Ikhambi lokugoma

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Ikhambi lokugoma ikhambi elinyusa amandla wamasosha omzimba ukuze ezolwa nasifo thizeni. Ikhambi lokugoma luvamise ukwakhiwa ngenxenye yegciwane elidala izifo. Kujwayele ukuthi lengxenye yegciwane kube amagciwane abulewe noma amacezu akhomba uhlobo legciwane. Lawa macezu aqeqesha amasosha omzimba ukuthi akwazi ukubona igciwane ukuze amasosha omzimba alwe nalo alibulale uma sekufika igciwane langempela.

Ukunika umuntu umuthi oqeqesha amasosha omzimba kuthiwa ukugoma. Akukho okuhlula ukugoma ekuvimbeni ukutheleleka ngezifo ezidalwa amagciwane.[1] Umlando utshengisa ukuthi ukugoma kwaqeda izifo okubalwa kuzo ingxibongo, kwaphinde kwanciphisa amazinga ezifo okubalwa kuzo i-polio, isimungumungwane, kanye ne-tetanus. Imithi kugoma kwaziwa igwema izifo okubalwa kuzo umkhuhlane,[2] i-HPV,[3] kanye nenqubulunjwana.[4]

Igama lomuthi womgongo kuthiwa i-vaccine ngesiNgisi okuyigama elaqanjwa ngu-Edward Jenner owalisungula olimini lwesiLathini olusho inqubulunjwana yezinkomo ngesitkhathi eqamba umuthi wokuligoma.

Ukusebenza kwalo[hlela | Hlela umthombo]

Imithi yoku goma iphephile futhi iyasebenza kahle ukulwa nezifo ezithelelanayo.[5][6][7][8] Kodwa ke, kukhona izindawo lapho ugugoma kuba buthaka khona.[9]

Amandla emithi yomgomo anqunyelwe izinto eziningi njenge:

  • Isifo (imithi yokugoma ethize isebenza kangcono kuneminye ngokuhambisana nesifo)
  • Uhlobo lomuthi womgomo (eminye imithi yomgomo ethize isebenza kangcono uma ibhekene nesifo eqondene naso)[10]
  • Uma isikhathi sokuthola umgomo sakhiwe kahle
  • Wonke umuntu unendlela yakhe yokuthi imithi yomgomo isebenza kanjani kuye
  • Ezinye izizathu kungabalwa kuzo ubuzwe, ubudala, kanye nofuzo.

Uma umuntu ogonyiwe uyasithola isifo agonyelwe sona (lokhu kuthiwa isifo esingena ngenkani) kuvamile ukuthi kwehle ukuthelelanana kwalesi sifo kwabanye abantu abangagonyiwe.[11]

Okulandelayo izinto okumele ziqaphelwe ukuze luzosebenza kahle uhlelo lokugoma abantu:[12]

  1. Ukwenziwa kahle izibalo ezitshengisa ukuthi mangakanani amazinga okugoma adingekayo kusukela esikhathini esincane kuya kwesilandelayo.
  2. Ukuqhubeka ukuqapha isimo sesifo zikhathi zonke.
  3. Ukuqhubeka namazinga aphezulu okugoma ngisho esehlile amazinga esifo emphakathini.

Ukugoma sekwaqeda izifo ezifana nengxibongo, eyaziwa njengenye yezifo ezazithelelana zibhubhisa abantu emhlabeni.[13] Ezinye izifo kubalwa kuzo i-rubella, i-polio, isimungumungwane, i-mumps, i-chickenpox, kanye nei-typhoid eseza cishe zaphela ngenxa yokugoma okwakusabalele.

Uma iningi labantu bangomile. Kuba nzima kakhulu ukuthi isifo sibhebhetheke. Lokhu kwaziwa ngokuthi ukuphepha komhlambi.

Ukugoma kuvimba ukuqala kokumelana nokusebenza komuthi obulala amagciwane. Umzekelo; izinhlelo zomgomo sezehlise amazinga ukumelana nokusebenza kwemithi efana ne-penicillin ebulala amagciwane anjenge-Streptococcus pneumoniae edala inyumoniya.[14]

Umgomo wesimungumungwana uvimbela ukufa kwabantu abangama 1-million minyaka yonke.[15]

Imithelela emibi[hlela | Hlela umthombo]

Ukugoma kwabantwana kuphephile.[16] Imithelela emibi ijwayele ukuba mncane.[17] Imithelela ijwayele ukuba imfiva, ubuhlungu endaweni yokujova, kanye nezinhlungu zomsipha. [17]

Imithelela emibi kakhulu ayijwayelekile.[16]

Izinhlobo[hlela | Hlela umthombo]

Imithi yomgomo yakhiwe ngezincezu zamagciwane.

Ziningi izihlobo ezisetshenziswayo.[18]

Okucishiwe[hlela | Hlela umthombo]

Kukhona imithi yomgomo eyakhiwe ngamagciwane acishiwe kusetshenziswa amakhemikhali, ukushisa, noma imisebe endmandla.[19] Imizekelo kungabalwa kuyo imithi yokugoma elwa nezifo ezifana ne-polio, hepatitis A, amarabi, kanye nomkhuhlane.[20]

Okuncishisiwe[hlela | Hlela umthombo]

Kukhona imithi yomgomo enamagciwane aphilayo, ancishisiwe. Le nhlobo yomgomo yenza umzimba ube namandla anyukile ukulwa nezifo kodwa awuphephile ukusetshenziswa kubantu abamasosha omzimba abuthaka.

Obekunobuthi[hlela | Hlela umthombo]

Kukhona indlela yokuthatha into ewubuthi, bucishwe ubuthi bayo ukuze kwakhiwe ngayo umuthi yomgomo obizwa nge-toxoid.[21]

Okuyingxenye[hlela | Hlela umthombo]

Kukhona umuthi wokugoma owakhiwa ngengxenye yegciwane thizeni ukuze kuzoqeqesheka amasosha omzimba.

Okuhlangene[hlela | Hlela umthombo]

Kukhona amagciwane ambozwe ngento okuthiwa i-polysaccharide edala ukuthi ifihleke kumasosha omzimba. Abacwaningi bakwazi ukuthatha i-polysaccharide emboze igciwane ayihlanganise neprotheni thizeni ezokwenza ukuthi amasosha omzimba akwazi ukulibona igciwane.

Imizamo emisha[hlela | Hlela umthombo]

Miningi imithi yomgomo emisha eqanjwayo kumanje. Yize imithi yokugoma eminingi yakhiwa kusetshenziswa amagciwane abulewe kanye nezingxenye zamanye amagciwane, kukhona imithi yokugoma eyokwenziwa eyakhiwe ngezinto ezingatholakazi emvelweni.

I-valence[hlela | Hlela umthombo]

Imithi yokugoma ingaba isimo sokuba-monovalant noma ibe multivalant. Umuthi wokugoma one simo sokuba-monovalant wakhelwe ukuthi ulwe nomazisi wegciwane elilodwa noma igciwane elilodwa. Umuthi wokugoma one simo sokuba-multivalant ukwazi ukubona ilwe namagciwane amaningi.

I-Heterotypic[hlela | Hlela umthombo]

Kukhona imithi yokugoma eyakhiwa ngokusebenzisa amagciwane aqhamuka ezilwaneni ukuze asetshenziswe kumuntu noma olunye uhlobo lwesilwane.

Ukuqeqesha amasosha omzimba[hlela | Hlela umthombo]

Uma amasosha omzimba athola umuthi wokugoma egazini awubona njengento eqhamuka ngaphandle komzimba, ayibulale bese “ayayikhumbula”. Uma sekufika igciwane langempela emzimbeni, amasosha omzimba ayakwazi ukukhumbulu bese:

  1. Ayalibulala igciwane ngaphambi kokuthi litholane nezithwana zomzimba;
  2. Ayalibona igciwane abulale lona kanye nesithwana somzimba lapho igciwane selingene khona.

Okusizayo kanye nokugcinayo[hlela | Hlela umthombo]

Imithi yokugoma ijwayele ukuhlanganisa nezinto ezisiza ukugoma eziqinisa amasosha omzimba. Kuyenzeka ukuthi imithi yokugoma ixutshwe nezinto ezenza ukuthi umuthi ugcineke ungaboli uma uhlaselwa amanye amagciwane kanye nesikhunta.

Uhlelo[hlela | Hlela umthombo]

Kufuneka ukuthi abantwana bathole umgomo ngesikhathi lapho khona imizimba yabo isikwazi isikwazi ukuba namasosha omzimba “anamandla aphelele”. Lokhu kuhambisana nohlelo lokugoma oluyinkimbinkimbi. Miningi imithi yokugoma ehambisana nezigaba zokukhula komuntu mpilo yonke. Umzekelo, isimungumungwana, i-tetanus, umkhuhlane, kanye nenyumoniya. Kuvamise ukuthi imithi yokugoma enikwa abantu asebekhulile kakhulu ibhekane nenyumoniya kanye nomkhuhlane.

Umlando[hlela | Hlela umthombo]

Ngaphambi kokuthi kube khona imithi yokugoma enamacezu aqhamuka kwingxibongo yezinkomo, abantu babekwazi ukuthelelelana ngamabomu ngegciwane lengxibongo. Kunobufakazi emlandweni obutshengisa ukuthi izwe laseShayina laseliqalile ukugomela ingxibongo eminyakeni engu-1000 edlule.[22]

Eminyakeni yangama-1760s, u- Edward Jenner wathola ukuthi abantu abasengayo kwakungenzeki ukuthi bathole ingxibongo ngoba basebetheleleke ngengxibongo yezinkomo. Ngonyaka ka 1796, u-Jenner wabuka ukhunta oluqhamuka esandleni somuntu osengayo otheleleke ngengxibongo yezinkomo, waluhlikihla esandleni somfana oneminyaka eyisi-8 okwatholakala ukuthi usegomekile ekutholeni ingxibongo emva kwamaviki ayisi-6. Kwatholala ukuthi akayitholanga ingxobongo.[23][24]

U-Jenner waqhubeka nalolucwaningo kwathi ngonyaka ka-1798 wabika ukuthi umuthi wakhe wokugoma usebenza ngokuphelile ezinganeni nakwabadala. Isizukulwane salomuthi wokugoma saqhamuka ngeminyaka yama-1800 ngu-Louis Pasteur.

Iminyaka yama-1900 yabona ukuqala kwemithi yokugoma eminingi, okubalwa kuyo imithi elwa ne-diphtheria, isimungumungwana, i-mumps, kanye ne-rubella. Kwa igxathu elikhulu ukutholakala komgomo we-polio ngeminyaka yo-1950 lapho okwaphinde kwanqotshwa khona ingxibongo eminyakeni yo-1960 no-1970. u-Maurice Hilleman waba nomthelela omkhulu ekwakhiweni yalemigomo.

Ukwakhiwa kwamakhambi okugoma amaningi kuze kube manje ime ngokuxhaswa uhulumeni, izikhungo zemfundo ephakeme kanye nabasizi bomphakathi abazimele.[25] Amakhambi okugoma amaningi awabizanga kakhulu aphinde asiza abezempilo.[26] Ukusetshenziswa kwamakhambi okugoma kunyuke kakhulu eminyakeni eyedlule.[27] Ngaphezu kwalokho, ukugonywa kwezilwane kusiza ukuthi zingatholi izifo nokuthi zingatheleli abantu ngezifo.[28]

Amadokodo okuqamba[hlela | Hlela umthombo]

Ukufaka idokodo lokuqamba ikhambi lokugoma kungaba ingqinamba ekuqanjweni kwamakambi okugoma amasha ngenxa yokuthi lawa madokodo awavikelekile kahle. Ukwenziwa kwamadokodo kwenzelwa ukuthi ligcineke liyimfihlo.[29]

Isigungu sezempilo umhlaba wonke i-WHO ithi into evimba ukuthi kwenziwe amakhambi okugoma emazweni azathuthuka imali, izinsiza kusebenza nabasebenzi abawaziyo umsebenzi.

Izindlela zokuthumela[hlela | Hlela umthombo]

Ukuthuuthukiswa kwezindlela ezintsha zokuthumela izinto, kunyusa ithemba lokwakhuwa kwamakhambi okugoma azothunyelwa ngokuphepha bese eyasetshenziswa. Izindlela ezincomekayo zokunikwa kwabantu abakhambi okugoma abala imigomo ethathwa ngomlomo. Ikhambi lokugoma elithathwa ngomlomo labonakala lisebenziseka kalula uma lisetshenziswa abasebenzi abangaqeqeshiwe. Ikhambi lokugoma elingasebinzisi umjovo[30] lisahlolwa ngezilwane okwamanje.[31][32] Kwakhiwe istembu esincane esifanisa nebhandishi elinamathelayo esinama-microscopic projections angu-20 000.[33]

Imikhuba[hlela | Hlela umthombo]

Ukwakhiwa kwamakhambi omgomo kunemikhuba ejwayelekile:[34]

  • Imigomo eminingi ibibhekiswe ebantwaneni kodwa manje sekubhekwe abasha nabadala.[34][35]
  • Ukuxutshwa kwamakhambi okugoma sekuyinto ejwayelekayo.[34]
  • Kubhekwa ezinye izindlela zokunika abantu imigomo
  • Amakhambi akhandelwa ukuthi agqugquzele amashosha omzimba angaphakathi nashintshashintshayo.[34]
  • Kunemizamo eyenziwayo ukuze kwakhiwe ikhambi lokugomela izifo ezibucayi kakhulu.[34]
  • Kukhona amakhambi okugoma akhandelwa ukuvikela ekuhlaselweni ngemithi.[34]
  • Ososayensi bazama ukwakha amakhambi okugoma okuzenzela ngokusebenzisa ingaphandle legciwane. Lokhu kuzosisa kubantu abangalizweli ikhambi lokugoma.[36]

Imithombo[hlela | Hlela umthombo]

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  28. Roser, Max; Vanderslott, Samantha (2013-05-10). "Vaccination". Our World in Data. https://ourworldindata.org/vaccination. 
  29. "The role of intellectual property in the global challenge for immunization". J World Intellect Prop 9 (4): 413–25. 2006. doi:10.1111/j.1422-2213.2006.00284.x. 
  30. WHO to trial Nanopatch needle-free delivery system| ABC News, 16 Sep 2014| "Needle-free polio vaccine a 'game-changer'". 2014-09-16. http://www.abc.net.au/news/2014-09-16/vaxxas-says-needle-free-polio-vaccine-a-game-changer/5748072. 
  31. "Australian scientists develop 'needle-free' vaccination". The Sydney Morning Herald. 18 August 2013. http://www.smh.com.au/technology/sci-tech/needleless-trial-set-for-start-20130417-2i0qw.html. 
  32. "Vaxxas raises $25m to take Brisbane's Nanopatch global". 2015-02-10. http://www.brw.com.au/p/tech-gadgets/brisbane_nanopatch_the_reverse_brain_DPyEGHC1ih6919r8X37SdO. 
  33. "Australian scientists develop 'needle-free' vaccination". The Hindu (Chennai, India). 28 September 2011. http://www.thehindu.com/sci-tech/health/medicine-and-research/australian-scientists-develop-needlefree-vaccination/article2493365.ece. 
  34. 34.0 34.1 34.2 34.3 34.4 34.5 "Vaccines: past, present and future". Nature Medicine 11 (4 Suppl): S5-11. April 2005. doi:10.1038/nm1209. PMC Template:=pmcentrez&artidTemplate:=7095920 7095920. PMID 15812490. http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=7095920. 
  35. "Adults now drive growth of vaccine market". Gen. Eng. Biotechnol. News 28 (11): pp. 22–3. 2008. http://www.genengnews.com/gen-articles/adults-now-drive-growth-of-vaccine-market/2490/. open access publication - free to read
  36. Staff (28 March 2013). "Safer vaccine created without virus". The Japan Times. Agence France-Presse – Jiji Press. http://www.japantimes.co.jp/news/2013/03/28/world/safer-vaccine-created-without-virus/#.VcLHxGCPKM_.