Ingabe isisu sengane yakho siyakhula futhi imilenze iya iba mincane? Ake sifunde ngalokhu (Kwashiorkor)?

Namuhla sizokhuluma ngesimo esiyingozi esingaba khona ezinganeni zethu ezincane, kodwa singase singazi ngokugcwele ngaso. Ngezinye izikhathi uma sibona ingane enesisu esikhulu nezingalo ezibuthakathaka, sicabanga ukuthi kukhona okunye okungahambi kahle. Kodwa lokhu kungaba ukuntuleka okukhulu kokudla okunempilo okubizwa ngokuthi (Kwashiorkor) . Ngakho-ke, kubaluleke kakhulu ukuqaphela lokhu.

Kuyini iKwashiorkor? Ake sikuqonde kalula.

Kalula nje, i-Kwashiorkor yisimo esibangelwa ukuntuleka okukhulu kwamaprotheni . Amaprotheni abalulekile ekukhuleni kwemizimba yethu, ikakhulukazi izingane ezincane. Ngakho-ke, i-Kwashiorkor yenzeka lapho umzimba ungatholi inani elidingekayo lamaprotheni kanye nezinye izakhamzimba ezibalulekile.

Okwenzekayo kulesi simo ukuthi uma kungekho amaprotheni anele, izicubu zomzimba ziqoqa amanzi futhi zivuvuke. Sibiza ngokuthi `(edema)` kwezokwelapha. Lokhu kuvuvukala kuyisici esiyinhloko esihlukanisa iKwashiorkor kwezinye izimo zokungondleki kahle. Ungabona ukuthi izitho zomntwana zincane, kodwa izandla, imilenze, ubuso, ikakhulukazi isisu sivuvukile. Uma ebona leso sisu sivuvukile, ngezinye izikhathi umuntu ongazi angase acabange ukuthi ingane idle kahle futhi igcwele. Kodwa empeleni, uhlushwa ukungondleki okukhulu .

Ubani othinteka kakhulu yilesi simo (Kwashiorkor)?

I-Kwashiorkor yisimo esingavamile ukubonwa emazweni athuthukile, njengeYurophu neMelika. Sivame ukubonwa emazweni asathuthuka. Ingozi iphezulu emazweni lapho ubumpofu, ukushoda kokudla, ukuhlanzeka okungekuhle, kanye nokusabalala kwezifo ezithathelwanayo kuvame khona.

Nakuba i-Kwashiorkor ingathinta noma ubani wanoma yimuphi ubudala, ivame ukuthinta izingane ezincane, ikakhulukazi lezo eziphakathi kweminyaka emi-3 nengu-5. Lesi yisikhathi lapho izingane eziningi zikhishwa ubisi lwebele futhi zijwayelane nokunye ukudla. Ngezinye izikhathi, ukudla ezikunikezwayo kungaba nama-carbohydrate amaningi (okungukuthi ukudla okunesitashi njengelayisi, isinkwa, namazambane) kodwa kube namaprotheni aphansi nezinye izakhamzimba. Yilapho inkinga iba yinto evamile khona.

Uyini umehluko phakathi kwe-(Kwashiorkor) kanye ne-(Marasmus)?

Manje ungase uzibuze, ingabe iKwashiorkor iwukuphela kohlobo olubi kakhulu lokungondleki kahle? Cha, kukhona olunye olubizwa ngokuthi iMarasmus . IKwashiorkor kanye neMarasmus yizinhlobo ezimbili eziyinhloko zokungondleki kahle kakhulu kwamaprotheni namandla abasebenzi bezempilo emhlabeni wonke abakuqaphelayo.

Umehluko omkhulu phakathi kwalezi ezimbili ngu:

• I-Kwashiorkor ngokuyisisekelo iwukuntuleka kwamaprotheni .
• I-Marasmus yisimo lapho zonke izakhamzimba ezinkulu, njengeprotheni, ama-carbohydrate, namafutha, zincishiswa khona, okusho ukuthi inani lamakhalori elidliwayo liyancishiswa.

Kalula nje, umuntu one-marasmus ubukeka emncane futhi enciphile. Ngokuvamile akatholi amakhalori anele. Kungaba ukuthi udla kancane kakhulu, noma umzimba wakhe usebenzisa amandla amaningi (isibonelo, ngenxa yohudo oluqhubekayo), noma kokubili. Kodwa umuntu one-kwashiorkor angase abonakale engadli amakhalori anele ngenxa yokuvuvukala, kodwa akatholi amaprotheni anele.

Ziyini izimpawu ze-Kwashiorkor? Sizibona kanjani?

Kulungile, pho singayibona kanjani le nkinga (Kwashiorkor)? Yiziphi izimpawu ingane engase izibone? Kubaluleke kakhulu ukuzazi lezi, ngoba uma kunjalo singathatha isinyathelo ngokushesha.

• Ukuvuvukala (i-edema): Lolu uphawu oluyinhloko. Ikakhulukazi emaqakaleni, emilenzeni, ezandleni nasebusweni, ukuvuvukala kwenzeka sengathi umzimba ugcwele amanzi.
• Ukuvuvukala kwesisu (isisu esikhulu): Isisu siyakhula ngenxa yokuqongelela koketshezi (ama-ascites). Abanye abantu bakubiza nangokuthi "isisu esithambile".
• Izinwele ziyashintsha: Izinwele ziyawoma, ziyaqhekeka, izinwele ziyawa, ngezinye izikhathi umbala wezinwele uyashintsha, ziba mhlophe (umbala uyancipha).
• Izinkinga zesikhumba (i-Dermatitis): Isikhumba siba soma futhi sibe namaqhubu. Kwezinye izindawo, singase sibonakale njengoqweqwe noma amabala abomvu. Uma silimala, ngeke siphole ngokushesha.
• Isibindi esikhulu: Lokhu kungaba uphawu lwesifo sesibindi esinamafutha.
• Ukulahlekelwa yimisipha: Imisipha emilenzeni iba mincane futhi ibe mincane. Kodwa ngokumangazayo, amafutha angaphansi kwesikhumba angase ahlale efana.
• Ukuphelelwa amanzi emzimbeni: Ukuntuleka kwamanzi emzimbeni.
• I-Anorexia: Ukulahlekelwa yisifiso sokudla kanye nesifiso sokudla.
• Ukucasuka nokukhathala ngokweqile: Ingane ivame ukucasuka, ukudinwa, futhi ayinasithakazelo sokudlala.
• Ukukhula kwezingane kuhamba kancane: azikhuli zinde, azikhuli, futhi zincane kunezinye izingane ezingontanga yazo.

Ezinye izinkinga ezingase zenzeke ngenxa ye-Kwashiorkor

Ngaphezu kwalezi zimpawu, uma lesi simo (Kwashiorkor) singelashwa kahle, singaholela ezinkingeni ezinkulu kakhulu. Lokhu kungaba yingozi ngisho nokuphila.

• Amazinga kashukela aphansi egazini (i-Hypoglycemia).
• Ukwehla kwezinga lokushisa lomzimba `(Hypothermia)`.
• Ukwehla komthamo wegazi (i-Hypovolemia) kanye nokushaqeka okubangelwa yi-hypovolemic shock.
• Ukungalingani kwama-electrolyte emzimbeni ngenxa yokuphelelwa amanzi emzimbeni.
• Amasosha omzimba abuthakathaka kakhulu. Ngenxa yalokho, izifo (ezifana nomkhuhlane, umkhuhlane, isifo sohudo, izifo zamaphaphu) zivame ukwenzeka, futhi amanxeba athatha isikhathi eside ukuphola.
• I-cirrhosis yesibindi (ukuqina kwesibindi) kanye nokwehluleka kwesibindi.
• I-pancreas (ekhiqiza ama-enzyme asisiza ekugayeni ukudla) iyancipha, okubangela izinkinga zokugaya ukudla.
• Ukuncishiswa kolwelwesi lomgudu wokugaya ukudla (i-mucosa yamathumbu). Lokhu ngezinye izikhathi kungaholela ekukhuleni ngokweqile kwamagciwane amancane amathumbu.
• Ukukhula okubambezelekile kakhulu kanye nokuthuthukiswa kobuchopho ezinganeni.
• Ekugcineni, ukuzila ukudla kungaholela ngisho nasekufeni.

Kungani lokhu (Kwashiorkor) kwenzeka? Ziyini izimbangela?

Ukuntuleka kwamaprotheni kubhekwa njengembangela eyinhloko yeKwashiorkor. Abacwaningi abaningi bakholelwa ukuthi lena yimbangela eyinhloko. Kodwa-ke, abanye abakwamukeli ngokugcwele lokhu. Ngoba kwezinye izimo, ukufaka amaprotheni ekudleni akukwazanga ukuvimbela noma ukwelapha iKwashiorkor. Lokhu kukhombisa ukuthi ukuntuleka kwamaprotheni kuyingxenye nje yendaba, kungase kube nezinye izimbangela.

Izinkinga eziyinhloko ezihlobene neKwashiorkor yilezi:

• Ukudla ukudla okunama-carbohydrate amaningi: Ikakhulukazi ezindaweni ezimpofu zase-Afrika, eMelika Ephakathi, naseNingizimu-mpumalanga ye-Asia, okuyizindawo ezisengozini enkulu, abantu bavame ukudla uhlobo olulodwa kuphela lwama-carbohydrate. Isibonelo, imifino enesitashi njengelayisi, ummbila, i-cassava, namazambane amnandi. Lokhu kushibhile futhi kulula ukukuthola kunokudla okucebile ngamaprotheni (njengenhlanzi, inyama, amaqanda, ubisi, kanye ne-lentile). Lokhu kuyiqiniso ikakhulukazi ezindaweni zasemakhaya lapho kwenziwa khona ukulima. Cabanga, kweminye imindeni, izingane zinganikwa ilayisi namazambane acutshunguliwe usuku lonke. Bese zingatholi amaprotheni anele. Omama abaswele amaprotheni bangadlulisela lokho kuntuleka ezinganeni zabo.
• Ukudla okungenalo ukudla okufakwe esikhundleni ngemva kokulunyulwa: Igama elithi Kwashiorkor livela olimini lwezwe lase-Afrika iGhana. Lisho into efana "nesifo esitholwa yingane endala lapho ifika ingane entsha." Lokhu kubhekisela esimweni esivamile kakhulu. Lapho ingane entsha iqalwa ukuncelisa, ingane endala esancelisa isuke ilunyulwa ngokuzumayo. Bese, ngenxa yokuntuleka kwezinsiza, ukungazi ngokudla okunempilo, noma kokubili, ingane elunyulwayo ayitholi ukudla okufakwe esikhundleni okufanele. Bese isimo sayo sokudla siyawohloka. Abanye omama banika ingane yabo encane irayisi noma iphalishi elincane. Kodwa bayakhohlwa ukwengeza okuthile okunamaprotheni amaningi njenge-lentile, ucezu oluncane lwenhlanzi, iqanda eliphuzi, noma abanayo imali eyanele yokwenza kanjalo.

Ngaphezu kwalokhu, kunezinye izici eziningana ezingaba nomthelela ekuthuthukisweni kweKwashiorkor:

• Ukuntuleka kwamavithamini abalulekile (njengevithamini A, amavithamini B) kanye namaminerali (njengensimbi, i-zinc).
• Ukuntuleka kwama-antioxidants (lezi yizinto ezivikela amangqamuzana omzimba) ekudleni.
• Ama-aflatoxin ubuthi obuvela ohlotsheni lwesikhunta olukhula kokusanhlamvu kanye namakinati akhuliswe ezindaweni ezifudumele nezinomswakama.
• Izimuncagazi ezifana nezimpethu nezifo ezithelelanayo ezifana nesimungumungwane, umalaleveva, kanye ne-HIV. Lezi zifo zenza umzimba ube buthaka futhi zinciphise ukumuncwa kwezakhamzimba.
• Izimo ezinkulu ezicindezelayo empilweni, njengendlala, ubumpofu, impi, kanye nezinhlekelele zemvelo.

I-Kwashiorkor itholakala kanjani?

Odokotela basithola kanjani lesi simo ngokunembile (Kwashiorkor)?

Esikhathini esiningi, udokotela uzoqala ngokuxilonga isimo ngokuhlola ingane ngokomzimba bese ebheka izimpawu esixoxe ngazo ekuqaleni (ikakhulukazi ukuvuvukala, izinguquko zesikhumba, kanye nokushintsha kwezinwele) .

Ngaphezu kwalokho:

• Buza umama noma umnakekeli ngokudla kwengane, ukuthi idla hlobo luni lokudla nsuku zonke, nokuthi ithola amaprotheni anele yini.
• Buza ngezifo zangaphambilini kanye nezifo eziqhubekayo.
• Isilinganiso sesisindo somntwana nokuphakama kanye nokuphakama ngobudala kulinganiswa futhi kuqhathaniswa namashadi okukhula e-World Health Organisation. Lezi zilinganiso zinganika udokotela umbono omuhle wokuthi ukungondleki kahle kwengane kukhulu kangakanani nokuthi kuthinte kangakanani ukukhula kwayo.

Iphathwa kanjani iKwashiorkor?

I-Kwashiorkor yisimo esidinga ukwelashwa okuphuthumayo. Uma ukwelashwa kuqhubeka isikhathi eside, kulapho izinkinga zingaba khona khona. I-World Health Organization (WHO) ichaze izinyathelo eziyi-10 okufanele zilandelwe lapho kwelashwa ukungondleki kahle okukhulu. Lokhu kufanele kwenziwe ngokucophelela okukhulu, ngaphansi kokuqashwa kwezokwelapha esibhedlela.

1. Ukuvimbela/Ukwelapha I-Hypoglycemia: Uma izingane ezingondlekile kahle zinikwa ukudla ngokuzumayo, amazinga kashukela egazini angase ehle kakhulu. Ngakho-ke, uketshezi oluhlelwe ngokukhethekile (oluqukethe i-glucose) lunikezwa kancane kancane.

2. Ukuvimbela/Ukwelapha i-Hypothermia: Izilwane ezingondlekile kahle zinobunzima bokulawula izinga lokushisa lomzimba wazo. Ngakho-ke, zidinga ukugcinwa zifudumele (zigqoke izingubo ezifudumele, nezingubo zokulala).

3. Ukuvimbela/Ukwelashwa Kokuphelelwa Amanzi: Ifomula ekhethekile ebizwa ngokuthi i-RESOMAL (`REhydration SOLUTION for MALnutrition`) inikezwa ukwelapha ukuphelelwa amanzi emzimbeni eKwashiorkor. Yenzelwe ukubuyisela nokugcina ibhalansi yoketshezi nosawoti (ikakhulukazi i-sodium) emzimbeni. Inganikezwa ngomlomo noma, uma kudingeka, ngepayipi.

4. Ukulungisa ukungalingani kwama-electrolyte: Ukungalingani kwama-electrolyte emzimbeni, njenge-potassium ne-magnesium, kuyingozi futhi kungaba yingozi empilweni. Lokhu kungashintsha, ikakhulukazi lapho umuntu ongondlekile eqala ukudla futhi. Izisebenzi zezempilo zizama ukulungisa lokhu kuqala, ngokuvamile ngesisombululo (se-RESOMAL).

5. Ukuvimbela/Ukwelashwa Kwezifo: Ngenxa yobuthakathaka besimiso somzimba sokuzivikela esihambisana neKwashiorkor, noma yikuphi ukutheleleka kuyingozi enkulu yokululama. Ngakho-ke, noma ngabe kukhona ukungabaza, kunikezwa ama-antibiotic e-broad spectrum.

6. Ukulungiswa kokuntuleka kwezakhamzimba ezincane:Ukuntuleka kwamavithamini namaminerali abalulekile njengevithamini A, i-folic acid, i-zinc, kanye ne-iron kuyalungiswa. Kodwa-ke, i-iron inikezwa kuphela ngemva kokuba ingane isilulame kancane.

7. Qala ukondla ngokucophelela: Lesi yisinyathelo esibaluleke kakhulu. I-metabolism (indlela yomzimba yokukhiqiza nokusebenzisa amandla) yabantu abangondlekile ishintshile. Lapho beqala ukondla futhi, i-metabolism yabo iqala ukushintsha futhi. Kodwa uma lokhu kwenzeka ngokushesha kakhulu, inkinga esongela ukuphila ebizwa ngokuthi "i-refeeding syndrome" ingenzeka. Ngakho-ke, ukondla kuqala ngokucophelela, ngamanani amancane, izikhathi eziningana ngosuku, ngaphansi kokuqashwa okuseduze. Ikakhulukazi e-(Kwashiorkor), amaprotheni kufanele aphinde afakwe kancane kancane, kancane kancane.

8. Ukukhula kwengane: Uma isimo sayo sesizinzile futhi ibonakala sengathi ibekezelela ukunceliswa kahle, inani lamakhalori namaprotheni anikezwayo liyakhuphuka kancane kancane. I-World Health Organization ithuthukise ukudla okwelaphayo okulungiselelwe ngokukhethekile, okucebile ngokudla okunempilo, okwenziwe ngomumo (RUTF). Lokhu kunganikezwa ngomlomo noma ngepayipi, uma kudingeka. Lesi yisigaba sokuvuselelwa kokudla okunempilo. Lokhu kungathatha amasonto amaningana (ngokuvamile amasonto ama-2-6).

9. Nikeza ukuvuselelwa kwezinzwa nokusekelwa ngokomzwelo: Izingane ezineKwashiorkor zingase ziphelelwe amandla futhi ziphelelwe amandla isikhathi eside. Intuthuko yazo yengqondo, yezinzwa, kanye neyenhlalo ingase iphazamiseke ngenxa yokungondleki kahle. Imisebenzi evuselelayo efana namathoyizi, ukukhuluma, nokunikeza uthando nothando ukuze zibasize baphinde bakhule kahle kuyingxenye yohlelo lokwelashwa. Uma kungenzeka, izisebenzi zezempilo zizobandakanya nonina wengane kule nqubo.

10. Ukulungiselela ukulandelwa ngemva kokululama: Ngaphambi kokuba umntwana akhishwe esibhedlela, izisebenzi zezempilo zinikeza imfundo nokwelulekwa kumama (noma umnakekeli) mayelana nokudla okunempilo, ukuncelisa, indlela yokulungisa ukudla okunempilo, ukuhlanzeka kokudla namanzi, kanye nokuvimbela izifo. Uma kudingeka, kunikezwa imijovo yokugoma. Uma kungenzeka, siza ekutholeni ukudla okuzinzile nokunomsoco.

Ungakuvimbela kanjani i-Kwashiorkor?

"Kungcono ukuvimbela isifo kunokuselapha uma sesikhulile." Ngakho-ke kunezinto esingazenza ukuze sizivimbele (Kwashiorkor).

• Imfundo nokwazisa: Kubaluleke kakhulu ukufundisa abazali nomphakathi ngokudla okuyisisekelo, ukubaluleka kokuncelisa (ukuncelisa ibele okungenani izinyanga eziyisithupha, kulandelwe ukuncelisa ngokudla okuhambisanayo kuze kube yiminyaka emibili), izidingo zokudla okunempilo zezingane nomama. Kubalulekile futhi ukufundisa indlela yokuqala ukudla okuhambisanayo eneminyaka efanele nangendlela efanele.
• Ukusekelwa kokudla okunempilo: Ukuqaliswa kwezinhlelo zokudla okunempilo nguhulumeni nezinhlangano ezahlukahlukene. Isibonelo, ukuhlinzeka ngezithako zokudla okunempilo (isib. iThriposha) komama abakhulelwe, omama abancelisayo nezingane ezincane. Futhi, ukukhuthaza izitshalo zasendaweni (njenge-moringa, isipinashi, uphizi, i-soy) ezihlinzeka ngamaprotheni kanye nezakhamzimba ezincane.
• Ukulawulwa kwezifo: Ukulawulwa kwezifo ezithathelwanayo (njengesifo sohudo, izifo zokuphefumula) kanye nezifo. Lokhu kwenza umzimba ube buthaka futhi kunciphise ukumuncwa kwezakhamzimba. Ukuthuthukisa inhlanzeko (ukugeza izandla, ukuphuza amanzi ahlanzekile, ukusebenzisa izindlu zangasese) kanye nokuhlinzeka ngemigomo ngesikhathi esifanele kusiza kakhulu ekuvimbeleni ukungondleki kahle.
• Ukuvikeleka kokudla: Wonke umndeni kufanele ube nokufinyelela kokudla okunempilo.

Kwenzekani uma iKwashiorkor ingelashwa? Ayini amathuba okululama?

Lokhu kuyinto okudingeka siyazi nakanjani.

Uma ingelashwa, i-Kwashiorkor ingaba yingozi. Ukufa kungabangelwa ukutheleleka, ukuphelelwa amanzi emzimbeni, ukwehluleka kwenhliziyo, noma ukwehluleka kwesibindi.

Ngisho noma ukwelashwa kuqala, kukhona ingozi yenkinga okukhulunywe ngayo ngaphambili ebizwa ngokuthi "i-refeeding syndrome." Yingakho ukwelashwa kwenziwa ngokulaliswa esibhedlela nangaphansi kokuqondisa kukadokotela.

Kodwa-ke, izingane ezithola ukwelashwa ngempumelelo nangesikhathi futhi zivuselelwe zingalulama kahle. Nakuba kunemiphumela ethile yesikhathi eside yeKwashiorkor (isib. ukukhula okulimele, ukukhubazeka kokufunda), nazo zingaphela.

Izinkinga ezivela ku-kwashiorkor ziba zimbi kakhulu futhi zihlala isikhathi eside uma zingalashwa. Ezinye izingane zingase zingaphinde zilulame ngokuphelele ekulibazisekeni kwazo kokukhula nokukhula. Zingase ziqhubeke nokuba sengozini yesifo sesibindi kanye nokuntuleka kokwanele kwe-pancreatic.

Ngakho-ke, khumbula, uma lesi sifo sisheshe sitholakale futhi ukwelashwa kuqala, imiphumela iba ngcono.

Okokugcina, iKwashiorkor ingase ingabonakali njengokungondleki kahle ngenxa yokuvuvukala nokuqunjelwa. Ingaba nemiphumela emibi engalindelekile nefihliwe njengokulahlekelwa yisifiso sokudla kanye nesifo sesibindi esinamafutha. Ukuze welaphe iKwashiorkor kahle, kubalulekile ukuyiqonda. Ukunikeza ukudla okunamaphrotheni amaningi ekhaya kungase kunganeli, futhi kungaba yingozi ngisho nangokwengeziwe. Ngakho-ke, uma unezimpawu zeKwashiorkor, kubalulekile ukufuna iseluleko sezokwelapha ngokushesha okukhulu, ikakhulukazi ezinganeni ezincane. Uma usheshe ungenelela, mancane amathuba okuthi uhlushwe ukungondleki kahle.

Ngakho-ke, yiziphi izinto ezibaluleke kakhulu okudingeka sizikhumbule kule ndaba?

Khumbula lokhu kahle:

• I-Kwashiorkor yisimo esibi kakhulu sokungondleki kahle esibangelwa ukuntuleka kwamaprotheni , ikakhulukazi esithinta izingane ezincane.
• Izimpawu eziyinhloko isisu esikhulu, izitho ezivuvukile, kodwa umzimba omncane . Ngaphezu kwalokho, kungase kube nezinguquko esikhumbeni nasezinweleni, ukulahlekelwa yisifiso sokudla, kanye nokucasuka.
• Lesi yisimo esingaba yingozi, ngakho-ke kubalulekile ukuthola usizo lwezokwelapha ngokushesha. Ungazami ukuselapha ekhaya.
• Mayelana nokudla kwengane, ikakhulukaziQiniseka ukuthi unika ingane yakho ukudla okucebile ngamaprotheni (njengenhlanzi, inyama, amaqanda, ubisi, amalentili, kanye nophizi). Qiniseka ukuthi ingane yakho ithola ukudla okunempilo lapho ilunyulwa ubisi lwebele.
• Ukuhlanzeka (ukugeza izandla, amanzi ahlanzekile) kanye nokuvimbela izifo (ukugoma) kusiza ekunciphiseni lesi simo.
• Uma ingane yakho inanoma yiziphi zalezi zimpawu, ungalibali futhi uvakashele udokotela noma isibhedlela esiseduze. Ukwelashwa okusheshayo kungasindisa impilo yengane futhi kunciphise imiphumela yesikhathi eside.

I- Kwashiorkor, ukungondleki kahle, ukuntuleka kwamaprotheni, ukudla okunempilo kwengane, ukuqunjelwa, ukuqunjelwa, ukuntuleka kokudla okunempilo