile (ukungasebenzisi ikhondomu ngesikhathi socansi lwesitho sangasese sowesifazane, somlomo, noma sendunu).
• Ukwabelana ngezinaliti noma amasirinji asetshenziselwa ukujova izidakamizwa. Ukusebenzisa imishini yezokwelapha engahlanzwanga kahle nakho kungaba yingozi.
• Ukulimala kwenaliti kwabasebenzi bezempilo ngesikhathi benakekela iziguli.
• Ukudluliselwa kwegciwane kusuka kumama kuya enganeni ngesikhathi sokubeletha. Lokhu akuvamile, ikakhulukazi uma kuthathwa izinyathelo zokuvimbela ezifanele.
• Ukudweba ama-tattoo noma ukubhoboza usebenzisa imishini engahlanzeki nakho kunengozi enkulu.

Ubani osengozini enkulu yokuthola i-Hepatitis D?

Amaqembu alandelayo asengozini enkulu yokuthola i-Hepatitis D ngokombono kaNirogi Lanka:

• Abantu asebevele bethelelekile nge-Hepatitis B (HBV): I-Hepatitis D ayinakuba khona ngaphandle kokuba khona kwe-Hepatitis B.
• Abantu abafaka imijovo yezidakamizwa: Ikakhulukazi labo ababelana ngezinaliti noma ezinye izinto.
• Abalingani bocansi: Noma ubani oxhumana ngokocansi nomuntu one-HBV kanye ne-HDV.
• Amalungu omndeni: Labo abahlala nomuntu one-HBV ne-HDV, ikakhulukazi uma izinto zomuntu siqu ezifana nezinsingo noma amabhulashi amazinyo zabelwana ngazo.
• Abantu abanesifo sengculazi.
• Amadoda alala namadoda: Ikakhulukazi uma enza ucansi olungavikelekile.
• Abasebenzi bezempilo: Noma labo abakweminye imikhakha lapho ukuchayeka njalo egazini noma oketshezini lomzimba kuvame khona.
• Abantu abanesifo sezinso abahlinzwa nge-hemodialysis.

Yiziphi izinkinga ezingaba khona ze-Hepatitis D?

I-Hepatitis D, ikakhulukazi uma iba yisifo esingamahlalakhona, ingabangela umonakalo omkhulu esibindini sakho. Izinkinga ezibalulekile zifaka:

• I-Cirrhosis: Lokhu ukusha kwezicubu zesibindi sakho. Ngokuhamba kwesikhathi, njengoba isibindi sakho siba lukhuni futhi siba nezibazi ezengeziwe, silahlekelwa ikhono laso lokusebenza kahle, ngendlela efanayo nendlela inxeba elijulile esikhumbeni sakho elishiya ngayo uphawu oluhlala njalo.
• Ukwehluleka kwesibindi: Lesi yisimo esibucayi lapho isibindi sakho singasakwazi ukwenza imisebenzi yaso ebalulekile, okubangela usongo oluqondile empilweni yakho.
• I-Hepatocellular carcinoma: Lolu uhlobo lomdlavuza wesibindi oyinhloko. Uma une-Hepatitis D engapheli, ingozi yakho yokuthola lo mdlavuza iphakeme kakhulu.

I-Hepatitis D itholakala kanjani?

Uma usola ukuthi unezimpawu ze-Hepatitis D noma ungoweqembu elisengozini enkulu, isinyathelo esingcono kakhulu ukubonana nodokotela ukuze ahlolwe. Ukuxilongwa kutholakala ngokuyinhloko ngokuhlolwa kwegazi . Ilabhorethri yakho izohlola ukuthi kukhona yini izinhlayiya zegciwane (i-HDV RNA) noma ama-antibodies umzimba wakho owakhiqizile ukulwa negciwane (ama-anti-HDV antibodies).

Ngaphezu kwalokho, ukuze kuhlolwe impilo yesibindi sakho kanye nobukhulu banoma yikuphi ukushaqeka, udokotela wakho angase ancome ukuthi kwenziwe i -ultrasound , i- FibroScan , noma i-elastography . Kwezinye izimo, kungadingeka i -biopsy yesibindi (isampula encane yezicubu zesibindi).

Ingabe ikhona ikhambi eliphelele le-Hepatitis D?

Uma ngikhuluma iqiniso, okwamanje akukho ikhambi eliqinisekile le-Hepatitis D. Kodwa-ke, ukutheleleka kwe-HDV okubukhali, ikakhulukazi ezimweni zokutheleleka kanyekanye, ngezinye izikhathi kungaxazululeka ngokwako ngaphandle kokwelashwa.

Kulabo abaphila ne-Hepatitis D engamahlalakhona, odokotela bagxila ekuphatheni igciwane, ekunciphiseni ukulimala kwesibindi, kanye nokuvimbela ezinye izinkinga. Ukwelashwa okungenzeka kufaka phakathi:

• Imijovo ye-Peginterferon alfa: Lokhu kuvame ukunikezwa kanye ngesonto cishe unyaka wonke ukusiza amasosha omzimba wakho ukulwa nokutheleleka. Sicela uqaphele ukuthi lokhu kungabangela imiphumela emibi.
• I-Bulevirtide (Hepcludex®): Lona umuthi omusha wokulwa namagciwane ovimbela igciwane le-HDV ukuthi lingangeni emangqamuzaneni esibindi sakho. Nakuba uvunyelwe ukwelashwa emazweni amaningana, ukutholakala kwawo kungahluka.
• Ukufakelwa isibindi: Uma isibindi sakho silimele kakhulu futhi singasasebenzi, ukufakelwa isibindi kungaba yindlela yokugcina yokwelapha.

Ucwaningo ngezindlela ezintsha zokwelapha luyaqhubeka eNirogi Lanka nasemhlabeni jikelele.

Kwenzekani uma ngine-Hepatitis D?

Uma kutholakale ukuthi une-Hepatitis D, udokotela wakho uzoqapha impilo yesibindi sakho . Lokhu kuhilela ukuhlolwa njalo, ukuhlolwa kwegazi okuqhubekayo, kanye nokuskena izithombe. Ukutheleleka okubangelwa yi-HDV noma i-HBV/HDV okunamandla kungaphela phakathi kwamasonto noma izinyanga.

Kodwa-ke, ukutheleleka okungaphezu kwalokhu kuvame ukuqhubekela phambili kube yi-Hepatitis D engapheli, engaphikelela iminyaka eminingi. Ithimba lakho lezokwelapha lingase lihlele izindlela zokwelapha ezithatha unyaka noma ngaphezulu.

Iyini iphrojekthi yesifo se-Hepatitis D?

Ukufa ngenxa yokutheleleka okubangelwa yi-HBV/HDV okunamandla akuvamile kakhulu (cishe u-1-5%), yize ukululama kungathatha amasonto noma izinyanga.

Kodwa-ke, ukutheleleka kwe-HBV/HDV okungamahlalakhona kuyingozi kakhulu . Phakathi kuka -70% no-80% wabantu abanalesi simo bangase babe ne-cirrhosis ngokuhamba kwesikhathi. Lokhu kungenzeka ngokushesha—ngezinye izikhathi phakathi neminyaka emibili yokuqala—noma kuqhubeke kancane eminyakeni emi-5 kuya kweyi-10. Ngeshwa, ingxenye enkulu yalabo abane-Hepatitis D engapheli (okubikwa ukuthi cishe u-15% phakathi kweminyaka emi-5-10) babhekene nezinkinga ezinkulu njengokwehluleka kwesibindi noma umdlavuza wesibindi. Yingakho ukuxilongwa okusheshayo nokuphathwa kochwepheshe kubalulekile.

Ingabe i-Hepatitis D ingavinjelwa?

Yebo, impela! Indlela engcono kakhulu nephumelela kakhulu yokuzivikela ku-Hepatitis D ukuvimbela i-Hepatitis B. Lokhu kungenxa yokuthi i-Hepatitis D ayikwazi ukwakheka emzimbeni wakho ngaphandle kokuba khona kwe-Hepatitis B.

• Gomela i-Hepatitis B. Lesi yisinyathelo esibaluleke kakhulu. Umuthi wokugomela uphephile kakhulu futhi usebenza kahle. Uma ungakagomi, kubalulekile ukuthi ukhulume nodokotela wakho ukuze uwuthole.
• Uma usola ukuthi uke wavezwa yi-Hepatitis B (isibonelo, ngokuxhumana negazi lomuntu onegciwane), funa usizo lwezokwelapha ngokushesha. Ungase ufanelekele umthamo womuthi wokugomela, kanye ne -Hepatitis B immune globulin (HBIG) , okufanele unikezwe zingakapheli amahora angama-24-48 ukusiza ukuvimbela ukutheleleka ukuthi kungangeni.

Uma usuvele uphila ne-Hepatitis B, unganciphisa ingozi yakho "yokutheleleka okuphezulu" ngokuthatha lezi zinyathelo zokuphepha:

• Gqoka amagilavu ​​​​ahlanzekile njalo uma ulindele ukuthintana negazi, ukuphuma kwamanzi esilondeni, noma olunye uketshezi lomzimba.
• Ungalokothi wabelane ngezinaliti, amasirinji, noma yimiphi imishini esetshenziselwa ukujova imithi.
• Ungabelani ngezinto zokuhlanzeka komuntu siqu njengezibhulashi zamazinyo noma izinsingo zokushefa, ngoba zingase zithwale igazi elincane.
• Sebenzisa amakhondomu njalo nganoma yiluphi uhlobo locansi.
• Uma udokotela wakho ekunike imithi yokulwa namagciwane ye-Hepatitis B, qiniseka ukuthi uyithatha njengoba nje kuqondiswe.

Uma ukhulelwe futhi uphila ne-Hepatitis B noma i-coinfection (i-HBV/HDV), odokotela bangathatha izinyathelo ezithile ngokushesha ngemva kokuzalwa kwengane yakho ukuze banikeze imijovo kanye nokwelashwa okudingekayo ukuze kuncishiswe kakhulu ingozi yokudluliselwa kwegciwane enganeni yakho.

Ngingayinakekela kanjani impilo yami ngenkathi ngiphila ne-Hepatitis?

Uma une-Hepatitis (B noma D), kunezinyathelo eziningana ongazithatha ukuze uvikele isibindi sakho ekulimaleni okwengeziwe:

• Gwema utshwala ngokuphelele. Utshwala bubangela ukucindezeleka okukhulu emangqamuzaneni esibindi, okungase kube nzima ngesibindi sakho ukubhekana naso uma sesivele sivuvukele.
• Yeka ukubhema noma ugweme ukuqala, njengoba ukubhema nakho kuyingozi empilweni yesibindi.
• Gcina isisindo esinempilo. Ukukhuluphala ngokweqile noma ukukhuluphala ngokweqile kungaba nomthelela ezifweni zesibindi ezinamafutha, okungaba kubi kakhulu isimo sakho sonke sesibindi.
• Xhumana nodokotela wakho noma uchwepheshe wezokudla ukuze uthole iseluleko esiqondene nawe mayelana nokudla okungcono kakhulu ukusekela impilo yesibindi. Ukudla okunempilo kubalulekile.
• Buza udokotela wakho ngaphambi kokuthatha noma yimiphi imithi ethengiswa ngaphandle kwemithi kadokotela (i-OTC). Isibonelo, ukusebenzisa njalo imithi yokunciphisa ubuhlungu njenge- Acetaminophen (Tylenol®) kungaba nzima esibindini sakho. Sebenzisa imithi enjalo kuphela ngaphansi kwesiqondiso sezokwelapha.
• Hlala uzibophezele ekuqokweni kwakho okulandelayo futhi uqedele konke ukuhlolwa kwempilo yesibindi okunconywayo. Lokhu kubalulekile ekuqapheni intuthuko yakho.

Kufanele ngimbone nini udokotela?

Uma uba nezimpawu ze-hepatitis (njengomkhuhlane, izinhlungu zomzimba, ukuphelelwa yisifiso sokudla, noma i-jaundice), noma uma usuvele une-Hepatitis B futhi ubona izimpawu zakho ziba zimbi ngokuzumayo, kufanele ubone udokotela wakho . Ngaphezu kwalokho, uma ukholelwa ukuthi uke wavezwa yi-Hepatitis B noma D, funa iseluleko sezokwelapha ngokushesha.

Kufanele ngiye nini eMnyangweni Wezimo Eziphuthumayo?

Funa usizo lwezokwelapha oluphuthumayo ngokushesha uma uhlangabezana nanoma yiziphi izimpawu ezilandelayo ezinzima:

• Ubuhlungu obukhulu besisu.
• Ukuhlanza okuqhubekayo noma okukhulu , ikakhulukazi uma ungakwazi ukugcina uketshezi luphansi.
• Ukuhlanza igazi noma izinto ezibukeka njengezinhlayiya zekhofi.
• I-jaundice eba yimbi kakhulu (ukuphuzi okukhulu kwamehlo noma isikhumba sakho).
• Ukudideka, ukudideka, noma ubunzima bokuhlala uphapheme (lokhu kungaba izimpawu ze- Hepatic Encephalopathy ).
• Umchamo onombala omnyama noma ukwehla okukhulu kokukhishwa komchamo.
• Izihlalo ezimpunga noma ezinombala wobumba.
• Ukuvuvukala okukhulu kwesisu.

Lokhu kungaba izimpawu zokucindezeleka okukhulu kwesibindi noma ukwehluleka ukusebenza.

Yimiphi imibuzo okufanele ngiyibuze udokotela wami?

KwaNirogi Lanka, sikukhuthaza ukuthi ube ngumhlanganyeli okhuthele ekunakekelweni kwakho. Uma uhlangana nodokotela wakho, cabanga ngokubuza:

• Nginaluphi uhlobo oluthile lwe-hepatitis?
• Yiziphi izindlela zami zokwelapha?
• Kuyodingeka ngihlale isikhathi esingakanani kulokhu kwelashwa?
• Iyiphi indlela efanele yokuphuza imithi yami, futhi yimiphi imiphumela emibi engaba khona?
• Ingabe kukhona izimpawu ezintsha noma izinguquko ezithile okufanele ngiziqaphele?
• Sinjani isimo sesibindi sami samanje, futhi yiziphi ezinye izivivinyo ezidingekayo?
• Yiziphi izinyathelo zokuphepha okufanele ngizithathe ukuze ngivimbele lokhu kusabalale kwabanye?
• Uma ngine-Hepatitis B, yini enye engingayenza ukuze ngivimbele ukuthola i-Hepatitis D?

Uyini umehluko phakathi kweHepatitis B neHepatitis D?

I-Hepatitis B kanye ne-Hepatitis D zombili izifo ezibangelwa amagciwane ezihlasela isibindi sakho ngqo. Umehluko obalulekile ukuthi i-Hepatitis D ingakuthelela kuphela uma usunayo kakade i-Hepatitis B. Igciwane le-Hepatitis D (i-HDV) lisebenza njengegciwane "elingaphelele"; alikwazi ukusinda noma ukuziphindaphinda lodwa futhi lithembele ngokuphelele "kusizweni" kwegciwane le-HBV ukuze libangele ukutheleleka.

Kubalulekile ukwazi ukuthi akuwona wonke umuntu one-Hepatitis B ozophathwa yi-Hepatitis D. Eqinisweni, abantu abaningi abaphila ne-Hepatitis B abanayo i-Hepatitis D.

I-Hepatitis D ivame kangakanani?

Ochwepheshe balinganisela ukuthi abantu abangu-5% kuya ku-15% abaphila ne-Hepatitis B emhlabeni wonke—cishe abantu abayizigidi ezingu-12 kuya ku-45—nabo bane-HDV. I-Hepatitis D ivame kakhulu ezindaweni ezithile zase-Afrika (njenge-Central Africa), e-Asia (isb., eMongolia, ePakistan), e-Amazon basin eNingizimu Melika, kanye nasezingxenyeni zaseMpumalanga Yurophu. Ayivamile e-United States naseNtshonalanga Yurophu. Nakuba ingandile kakhulu eSri Lanka, ingozi isalokhu ikhona, futhi kuyalulekwa ukuthi kuqashelwe.

Ngenxa yokuthi igciwane le-Hepatitis D lidinga igciwane le-Hepatitis B (HBV) ukuthi libangele ukutheleleka, isu lakho lokuzivikela lilula: zonke izinyathelo ozithathayo ukuvimbela ukutheleleka kwe-HBV nazo zikuvikela ku-Hepatitis D. Ngaphezu kwalokho, ngenxa yokusetshenziswa kabanzi komjovo we-Hepatitis B, inani le-Hepatitis B, ngenxa yalokho, amacala e-Hepatitis D liyancipha kancane kancane emhlabeni jikelele. Lokhu kubalulekile, njengoba abantu abaningi bengathwala i-Hepatitis B ngaphandle kokubonisa izimpawu nhlobo.

Uma unesifo esingamahlalakhona, sebenzisana eduze nodokotela wakho ukuze uqaphe impilo yesibindi sakho njalo. Ucwaningo oluqhubekayo lwezokwelapha mayelana nezindlela ezintsha zokwelapha luyaqhubeka nokunikeza ithemba lezinketho zokwelapha eziphumelela kakhudlwana esikhathini esizayo.

Okubaluleke kakhulu okuthathwayo

I-Hepatitis D yisifo sesibindi esiyingqayizivele. Iphuzu elibaluleke kakhulu okufanele ulikhumbule ukuthi awukwazi ukuthola i-Hepatitis D ngaphandle kokuthi igciwane le-Hepatitis B selivele likhona emzimbeni wakho. Ngakho-ke, ukuvimbela i-Hepatitis B kuyindlela ephumelela kakhulu yokuzivikela ku-Hepatitis D.

Ukuthola umuthi wokugomela i-Hepatitis B, ukwenza ucansi oluphephile, nokungabelani ngezinaliti noma amasirinji kuyizinyathelo ezibalulekile ongazithatha ukuze uzivikele ku-Hepatitis B kanye ne-Hepatitis D.

Uma usuvele utholakale une-Hepatitis B, sicela ungesabi. Kubalulekile ukulandela iseluleko sikadokotela wakho, ukuya kuzo zonke izivivinyo ezihleliwe, futhi ugweme izinto ezicindezela isibindi, njengotshwala obuningi noma imithi engakatshelwanga ngumhlinzeki wakho wezempilo. Ukwenza kanjalo kunganciphisa kakhulu ingozi yakho yokuthola i-Hepatitis D.

Hlala uqaphile mayelana nanoma yiziphi izimpawu. Uma unenkinga, xhumana nodokotela wakho ngokushesha. Ukutholwa kusenesikhathi kuyithuluzi lakho elingcono kakhulu lokunciphisa izinkinga nokugcina impilo enempilo nesebenzayo neNirogi Lanka.

Amathegi: I-Hepatitis D, I-Hepatitis D, isibindi, isifo sesibindi, amagciwane, I-Hepatitis B, I-Hepatitis B, i-HDV, i-HBV, i-jaundice, i-Jaundice, ukuvuvukala kwesibindi, i-Cirrhosis, ukwehluleka kwesibindi, umdlavuza wesibindi