Msaada wa haraka sana, Upungufu wa Damu (ANAEMIA)

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pole sana wa jamii forum na hongera sana kwa mheshimiwa lema kupita rufaa yake. Kwa kifupi ni mdogo wangu yapata sasa wiki 3 alikuwa amelazwa hospital moja ya wilaya lakini kama wiki 1 iliyopita alizidiwa kabisa na ikabidi akimbizwe hospital ya Rufaa na mpaka sasa ninavyosema yuko hapo amelazwa kweli madaktari wanahangaika sana tangu mwanzo ameonekana alikuwa na malaria kali iliyomsababishia kuishiwa damu na aliongezewa alipofikishwa hospital ya rufaa. Jana walipomfanyia tena uchunguzi wa damu wakakuta damu haitoshi inabidi aondgezewe tena na wakasema kuwa anasumbuliwa na Sickle cell Anaemia. Swali langu kwa ufahamu wangu huu ugonjwa unatokana na kurithiwa cha ajabu zaidi huyu bwana mdogo anazaidi ya miaka 13 na hajawahionekana na tatizo kama hili na hata kwenye ukoo wetu sijawahi sikia kuna mtu anatatizo kuanzia kwa babu na bibi zao na akina baba na mama maana namshukru Mungu niliishi nao kwa muda mrefu kabla hawajatutangulia mbele za maisha hadi kuja kwa babu na bibi zangu sijawahi ona au sikia mpaka wametangulia mbele za haki. Naomba ufafanuzi na pia msaada wa haraka kwa yeyote aliye na ufahamu na hili tatizo na nifanyeje kuwasaidia wao wanamuunguza maana niko nje ya nchi. Asante sana
 
Ngoja Riwa aje atupe ufafanuzi, mimi pamoja na last born wetu tuna tatizo hili isipokuwa tuliambiwa na Daktari kuwa aina ya sickle cell anemia tuliyonayo haina madhara sana. Angalizo tulilopewa tusioe/kuolewa na mtu mwenye tatizo kama hili. bahati mbaya tuligundua tatizo hili wakati wazazi wetu wote wameshatangulia mbele za haki. Wangekuwepo labda wangesema kama tumerithi au la!
 
asante sana ila mimi kinachonishangaza maana wazazi wetu wote wapo hai na babu na bibi nimekaa nao miaka zaidi ya 20 mpaka wanafariki sikuweza kusikia kitu kama hiki ndio leo napigiwa simu nilishangaa sana na kwa uelewa wangu kwa huu ugonjwa huwa unarithiwa
 
Mkuu Mwanaweja hakuna kitu cha kushangaza kuhusu maradhi. Hata kama kwenye Familia yenu hakuna mtu aliye kuwa na hayo maradhi basi sio kitu cha kushangaza ni maradhi tu ya kawaida angalia hawa watu wanao umwa na hayo Maaradhi nchi Uingereza Je hao wote wamepata haya maradhi kwa kurithi?



More than 12,500 people in the UK have sickle cell anaemia.
Dr Gill Jenkins last medically reviewed this article in August 2009.






What is sickle cell anaemia?

Sickle cell anaemia is an inherited genetic condition in which there's an abnormality in haemoglobin, the oxygen-carrying protein found in red blood cells.
People with sickle cell anaemia have a type of haemoglobin known as sickle haemoglobin (HbS), which is different from normal haemoglobin (HbA).
Normal red blood cells can bend and flex easily, and so travel around the blood vessels easily. When sickle haemoglobin gives up its oxygen to the tissues, it sticks together to form long rods inside the red blood cells, making these cells rigid and sickle-shaped.
They are then less able to squeeze through small blood vessels. These small blood vessels easily become blocked, preventing oxygen from getting through and causing severe pain and damage to organs.

Symptoms of sickle cell anaemia

Blockage of a blood vessel causes an attack known as a crisis. This is more likely to happen when the person is stressed by another illness, exhaustion, cold, dehydration, low oxygen levels (such as when flying) and other problems.
Organs such as the liver, kidney, lungs, heart and spleen become damaged, causing severe pain, especially in the bones. The red blood cells also break up easily, leading to anaemia. Even without severe crises, chronic anaemia can occur causing tiredness. People with sickle cell disease are also more prone to infection and should see their doctors promptly if they think they have any infection.

Causes of sickle cell anaemia

The majority of people with sickle cell disease are of African or Caribbean descent, although it also affects those from Asia, the Middle East and the eastern Mediterranean.
Everyone has two copies of the haemoglobin gene, one from each parent. Those with sickle cell anaemia have two HbS genes. Those who have one HbA gene and one HbS gene are said to have sickle cell trait and are referred to as carriers. There are 240,000 carriers of sickle cell anaemia and they're only at risk of problems under extreme conditions, such as during major surgery.
Testing during pregnancy, from 11 weeks and usually with CVS (chorionic villus sampling), can identify the haemoglobin type of the baby, while adults can easily be screened.



Treatment of sickle cell anaemia

It's important for sickle cell patients to try to keep healthy.
A good diet, supplements of folic acid, vitamin D and zinc, avoiding smoking and alcohol (both of which can affect the condition of blood vessels). Vaccination against infections such as flu, pneumococcus meningitis and Hepatitis B will all help reduce the risk of a crisis. Some patients are given long term antibiotics.
It's also recommended to avoid:

  • Constricting garments
  • Overexertion
  • Dehydration
  • Cold temperatures
There's no cure for sickle cell anaemia, but the frequency and severity of crises and their complications can be reduced by avoiding the triggers and prompt recognition and treatment of a crisis.
Bone marrow transplants have been used in some cases and, while it is still early days, the procedure holds promise for the future. Transplants offer a possible cure by providing a source of normal blood-making cells. However, they must be done very early in the disease, before the condition damages vital organs.
UK guidelines recommend that all children under 16 with sickle cell disease have the opportunity to discuss bone marrow transplant with a specialist – this should include the risks (including an approximate five per cent risk of death), success rates (around 85 per cent) and the difficulties involved in finding a donor (at best around only one in ten of those with sickle cell will have a matching donor).
 
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MziziMkavu nimekupata mimi nilikuwa nasoma article nyingi wanaelezea ni ugonjwa wa kurithi sasa nikawa nashindwa kupata majibu ya haraka. An way Mungu ndie ajue maisha yetu na mapitio ya maisha yetu. Ngoja tujitahidi kwa kadri tunavyoweza tukiendelea kuomba kwa Mwenyezi Mungu atujaliaye uzima
 
Mkuu Mwanaweja ninakupa hii ya kiswahili UPUNGUFU WA DAMU MWILINI (ANEMIA)


Upungufu wa damu mwilini au Anemia ni miongoni mwa magonjwa yanayosumbua watu wengi duniani. Anemia humaanisha kupungua kwa kiwango cha chembechembe nyekundu za damu (RBC’s) katika mzunguko wake, au kupungua kwa wingi wa hemoglobin kwenye damu.

Kazi ya hemoglobin ambayo hupatikana ndani ya chembechembe nyekundu za damu ni kubeba gesi ya oksijeni kutoka katika mapafu na kusambaza kwenye tishu. Kwa sababu hiyo upungufu wa damu husababisha ukosefu wa hewa muhimu ya oksijeni katika viungo au hypoxia.

Kwa mujibu wa shirika la Afya duniani (WHO), viwango vya hemoglobini hutofautiana kati ya jinsia moja na nyingine, na kati ya nchi au eneo na eneo. Hata hivyo, iwapo nchi zote zitazingatia viwango hivi vya WHO, kunaweza kutokea mkanganyiko hususani kwa nchi zinazoendelea kama za

Afrika hivyo basi ili kuepuka hali hiyo Wizara za afya za nchi husika zimejiwekea viwango vyao kutokana na mazingira ya nchi zao.
Kwa mujibu wa takwimu za WHO, na kulingana na jinsia, mtu aliye na chini ya viwango vifuatavyo huhesabika kuwa na upungufu wa damu, kwa wanaume chini ya 13g/dl, wanawake wasio wajawazito chini ya 12g/dl wakati wanawake wajawazito na watoto ni chini ya 11g/dl.

Upungufu wa damu husababishwa na nini?

Mambo yanayoweza kusababisha upungufu wa damu yanaweza kugawanywa katika makundi makuu matatu, ambayo ni:

  • Kupungua kwa uzalishwaji wa chembe nyekundu za damu yaani impaired production of rbcs kunakoweza kutokea iwapo kuna upungufu wa madini muhimu ya chuma (iron deficiency) hali ambayo husababishwa na mtu kuwa na minyoo aina ya hookworms au mtu kuwa na vidonda vya tumbo; upungufu wa vitamin hasa vitamin B12 pamoja na upungufu wa folic acid; na magonjwa sugu ya figo (chronic renal failure)
  • Kuongezeka uharibifu wa chembe nyekundu za damu kuliko kawaida yaani increased destruction of rbcs. Hali hii huitwa hemolytic anemia ambayo inaweza kutokea iwapo mtu ana kasoro katika umbo la chembe zake nyekundu za damu kwa mfano iwapo ana magonjwa ya hereditary spherocytosis au sickle cell; aliongezewa damu isiyoendana na kundi lake yaani blood transfusion reaction; ana malaria, au saratani ya damu kama vile chronic lymphocytic leukemia.
  • Kupoteza damu yaani blood loss ambayo yaweza kusababishwa na mambo kama ajali; kupoteza damu wakati wa upasuaji; na kupoteza damu kunakotokea kwa wanawake mara baada ya kujifungua au postpartum hemorrhage (PPH).
  • Sababu nyingine zinazoweza kusababisha upungufu wa damu mwilini ni pamoja na kuungua (burns); matumizi ya dawa au kemikali zinazoathiri sehemu laini ya mifupa inayohusika na uzalishaji wa chembe nyekundu za damu (bone marrow); magonjwa yanayosababisha kuharibika kwa chembe nyekundu za damu kabla ya muda wake kama vilethrombocytopenic purpura na hemolytic uremic syndrome


Dalili za Anemia ni zipi?

Kwa ujumla dalili za upungufu wa damu ni pamoja na

  • Mwili kuwa mchovu au mlegevu
  • Kupungua na kukosekana kwa umakini
  • Mgonjwa kushindwa kupumua vizuri hasa baada ya kutoka kufanya kazi nzito au mazoezi
  • Mapigo ya moyo kwenda haraka
  • Kucha kuwa na umbo la kijiko (Koilonchyia) na kukatika kirahisi. Hali hii hutokea kwa wenye upungufu wa madini ya chuma.
  • Kuwa na manjano (jaundice) kwenye macho, ngozi na sehemu nyingine za mwili kutokana na kuongezeka kwa uharibifu wa chembe nyekundu za damu.
  • Wakati mwingine, iwapo anemia ni kali, mgonjwa anaweza pia kuwa na dalili za moyo kushindwa kufanya kazi (heart failure) kama vile kuvimba miguu, au kushindwa kupumua wakati wa kulala bila kuinua kitanda (flat)
  • Baadhi ya wagonjwa wenye anemia inayotokana na upungufu wa madini ya chuma mwilini hupendelea kula vitu kama udongo, chaki, penseli, mchele mbichi, au vipande vya barafu, hali ambayo kitaalamu huitwa PICA.

Vipimo na Uchunguzi: Vipimo kwa ajili ya tatizo hili vimelenga kutambua iwapo mgonjwa ana upungufu wa damu pamoja na kutambua chanzo chake. Vipimo hivyo ni

  • Kupima damu na viainishi vyake (complete blood count/full blood picture with red cell indices) kama vile MVC, MCH na MCHC.
  • Kuchunguza damu kwenye darubini (peripheral blood smear) ambayo husaidia kugundua iwapo kuna tatizo kwenye umbo la chembe nyekundu za damu.
  • Hemoglobin electrophoresis
  • Sickling test iwapo mgonjwa anahisiwa kuwa na ugonjwa wa sickle cell
  • Kuchunguza choo (stool examination) husaidia kugundua uwepo wa minyoo (hookworms)
  • Kuchunguza mkojo (urine examination)
  • Kucuhunguza uwepo wa vidonda vya tumbo kwa kutumia Endoscopy na vipimo vya barium
  • Kuchunguza sehemu ya mifupa inayozalisha chembe nyekundu za damu (bone marrow examination)

Matibabu ya Upungufu wa damu

Matibabu ya upungufu wa damu hutegemea kiwango cha upungufu (ukubwa wa tatizo) na chanzo chake. Kulingana na chanzo, matibabu yanaweza kujumuisha

  • Lishe yenye virutubisho muhimu kwa ajili ya wenye upungufu wa madini ya chuma, vitamin B12, na folic acid. Vyakula kama mboga za majani, nyama, na matunda hushauriwa sana.
  • Matumizi ya dawa za corticosteroids hasa kwa wagonjwa wenye autoimmune hemolytic anemia
  • Kuacha matumizi ya dawa au kemikali zenye kuathiri sehemu za mifupa zinazohusika na uzalishaji chembe za damu
  • Kuongezewa damu kwa wale walio poteza kiasi kikubwa cha damu au wale wenye dalili za moyo kushindwa kufanya kazi.
  • Kwa wenye minyoo ya hookworms hupewa dawa za kuua na kuondoa minyoo mwilini.
  • Kutibu malaria ipasavyo
  • Kutibu vidonda vya tumbo kwa wenye tatizo hili

Jinsi ya kuzuia upungufu wa damu: Namna ya kuzuia upungufu wa damu ni pamoja na kujitahidi kula mlo kamili wenye mchanganyiko wa nyama, mboga za majani, maziwa na matunda; kutambua dalili na kutibu haraka magonjwa yawezayo kuleta upungu wa damu; pamoja na kuwapa mama wajawazito vidonge vyenye madini ya chuma na folic acid. http://tanzmed.com/index.php?option...70:upungufu-wa-damu-mwilini-anemia&Itemid=210
 
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mimi mtoto wangu,ana sickle cell carer.alivyozaliwa baada ya kama ya wiki i hivi au mbili nimeshasahau alitolewa damu{nchi niliyopo ni kawaida mtoto huwa anatolewa damu}kama routine test tu.nikaambiwa ana hilo tatizo,wakaniambia amerithi either kwa baba au mama.nikachekiwa tatizo likawa hakupata kutoka kwangu.ila maelezo niliyopewa ni kuwa akija kuwa na mtu ambae cerer mwenziwe,siku akija kupata mtoto atakuwa na ugonjwa wa sickle cell
 
Wamfanyie uchunguzi zaidi anaweza akawa na shida kwenye platelets; pia malaria huchangia damu kuisha. Kwa muda ni kumuongezea na kumpa iron rich food kama juice ya matembele!
 
asanteni sana ndugu zangu kwa ushauri wenu najitahidi kuwapigia simu nakuwasisitiza nini wafanye haswa hili la vyakula ninaimani ikimpendeza Mungu atarudi kwenye afya yake kama hapo awali. Pamoja sana
 
Sickle cell disease (SCD) denotes all genotypes that contain at least 1 sickle gene, in
which haemoglobin (Hb) S makes up at least half of the Hb present
o In addition to homozygotic HbSS (sickle cell anaemia [SCA]) in which only HbS is
produced, at least 5 other major genotypes are linked to the disease, including:
HbS– β0 thalassemia- almost indistinguishable from SCA phenotypically
HbSC disease with intermediate clinical severity
HbS/hereditary persistence of foetal Hb (S/HPHP) - mild form or symptom free
HbS/HbE syndrome - rare and generally mild clinical course
Other rare combinations
SCA is the most severe and most common form
• Sickle cell anaemia originates from inheritance of one copy of the sickle cell gene from
each parent, who may either be heterozygous (Hb AS) or homozygous (Hb SS)
• Sickle cell trait is when one has normal adult Hb A and an abnormal Hb S (i.e.
heterozygous [HbAS])
o These children are asymptomatic
• HbS is a result of the substitution of valine for glutamic acid in position 6 of the beta (ß)
chain of Hb
Note: HbAS offers some protection against falciparum malaria. The infestation of the malaria
plasmodium is halted by the sickling of the cell which it infests.
Characteristics of Red Blood Cells with Abnormal Haemoglobin (HbSS)
• Red blood cells (RBC) are abnormal and have short life span of 8 to 20 days
• Under low oxygen tension (that is when deoxygenated)
o Cells become elliptic (thus the name sickle cell), rigid, sticky and fragile
o Cells clump together and occlude small blood capillaries
Clinical Features of Sickle Cell Anaemia
Although a diagnosis of the disease can be made at birth, clinical abnormalities usually do
not occur before 6 months
• By the end of childhood, functional asplenia due to repeated sickling of red cells and
ultimately infarction of splenic tissue results in susceptibility to overwhelming infection
with encapsulated organisms such as Streptococcus pneumoniae and Haemophilus
influenzae
The risk is decreased but still significant even in the vaccinated population
• Subsequently, other organs are damaged
• Typical manifestations include recurrent pain and progressive infarction
Sickle Cell Crises;
Vaso-occlusive (thrombotic) or painful crisis
o The most common form of crisis
o Caused by occlusion of the small blood vessel and restrict blood flow to organs
o This results into ischaemia, pain and organ damage
o Pain in the limbs and joints and tenderness
o Hydration and analgesics are the mainstay of therapy
o If IV fluids needed, give isotonic sodium chloride solution
• Sequestration crisis
o Also called ‘acute or splenic sequestration crisis'
o A medical emergency
o Is specific form of acute hypersplenism in young children
o A large amount of blood is trapped in the spleen causing a sudden fall in Hb
o Children develop painful, rapid and massive splenic enlargement with consumption of
large volumes of erythrocytes
o They present with marked pallor, shock or sudden weakness, dyspnea, and left-sided
abdominal pain in addition to the splenomegaly
o Death due to hypovolemic shock occur rapidly
Treatment consists of IV fluids and erythrocyte (packed red blood cell) transfusions
o To prevent recurrences, splenectomy may be indicated
o In most patients with SCA, the spleen eventually involutes and sequestration is no
longer a problem
• Acute chest syndrome
o Common cause of morbidity and mortality
o Triggered by painful crises, respiratory infection or surgery
o This condition is characterized by:
�� Difficulty breathing
�� Tachycardia, tachypnea and hypoxemia are common
�� Patients present with a new infiltrate on chest X-ray, often with chest pain and
fever
o Treatment includes oxygen therapy, IV antibiotics, and analgesics
o Simple transfusion administered early may halt progressive respiratory deterioration
• Haemolytic crisis
o Acute accelerated drop in Hb level
o The RBC breaks down at a faster rate
• Aplastic crisis
o Associated with Parvovirus B19 infection
o Depression of the RBC precursors in the bone marrow
o Presents with pallor, tachycardia and fatigue
o Inadequate production of RBC can be life threatening when the RBC life span is short
Hypersplenism
• Hypersplenism is a clinical syndrome in which cytopenias result when splenic function
becomes excessive as the spleen enlarges
• This has been attributed to the following four possible mechanisms
o Excessive splenic phagocytic activity
o Splenic production of antibodies that results in the destruction of hematopoietic cells
o Over activity of splenic function
o Splenic sequestration
• If results in recurrent severe anaemia necessitating repeated blood transfusion,
splenectomy may be indicated (refer to hospital)
: Complications and Management
• Avascular necrosis of head of femur
• Autosplenectomy due to repeated infarcts
• Osteomyelitis by salmonella
• Acute papillary necrosis causing haematuria
• Prone to infections due to low immunity
• Chronic ulcers (legs)
• Priapism may occur at any age but more common after puberty
• Cerebral infarction
o Presenting complaint depends on the nature of the event and includes gait disturbance,
aphasia, altered level of consciousness, hemiparesis or hemiplegia or seizures
• Blindness from retinal detachment
• Gallstones (cholelithiasis) because of chronic haemolysis
Management
• Investigations
o Hb range typically 6-8 g/dl
o Sickling test (may be negative if transfused within last 3 months)
o Hb electrophoresis (done at hospital level)
o Full blood picture (FBP) may apart from anaemia, indicate macrocytosis
(megaloblasts or reticulocytes), total white blood cells (WBC) may be high
(leucocytosis)
o In hypersplenism, anaemia, reduced levels of WBC's and platelets may be seen
o Reticulocytosis (high number of immature RBC's)
Treatment
• No specific treatment, but the following help to alleviate symptoms
o Prophylaxis with folic acid 5mg daily, and chloroquine 5 mg/kg weekly to prevent
malaria
o Do not give iron as there are plenty of iron stores coming from the destruction of the
Haem group that may actually lead to iron overload
o When a child has malaria, treat with Artemether/Lumefantrine (ALu) or Quinine if
they have severe malaria
o Growth monitoring, immunization and proper nutrition
o Treat other infections vigorously
• For sickle cell crises
o Sickle cell crises are precipitated by fever, dehydration, infection, hypoxia or surgery
o Give analgesics (e.g. paracetamol)
o IV fluids , normal saline or ringer's lactate
o Treat infections vigorously (give pre-referral antimalaria and antibiotics,( i.e. inj.
quinine 10 mg/kg IM and inj. chloramphenical 25 mg/kg IM respectively)
o Keep warm, and refer to hospital


(mkuu hiyo ni kwa ufupi tu ,ukiwa na swali unaweza kuuliza)
ila in addition nina wasiwasi kama hiyo ya dogo wako ni SCD kweli
 

nimekusoma mkuu asante sana. Kweli sijui maana mimi siko home nawasiliana nao kwenye simu na taarifa walizo nipa ni SCD ndio inamsumbua waliambiwa hivyo na doctor. Ila kwa sasa yuko nje anaendelea vizuri sijui sasa lakini yote
ni ya Mungu
 
Kaunga said:
Wamfanyie uchunguzi zaidi anaweza akawa na shida kwenye platelets; pia malaria huchangia damu kuisha. Kwa muda ni kumuongezea na kumpa iron rich food kama juice ya matembele!
Click to expand...

kama ni Sickle cell anaemia kweli ,hakuna sababu ya kumpatia Iron zaidi kwani itasababisha Iron overload as they tend to have much iron kwenye mwili wao.
 
pole sana ndugu yangu kwa matatizo atapona tu kama hakuzaliwa nao
 
kid kama ni 13 ana jinsia gani?? gani ni me akijitahd sana kujikinga na maradhi hana neno na kula vizuri hasa mboga za majani matunda maziwa na maji hana neno. angekuwa mdada shida inhgekuja wakati wa kidanguro chekundu.

but huwa wanaish vzr tu na igawa magonjwa huwasumbua kidogo. waambie wanaokaa nae wajitahd asipate jaundice yaani asiwe wa njano macho na kucha kwani hii huonyesha upungufu wa dam mwilini.
 

ndugu yaangu nakushukuru sana kwa ushauri wako ni mwanaume kweli Mungu ni mkubwa maana naona anaendelea vizuri japo kama mjuavyo ugonjwa huingia siku mmoja lakini kutoka au kurudi kwenye hhali ya kawaida/mwanzo inaweza chukua muda najitahidi kuwasiliana nao ili wajitahidi kumpa mbonga za majani na matunda bila kusahau maziwa. pamoja dada yangu
 
Smile said:
pole sana ndugu yangu kwa matatizo atapona tu kama hakuzaliwa nao
Click to expand...

asante sana smile pamoja tuombeane tu maana tuwapo hapa dunia kuna kila mawimbi haswa ya majaribu na magonjwa ya kila aina
 
Dalili za ukimwi hizo kupungukiwa damu mara kwa mara
 
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