Ikibazo cy’udukoko tugira ubudahangarwa ku miti, kizwi nka Antimicrobial Resistance (AMR), gikomeje kuba kimwe mu bibazo bikomeye byugarije ubuzima bw’abatuye Isi, aho impuguke zigaragaza ko niba nta ngamba zihamye zifatwa, kizakomeza guhitana abantu benshi mu myaka iri imbere.
AMR ibaho igihe udukoko dutera indwara twihinduranyije ku buryo imiti yagombaga kutwica itakibasha kuduhashya. Ibi bituma kuvura indwara byari byoroshye mbere birushaho kugorana, bikazamura ibyago byo kurwara igihe kirekire ndetse no gupfa.
Ku rwego rw’Isi, imibare igaragaza ko mu mwaka wa 2021 gusa abantu bagera kuri miliyoni eshanu bapfuye bazize indwara zifitanye isano n’udukoko twari twaramaze kugira ubudahangarwa ku miti. Abahanga mu buzima bavuga ko benshi muri abo bantu baba bararokotse iyo iyo miti iba ikibasha gukora akazi kayo nk’uko byari bisanzwe.
Icyakora impungenge zirushaho kwiyongera kuko hateganywa ko hagati ya 2025 na 2050 abantu bagera kuri miliyoni 30 bashobora kuzicwa n’iki kibazo mu gihe nta bikorwa bikomeye byaba bifashwe ngo kigabanywe.
U Rwanda na rwo rwamaze kubona uburemere bw’iki kibazo. Nubwo igihugu cyashoye imbaraga nyinshi mu rwego rw’ubuzima mu myaka ishize, imibare igaragaza ko hagati ya 2019 na 2021 abantu barenga ibihumbi 17 bahitanywe n’ingaruka ziterwa n’udukoko twanze imiti.
Mu rwego rwo guhangana n’iki kibazo, igihugu cyashyizeho gahunda nshya y’imyaka ine izarangira mu 2029, igamije kurwanya AMR mu buryo buhuriweho n’inzego z’ubuzima bw’abantu, ubw’amatungo ndetse n’ibidukikije.
Iyi gahunda ishingiye ku mahame ya One Health, aho ubuzima bw’umuntu, ubw’amatungo n’ubw’ibidukikije bifatwa nk’ibifitanye isano ikomeye.
Mu kuyishyira mu bikorwa, hateganyijwe ingengo y’imari ya miliyoni 29,6 z’Amadolari ya Amerika, angana n’arenga miliyari 43 z’Amafaranga y’u Rwanda.
Muri ayo mafaranga, Ikigo cy’Igihugu gishinzwe Ubuzima (RBC) kizahabwa 36,1%, bingana n’arenga miliyari 14,5 Frw, mu gihe Ikigo cy’Igihugu gishinzwe Guteza Imbere Ubuhinzi n’Ubworozi (RAB) kizahabwa 35,7%, bingana n’arenga miliyari 14,3 Frw.
One Health Secretariat izahabwa amafaranga azifashishwa mu guhuza ibikorwa by’inzego zitandukanye, mu gihe Kaminuza y’u Rwanda n’Ikigo cy’Igihugu gishinzwe Kubungabunga Ibidukikije na byo bifite uruhare rukomeye muri gahunda yose.
Ubukangurambaga bwihariye bugenewe miliyari 6,3 Frw buzafasha abaturage kumenya ububi bwo gukoresha nabi imiti ya antibiotique, kumva uburyo indwara zikwirakwira ndetse no gufasha amashuri, ibigo by’ubuvuzi n’imiryango kubona ibikoresho byifashishwa mu gukumira AMR.
Hari kandi miliyari 14,3 Frw zizashorwa mu kongerera ubushobozi laboratwari no kunoza uburyo bwo gukurikirana aho ikibazo cya AMR gihagaze mu gihugu hose.
Izindi miliyari 16 Frw zizakoreshwa mu bikorwa byo gukumira indwara hakoreshejwe isuku n’isukura, uburyo bwo kwirinda udukoko dutera indwara ndetse no guteza imbere uburyo bufasha abantu n’amatungo kugumana ubuzima bwiza.
Muri gahunda nshya kandi hazibandwa ku mahugurwa ahabwa abaganga bandika imiti, abakozi ba za farumasi ndetse n’abaturage muri rusange. Intego ni ukugabanya ikibazo cy’abafata antibiotique nabi cyangwa bakazifata batabiherewe uburenganzira n’abaganga.
Imibare y’ubushakashatsi yerekana ko nubwo abanyeshuri biga ubuvuzi benshi basobanukiwe n’ingaruka za AMR, ikibazo kigihari. Abagera kuri 95% bazi neza ko gukoresha nabi antibiotique bishobora guteza ikibazo gikomeye cy’ubudahangarwa bw’udukoko, ariko hafi 49% bavuga ko hari igihe bafata iyo miti batayandikiwe.
Abagera kuri 12% biyemerera ko bayifata bishakira kwivura indwara bumva ko zoroshye, mu gihe Amoxicillin ari yo miti ikoreshwa cyane kurusha indi.
Ubushakashatsi kandi bwagaragaje ko abanyeshuri bangana na 72% bagura iyo miti muri za farumasi ziri hafi yabo.
Mu bitaro bikuru byo mu Rwanda, nibura abantu bane muri buri 10 bahabwa antibiotique. Muri iyo miti itangwa, 65% ifite ubushobozi bwo gutuma udukoko twongera kubaka ubudahangarwa kuri yo iyo ikoreshejwe nabi.
Ku rwego rw’ubworozi na ho ikibazo kiracyahangayikishije. Hafi 70% bya antibiotique zikoreshwa ku Isi zikoreshwa mu bworozi, ibintu bituma habaho amahirwe menshi y’uko udukoko twubaka ubudahangarwa.
Mu Rwanda, hagati ya 2019 na 2021, hatumijwe mu mahanga toni nyinshi za antibiotique zikoreshwa mu buvuzi bw’amatungo. Muri zo, 50,3% zari izo mu bwoko bwa tetracyclines, 22,3% zari sulfonamides naho 11,5% zari aminoglycosides.
Abashinzwe ubuzima bw’amatungo bavuga ko gucunga neza ikoreshwa ry’iyi miti ari ingenzi kugira ngo hirindwe ko udukoko twarushaho kugira ubudahangarwa.
Ubushakashatsi bwakozwe mu bworozi bugaragaza ko 52,6% by’aborozi bafite ubumenyi bukenewe mu kwita ku matungo yabo, 56% bafite ubushake bwo kubahiriza amabwiriza y’ubuvuzi bw’amatungo, mu gihe 52,8% ari bo bakurikiza neza imyitwarire ikwiye.
Hagati aho, igihugu cyateye intambwe ikomeye mu kongera ubushobozi bwo gupima no gukurikirana ikibazo cya AMR. Mu gihe mu 2024 hari laboratwari esheshatu gusa zipima udukoko twanze imiti, ubu hamaze kubakwa laboratwari 18.
Muri izo, 12 zita ku buzima bw’abantu naho esheshatu zikita ku buzima bw’amatungo. Zifasha abaganga kumenya umuti ushobora gukora nyuma yo gupima neza ubwoko bw’udukoko n’ubushobozi bwatwo bwo guhangana n’imiti.
Ubushobozi bw’izi laboratwari na bwo burashimishije. Ku rwego rw’ibitaro by’akarere, ubuziranenge bw’ibisubizo bugera kuri 85,5%, mu gihe laboratwari z’igihugu zigeze ku rwego rwa 90%.
Ibi byose bishyigikiwe n’urwego rw’ubuzima rwagutse rugizwe n’ibitaro bikuru umunani, ibitaro bine by’intara, ibitaro 40 by’uturere, ibigo nderabuzima 515 n’amavuriro mato 1.243.
Abajyanama b’ubuzima barenga ibihumbi 58,5 na bo bazagira uruhare rukomeye mu kugeza ubutumwa ku baturage, gukurikirana uko ikibazo gihagaze no gufasha abaturage kumenya uburyo bwo gukoresha neza imiti.
Gahunda nshya yo kurwanya AMR izagera mu turere 30 tw’u Rwanda, imirenge 416, utugari 2.148 n’imidugudu 14.837.
Abasesenguzi bavuga ko nubwo ikibazo cya AMR kigenda gifata indi ntera ku Isi hose, kuba u Rwanda rwarafashe icyemezo cyo gushora miliyari zirenga 43 Frw mu gukumira no kugenzura iki kibazo bishobora kugabanya ingaruka zacyo mu gihe kiri imbere.
Icyakora, bagaragaza ko intsinzi y’iyi gahunda izaterwa cyane n’imyitwarire y’abaturage, abaganga, aborozi n’abatanga imiti, kuko gukoresha antibiotique nabi ari cyo gitera cyane ubwiyongere bw’udukoko twanze imiti.
Tubibutse ko mushobora gukomeza kudukurikirana ku mbuga nkoranyambaga.
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