Cerebral malaria wata cuta ce mai tsanani wadda ke shafar ƙwaƙwalwa, wadda ake samu sakamakon kamuwa da ƙwayar cutar Plasmodium falciparum, wadda ita ce mafi haɗari daga cikin ƙwayoyin cutar malariya. Wannan nau’in malariya na ɗaya daga cikin manyan dalilan mutuwar yara da manya a ƙasashen da ke fama da cutar malariya, musamman a Afirka. Cutar tana da tasiri sosai ga tsarin jini da ƙwaƙwalwa, inda ƙwayoyin cutar ke toshe jijiyoyin jini a cikin ƙwaƙwalwa, haifar da kumburi da raguwar iskar oxygen zuwa sassa daban-daban na ƙwaƙwalwa.
Cerebral malaria na daga cikin cututtuka masu haɗari a duniya saboda tana iya kaiwa ga mutuwa cikin sauri idan ba a samu kulawa ta gaggawa ba, kuma waɗanda suka tsira daga cutar na iya fuskantar matsaloli na dogon lokaci a ƙwaƙwalwa da tsarin jiki, kamar matsalolin hankali, raguwar fahimta, da matsalolin motsi. Haka kuma, cutar tana da matuƙar muhimmanci a fannin lafiya saboda yawan ɓarkewarta a ƙasashe masu ƙarancin tsarin kiwon lafiya da kayan aikin asibiti.
Ma’anar cerebral malaria
Cerebral malaria na nufin nau’in malaria mai tsanani wanda ke shafar ƙwaƙwalwa da tsarin jini na ƙwaƙwalwa. Ana samun wannan cuta ne lokacin da ƙwayoyin plasmodium falciparum suka shiga cikin jini kuma suka toshe ƙananan jijiyoyin jini na ƙwaƙwalwa. Wannan toshewar na hana iskar oxygen da abinci isa ga ƙwayoyin halittar ƙwaƙwalwa, wanda ke haifar da kumburi, lalacewar ƙwaƙwalwa, da alamomi masu tsanani kamar matsalolin tunani da motsi.
Cerebral malaria tana faruwa ne galibi a yara ‘yan ƙasa da shekaru biyar a yankunan da malariya ke yawan faruwa, amma manya ma na iya kamuwa musamman idan ba a sami rigakafi ko magani cikin lokaci ba. Wannan cuta na da alaƙa kai tsaye da yawan kamuwa da cutar malariya mai tsanani, wanda ya bambanta daga nau’ikan malariya na asali saboda haɗarinta ga ƙwaƙwalwa da rayuwa gabaɗaya.
Tarihin cutar
Cerebral malariya an fara gano tasirinta sosai a farkon ƙarni na 20, lokacin da masana kimiyya suka fara lura da cewa wasu mutane, musamman yara, suna mutuwa cikin sauri bayan kamuwa da malariya mai tsanani. Tun kafin wannan lokaci, malariya ta kasance sanadiyar rashin lafiya da mutuwa a yawancin sassan Afirka, Asiya, da Latin Amurka, amma ba a san bambanci tsakanin nau’ikan malariya masu tsanani da wadanda ba su da haɗari ba.
Bincike da aka gudanar daga shekarun 1940s zuwa 1960s ya tabbatar da cewa Plasmodium falciparum ce ke haifar da cerebral malaria, musamman saboda ƙarfin ƙwayar cutar na shiga cikin ƙananan jijiyoyin jini a ƙwaƙwalwa da haifar da toshewa da kumburi. A shekarun baya-bayan nan, binciken kimiyya ya nuna yadda tsarin jini, jijiyoyi, da ƙwayoyin halittar jiki ke haɗuwa da ƙwayar cutar, wanda ya ba da haske kan yadda cutar ke haifar da mutuwar mutane.
A halin yanzu, cerebral malaria na ɗaya daga cikin manyan dalilan mutuwar yara ‘yan ƙasa da shekaru biyar a Afirka, inda cutar ke yaɗuwa sosai sakamakon rashin ingantaccen rigakafi, tsafta, da kulawa ta gaggawa.
Nau’ikan cerebral malaria
Malariya na da nau’o’i daban-daban waɗanda aka fi sani da Plasmodium species, ciki har da Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale, Plasmodium malariae, da Plasmodium knowlesi. Daga cikin waɗannan, Plasmodium falciparum ita ce mafi haɗari kuma ita ce ke haddasa cerebral malaria.
Ƙwayar cutar plasmodium falciparum na da ƙarfin shiga cikin ƙananan jijiyoyin jini a ƙwaƙwalwa, wanda ke haifar da kumburi, raguwar iskar oxygen, da matsalolin jini. Wannan ya bambanta ta da sauran nau’o’in malaria kamar plasmodium vivax ko plasmodium ovale, waɗanda yawanci ba sa haifar da cerebral malariya, sai dai suna iya haifar da zazzaɓi mai tsanani, gajiya, da matsalolin jini a wasu lokuta.
Cutar cerebral malaria na iya faruwa tare da wasu nau’o’in malariya mai tsanani, inda mutane ke fama da zazzaɓi mai tsanani, ƙarancin jini (anaemia), hypoglycemia (rashin sukari a jini), da acidosis (ƙaruwa sinadarin acid a jini). Wannan ya nuna cewa cerebral malaria ba cuta ce guda ɗaya ba kawai, tana shafar dukkan tsarin jiki da rayuwar mutum gabaɗaya.
Hanyoyin yaɗuwa
Cutar na yaɗuwa ne ta hanyar cizon sauro nau’in anopheles mai ɗauke da ƙwayar plasmodium falciparum. Lokacin da sauron ya ciji mutum, ƙwayar cutar na shiga jini sannan ta fara zagayawa a jikin mutum, inda take ninka kanta a hanta kafin ta shiga cikin jini gabaɗaya. Wannan zagayawar cutar ne ke haifar da tsanantar cutar, ciki har da nau’in cerebral malaria.
Ba kamar wasu cututtuka da ke iya yaɗuwa kai tsaye daga mutum zuwa mutum ba, cerebral malaria ba ta yaɗuwa ta hanyar jima’i, ruwa, ko abinci. Duk da haka, akwai matakai na kariya da ke hana yaɗuwar cutar, musamman amfani da gidan sauro masu magani, kawar da ruwan da ke taruwa inda sauro zai iya haihuwa, da shan maganin rigakafi ga yara da ke cikin haɗari.
Alamomin cutar
Alamomin cerebral malaria suna bayyana sosai kuma suna da haɗari ga rayuwa. A farkon kamuwa, mutum na iya nuna alamomin malariya na yau da kullum, kamar zazzaɓi mai tsanani, ciwon kai, gajiya, amai, da ciwon jiki.
Bayan lokaci, cutar na iya haifar da alamomin musamman na ƙwaƙwalwa, ciki har da rashin hankali ko tashin hankali, raguwar kulawa da motsi, da canje-canje a yanayin halayyar mutum. A wasu lokuta, yawan zazzaɓi da kumburi a ƙwaƙwalwa na iya kaiwa ga matsalolin numfashi, lalacewar jijiyoyi, da rashin daidaiton jini.
Alamomin cerebral malaria suna bayyana da sauri, yawanci cikin kwanaki 7 zuwa 14 bayan kamuwa da cutar, kuma kulawa ta gaggawa daga likita na da matuƙar muhimmanci don rage haɗarin mutuwa da ƙuntatawa ga ƙwaƙwalwa.
Illoli da matsalolin cutar
Cerebral malaria na ɗaya daga cikin mafi haɗari a cikin nau’ikan malariya, saboda tana kaiwa ga matsaloli masu tsanani ga ƙwaƙwalwa da sauran sassan jiki. Daga cikin illolin cutar akwai rashin kuzari ko yin martani, wanda ke iya ɗorewa na wasu lokuta ko har abada ga waɗanda suka tsira. Haka kuma, yawan toshewar jijiyoyin jiji na iya haifar da lalacewar jijiyoyin, matsalolin tunani, da matsalolin motsi.
Wasu majinyata na iya fuskantar matsalolin numfashi saboda kumburi a ƙwaƙwalwa da rashin daidaiton jijiyoyin tsakiya. Cerebral malaria na iya haddasa raunin jiki, gajiya mai tsanani, da rage ƙarfin garkuwar jiki, wanda ke sa mutum ya zama mai saurin kamuwa da wasu cututtuka.
A lokuta masu tsanani, rashin kulawa cikin sauri na iya kaiwa ga mutuwar majinyaci. Ga yara, musamman ƙasa da shekaru biyar, haɗarin illoli da matsaloli yana da matuƙar girma. Majinyatan da suka tsira na iya fuskantar lalacewar ƙwaƙwalwa na ɗan lokaci ko na dindindin, ciki har da matsalolin fahimta, rashin daidaiton motsi, da matsalolin ji.
Hanyoyin gwaje-gwaje
Tantance cerebral malaria na buƙatar haɗa gwaje-gwaje na jini a asibiti.
Blood smear
Ana yin blood smear microscopy don gano ƙwayar cutar plasmodium falciparum a cikin jini, inda ake iya tantance yawan ƙwayoyin cutar. Wannan shi ne mafi inganci wajen tabbatar da kamuwa da malariya mai tsanani.
Rapid Diagnostic Tests
Rapid diagnostic tests suna bayar da sakamako cikin sauri, suna gano antigens na plasmodium falciparum a jini. Wannan yana da amfani musamman a wuraren da ba a samu cikakkun na’urori na ɗakin gwaje-gwaje ba.
Lumbar puncture
Haka kuma, a cerebral malaria, likita na iya amfani da lumbar puncture (LP) idan akwai bukata don kawar da wasu cututtuka da ke haifar da toshewar jijiyoyin jiji, amma LP ba shi ne gwaji na kai tsaye don malariya ba.
Wasu hanyoyi
Hanyoyin duba yanayin jiki kamar glasgow coma scale (GCS), duba toshewar jijiyoyin jiji, da lura da yanayin numfashi suna taimakawa wajen tabbatar da cewa cutar ta kai ga ƙwaƙwalwa. Haɗa waɗannan gwaje-gwaje da lura a asibiti na taimakawa wajen gano cutar cikin sauri da inganci, wanda ke da matuƙar muhimmanci wajen fara magani da gaggawa.
Magani da ariya
Cerebral malaria cuta ce mai tsanani wadda ke buƙatar magani na gaggawa domin rage haɗarin mutuwa da illolin ƙwaƙwalwa. Ana amfani da ƙwayoyin maganin antimalarial masu ƙarfi, musamman intravenous (IV) artesunate ko quinine, dangane da yanayin majinyaci da tsawon lokacin da aka fara magani. Ga yara, kula na musamman tana da muhimmanci saboda suna cikin haɗari mafi girma.
Tallafa wa jiki yana da matuƙar muhimmanci wajen murmurewar majinyaci. Wannan ya haɗa da shan ruwa sosai, kiyaye yanayin zafi na jiki, da kulawa da numfashi idan akwai matsalolin huhu ko toshewar jijiyoyin jini. Matakan kariya sun haɗa da shigar da majinyaci cikin ɗaki mai tsafta, rage haɗuwa da wasu masu cutar, da kula da yanayin lafiya gabaɗaya domin rage matsaloli masu tsauri.
Kariya ta fi dacewa fiye da magani. Ana iya rage haɗarin kamuwa da cerebral malaria ta hanyar amfani da gidan sauro masu magani domin kariya daga cizon sauro da kawar da wuraren da sauro ke yawan taruwa, musamman a lokacin damina.
Rigakafi
Rigakafi yana ɗaya daga cikin muhimman hanyoyi na rage yaɗuwar cerebral malaria. Akwai alluran rigakafin cutar malariya da aka samar, musamman RTS,S/AS01 (Mosquirix), wanda aka yi amfani da shi a wasu ƙasashen Afirka don rage kamuwa da cutar, musamman a yara ƙasa da shekaru biyar. Rigakafin yana rage yawan kamuwa da cutar mai tsanani da cerebral malaria, kuma yana taimakawa wajen rage mutuwar yara a wuraren da malariya ke da yawa sosai.
Bugu da ƙari, wayar da kan al’umma game da hanyoyin kariya, tsafta, da amfani da gidan sauro na taimakawa sosai wajen hana yaɗuwar malariya da cerebral malaria. Rigakafi, haɗe da matakan kariya na muhalli, na samar da ingantacciyar kariya ga yara da manya a wuraren da malariya ke da tasiri sosai.
Cerebral malaria a Najeriya
Cerebral malaria cuta ce mai tsanani wadda ke shafar yara da manya a Najeriya, musamman a yankunan da malariya ke da yawa a lokacin damina da bayan damina. Yawanci yara ‘yan ƙasa da shekaru biyar suna cikin haɗari mafi girma, inda rashin magani cikin lokaci ke haifar da toshewar jijiyoyin jini, matsalolin ƙwaƙwalwa, da mutuwa.
Rahotanni daga National Malaria Elimination Programme (NMEP) da cibiyoyin kiwon lafiya sun nuna cewa cerebral malaria tana ɗaya daga cikin manyan dalilan mutuwar yara a asibitocin ƙasar. Yaɗuwar cerebral malaria a Najeriya na da alaƙa da rashin amfani da gidan sauro, rashin tsafta a wuraren zama, da rashin samun magani cikin gaggawa.
Matakan rage haɗari sun haɗa da wayar da kan jama’a game da hanyoyin kariya, rarraba gidajen sauro ga cikin al’umma, samar da magungunan antimalarial cikin sauƙi a asibitoci da cibiyoyin kiwon lafiya na gida, da rigakafin yara da malariya vaccine RTS,S/AS01 a wasu jihohi masu haɗari. Bincike da lura na ci gaba da taimaka wajen rage yaɗuwar cerebral malaria da mutuwar yara a Najeriya.
Manazarta
Abdullahi, S., & Musa, A. (2020). Cerebral malaria in children: Epidemiology and clinical management in Nigeria. Nigerian Journal of Paediatrics, 47(2), 45–56.
National Malaria Elimination Programme (NMEP). (2022, March). Malaria in Nigeria: 2022 annual report. Federal Ministry of Health.
Ojurongbe, O., Fagbamila, I., & Adepoju, T. (2019). Clinical features and outcomes of cerebral malaria in Nigerian children. African Health Sciences, 19(3), 2804–2813.
World Health Organization. (2021, September). World malaria report 2021. WHO.
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