Alurar rigakafin kwalara

A karshen karni na 20, an fara amfani da allurar rigakafin cutar kwalara a cikin gaggarumar sikeli, inda aka yi wa miliyoyin alluran rigakafi, a matsayin wani makami na shawo kan barkewar cutar kwalara baya ga al'adun gargajiya na inganta samar da tsaftataccen ruwa, tsafta, wanke hannu, da dai sauransu. hanyoyin inganta tsafta. Alurar riga kafi na Dukoral monovalent daga kasar Sweden, wanda ya haɗu da formalin, da zafin-kashe dukkan ƙwayoyin Vibrio cholerae O1, da recombinant kwalara toxin B subunit, an ba shi lasisi a cikin shekarar 1991, galibi don matafiya.^[4] Daga cikin allurai miliyan da aka sayar a cikin shekaru goma masu zuwa, an ba da rahoton sakamako mara kyau guda 63. Maganin rigakafin shanchol bivalent (wanda kuma aka kera a ƙarƙashin sunan mORCVAX), wanda ya haɗa O1 da O139 serogroups, an ba shi lasisin asali a Vietnam a cikin shekarar 1997 kuma an ba shi a cikin allurai miliyan 20 ga yara a Vietnam cikin shekaru goma masu zuwa. Tun daga shekara ta 2010, Vietnam ta ci gaba da haɗa allurar rigakafin kwalara a cikin shirinta na kiwon lafiyar jama'a, tare da gudanar da allurar rigakafin ta hanyar yawan alurar riga kafi na yara masu shekaru makaranta a yankunan kwalara. Ana amfani da allurar rigakafin kwalara ta hanyar 'yan bayan gida da kuma mutanen da ke ziyartar wuraren da akwai haɗarin kamuwa da cutar kwalara. Duk da haka, tun da ba ya samar da rigakafi kashi 100 daga cutar, ana kuma ba da shawarar kiyaye tsaftar abinci yayin ziyartar yankin da ke da hatsarin kamuwa da cutar kwalara. Ko da yake an kwatanta kariyar da aka lura a matsayin "matsakaici", garkuwar garken garken na iya haɓaka tasirin rigakafin. An ba Dukoral lasisi ga yara masu shekaru biyu zuwa sama, Shanchol na yara masu shekara ɗaya da haihuwa. Gudanar da rigakafin ga manya yana ba da ƙarin kariya ta kai tsaye (kariyar garken garken) ga yara.^[5]Hukumar Lafiya ta Duniya (WHO) ta ba da shawarar yin amfani da allurar rigakafi da kuma mai da hankali, tare da yin mahimman bayanai kamar haka: WHO ta ba da shawarar a yi amfani da allurar rigakafin cutar kwalara da ake da su a halin yanzu a matsayin madaidaicin kulawar gargajiya da matakan rigakafi a wuraren da cutar ke da yawa kuma ya kamata a yi la'akari da su a wuraren da ke fuskantar barazanar barkewar cutar. Alurar riga kafi bai kamata ya kawo cikas ga samar da wasu manyan abubuwan da suka shafi kiwon lafiya ba don sarrafawa ko hana barkewar cutar kwalara. Za'a iya yin la'akari da allurar rigakafin cutar ta hanyar iyakance girman barkewar cutar da aka dade, idan dai kayayyakin more rayuwa na cikin gida sun ba da damar hakan, da zurfin zurfi. An gudanar da nazarin bayanan kwalara da suka gabata da kuma gano takamaiman wurin da aka yi niyya.^[6]Hukumar ta WHO a karshen shekarar 2013 ta kafa tarin juzu'i na allurai miliyan biyu na OCV. Kayayyakin yana karuwa zuwa miliyan shida yayin da kamfanonin Koriya ta Kudu suka fara samar da kayayyaki shekarar (2016), tsofaffin kayayyakin da ba su iya kula da bukatar WHO a Haiti da Sudan na shekarar 2015, ko kuma shekarun baya. GAVI Alliance ta ba da gudummawar dala miliyan 115 don taimakawa wajen biyan kuɗi.^[7]

Baka

Dukoral: vial na rigakafin da ba a kunna ba tare da fakitin buffer sodium bicarbonate.Alurar rigakafin baki gabaɗaya nau'i biyu ne: marasa aiki da ragewa.Magungunan baka da ba a kunna ba suna ba da kariya a kashi 52 cikin 100 na lokuta a shekara ta farko bayan rigakafin da kuma kashi 62% cikin 100% na lokuta a shekara ta biyu. Bambance-bambancen biyu na allurar baka da ba a kunna ba a halin yanzu ana amfani da su: WC-rBS da BivWC. WC-rBS (an kasuwa a matsayin "Dukoral") allurar rigakafin da ba a kunna ta ba ce mai ɗauke da kisa duka ƙwayoyin V. cholerae O1 tare da ƙarin recombinant kwalara toxin B subunit. BivWC (an kasuwa kamar "Shanchol" da "mORCVAX") allurar rigakafin da ba a kunna ba ta bivalent wacce ke dauke da dukkan kwayoyin halittar V. cholerae O1 da V. cholerae O139.^[8] Ana samun mORCVAX a cikin Vietnam kawai.Nau'in kwayoyin cuta na Inaba da Ogawa serotypes da na El Tor da na Classical biotypes suna cikin allurar. Ana ɗaukar Dukoral da baki tare da buffer bicarbonate, wanda ke kare antigens daga acid na ciki. Alurar riga kafi yana aiki ta hanyar haifar da ƙwayoyin rigakafi a kan duka sassan ƙwayoyin cuta da CTB. Kwayoyin rigakafin ƙwayoyin cuta na hanji suna hana ƙwayoyin cuta mannewa ga bangon hanji, wanda hakan zai hana yin mulkin mallaka na V. cholerae O1. Magungunan rigakafi na hanji suna hana gubar kwalara ta ɗaure a saman mucosal na hanji, ta yadda za su hana bayyanar cututtuka na zawo mai guba. Alurar riga kafi na baka mai rai (CVD 103-HgR ko Vaxchora), wanda aka samo daga nau'in serogroup O1 na Inaba na gargajiya, FDA ta Amurka ta amince da shi a cikin shekarar 2016.^[9]

Mai allura

Ko da yake ba kasafai ake amfani da su ba, allurar rigakafin kwalara na da tasiri ga mutanen da ke zaune a inda cutar kwalara ta zama ruwan dare. Suna ba da wani mataki na kariya har zuwa shekaru biyu bayan harbi ɗaya, kuma na shekaru uku zuwa huɗu tare da haɓaka shekara-shekara. Suna rage haɗarin mutuwa daga cutar kwalara da kashi 50 cikin ɗari a cikin shekara ta farko bayan rigakafin.^[10]

Dukansu nau'ikan allurar baka da ake samu gabaɗaya suna da lafiya. Ciwon ciki mai sauƙi ko gudawa na iya faruwa. Suna da aminci a lokacin da suke ciki da kuma waɗanda ke da ƙarancin aikin rigakafi. Suna da lasisi don amfani a cikin ƙasashe sama da 60%.^[11] A cikin kasashen da cutar ta zama ruwan dare, ana ganin maganin yana da tsada.

Alurar rigakafin kwalara ta wata ma'aikaciyar jinya 'yar Guinea ta yin amfani da allurar jet a Ziguinchor, Senegal, 1973An samar da allurar rigakafin kwalara na farko a ƙarshen karni na 19. Akwai majagaba da yawa a cikin haɓakar rigakafin:Wani sanannen ƙoƙari na farko na rigakafin cutar kwalara Louis Pasteur ne ya yi shi kuma an yi shi ne don hana cutar kwalara a cikin kaji. Wannan ita ce rigakafin farko da aka yi amfani da ita a cikin dakin gwaje-gwaje. Daga baya amfani da shi ya nuna wannan rigakafin kwalara na farko ba shi da amfani. A cikin shekarar 1884, likitan ɗan Spain Jaume Ferran i Clua ya ƙirƙiri wani maganin rigakafi mai rai wanda ya keɓe daga masu cutar kwalara a Marseilles, kuma ya yi amfani da shi a kan mutane sama da 30,000 a Valencia a lokacin annobar wannan shekarar. Duk da haka, maganin rigakafinsa da allurar rigakafinsa ya kasance mai yawan cece-kuce kuma takwarorinsa da kwamitocin bincike da yawa sun ƙi su, amma ya ƙare yana nuna tasirinsa kuma an gane shi da shi.^[12] A shekara ta 1892, Waldemar Haffkine ya samar da maganin rigakafi mai inganci tare da rashin lahani, daga baya ya gwada shi akan mutane fiye da 40,000 a yankin Calcutta daga 1893 zuwa 1896. Alurar rigakafinsa ta sami karbuwa daga al'ummar likitoci, kuma ana la'akari da shi a matsayin rigakafin cutar kwalara na farko na ɗan adam. A ƙarshe, a cikin 1896, Wilhelm Kolle ya ƙaddamar da wani maganin kashe zafi wanda ya fi sauƙi a shirya fiye da na Haffkine, yana amfani da shi a babban sikelin a Japan a shekarar 1902.An fara fara amfani da allurar cutar kwalara a cikin 1990s.

Matsayin shari'a

A cikin 2016, Hukumar Kula da Abinci da magunguna ta Amurka (FDA) ta amince da Vaxchora, allurar baki guda ɗaya don hana kwalara ga matafiya. Tun daga watan Yuni 2016, Vaxchora ita ce kawai maganin da FDA ta amince da shi don rigakafin kwalara.^[13]

Tattalin Arziki

Kudin rigakafin cutar kwalara yana tsakanin dalar Amurka 0.10 zuwa dalar Amurka 4.00 ga kowace allurar. Alurar rigakafin Vaxchora na iya kashe sama da dalar Amurka $250.^[14]