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Anemia tsakanin manya masu fama da ciwon sukari suna halartar babban asibiti a gabashin Habasha: nazari mai zurfi
Teshome Tujuba, 1 Behailu Hawulte Ayele, 2 Sagni Girma Fage, 3 Fitsum Weldegebreal41, Medical Laboratory, Guelmsau General Hospital, Guelmsau City, Ethiopia 2 School of Public Health, Faculty of Health and Medicine, Haramaya University, Harala State, Ethiopia; 3 School of Nursing and Midwifery, Faculty of Health and Medicine, Haramaya University, Ethiopia; 4 Faculty of Health and Medicine, Haramaya University, Harar City, Ethiopia News Agency: Sagni Girma Fage, Faculty of Health and Medical Sciences, Haral University, Ethiopia, Harar, Ethiopia POBox 235 Email giruu06@gmail.com Background: Although anemia is a common disease among diabetic patients, there is very little evidence of anemia in this part of the population in Ethiopia, especially in the research environment. Therefore, the purpose of this study was to evaluate the degree of anemia and related factors in adult diabetic patients treated in a general hospital in eastern Ethiopia. Methods: A cross-sectional study of health basics was conducted on 325 randomly selected adult diabetic patients. Follow-up clinic at the Gramsoe General Hospital in eastern Ethiopia. Use pre-tested structured questionnaires to collect data through interviews and then perform physical and laboratory measurements. Then enter the data into EpiData version 3.1, and use STATA version 16.0 for analysis. Fit a binary logistic regression model to identify factors related to anemia. When p-value<0.05, all statistical tests are declared significant. Results: The degree of anemia in adult diabetic patients was 30.2% (95% confidence interval (CI): 25.4%-35.4%). Men (36%) have higher anemia than women (20.5%). Male (adjusted odds ratio (AOR) = 2.1, 95% CI: 1.2, 3.8), DM ≥ 5 years (AOR = 1.9, 95% CI: 1.0, 3.7), comorbidities (AOR = 1.9, 95) %CI : 1.0, 3.7) and suffering from diabetic complications (AOR = 2.3, 95% CI: 1.3, 4.2) were significantly associated with anemia. Conclusion: Anemia is a moderate to moderate public health problem among adult DM patients in the study subjects. Male gender, the duration of DM, the presence of DM complications, and DM comorbidities are factors related to anemia. Therefore, routine screening and appropriate management should be designed for men, DM patients with long DM duration, and anemia patients with complications and comorbidities, so as to improve the quality of life of patients. Early diagnosis and regular monitoring of diabetes may also help minimize complications. Keywords: Anemia, Diabetes, General Hospital, Eastern Ethiopia
Anemia yana nufin raguwar adadin jajayen jini masu yawo (RBC) da / ko rage ƙarfin ɗaukar iskar oxygen a sakamakon haka, wanda bai isa ba don biyan bukatun ilimin lissafin jiki na jikin mutum.1,2 Yana shafar ƙasashe masu tasowa da masu tasowa, don lafiyar ɗan adam, ci gaban zamantakewa da tattalin arziki.3 Akwai kusan mutane biliyan 1.62 da ke fama da cutar anemia a duniya, wanda ya kai kashi 24.8% na al'ummar duniya.4
Ciwon sukari mellitus (DM) cuta ce ta rayuwa, wacce aka raba ta zuwa nau'in I_juvenile ko ciwon sukari mai dogaro da insulin da nau'in ciwon sukari na II_non-insulin-dogara.5 A cikin masu ciwon sukari, anemia galibi saboda kumburi, magunguna, ƙarancin abinci mai gina jiki, cututtukan koda, cututtukan autoimmune masu biye, raguwar dangi na 6,7 a cikin samar da erythropoietin, ƙarancin ƙarfe ko aiki cikakke, da kuma gajarta rayuwar kwayar jini.8,9 Saboda haka, anemia ya zama ruwan dare a cikin masu ciwon sukari.10,11 A cikin manya, yawancin anemia shine 24% a tsakanin mata masu shekaru 15-49 (shekaru 15-49) da 15% a cikin maza masu shekaru 15-49.12
A cikin marasa lafiya tare da DM, musamman waɗanda ke da cututtukan koda ko rashin wadatar koda, yawancin anemia yana kusan sau 2 zuwa 3 fiye da na marasa lafiya ba tare da DM ba.13,14 Anemia da ciwon sukari, irin su nephropathy, retinopathy, neuropathy, raunin rauni mai rauni, da cutar macrovascular [15,16], suna da mummunar tasiri akan rayuwar marasa lafiya.17-19 Duk da waɗannan hujjoji, rahotannin bincike sun nuna cewa kusan kashi 25% na masu ciwon sukari har yanzu ba za su iya gane anemia ba.20,21
Sanin farko da kuma maganin anemia a cikin marasa lafiya na DM na iya taimakawa wajen rage cututtuka da mace-mace, da inganta rayuwarsu.22 Duk da haka, gabaɗaya, kimantawar anemia a cikin marasa lafiya masu ciwon sukari a Habasha yana da ƙasa sosai, kuma ya zuwa yanzu, babu wani bincike da ya dace.Wannan gaskiya ne musamman a fannin karatu.Sabili da haka, wannan binciken yana da nufin ƙididdige ƙimar anemia a cikin masu ciwon sukari a babban asibitin Gramsoe da ke gabashin Habasha da kuma ƙayyade abubuwan da ke da alaƙa.
An gudanar da binciken ne a Babban Asibitin Glymso (GGH) da ke Garin Glymso, gundumar Habro, Jihar Oromiya, Gabashin Habasha.Asibitin yana da tazarar kilomita 390 gabas da Addis Ababa, babban birnin kasar Habasha.23 A cewar rahoton ofishin lafiya na gundumar Habro, GGH wata cibiya ce ta isar da sako ga kimanin mutane miliyan 1.4 a yankin da ke kewaye.Yana ba da sabis na kiwon lafiya ga marasa lafiya fiye da 90,000 a cikin sassa daban-daban da dakunan shan magani kowace shekara.Asibitin ciwon sukari ɗaya ne daga cikin rukunin ƙwararrun da ke ba da sabis ga kusan masu ciwon sukari 660.Gundumar Habro tana kan tsayin mita 1800-2000.
An gudanar da bincike-bincike na asibiti daga Yuni 9, 2020 zuwa Agusta 10, 2020. Mahalarta masu cancanta sune manya (≥18 shekaru) marasa lafiya na ciwon sukari waɗanda aka biyo baya a GGH.Manya masu fama da ciwon suga da aka yi wa ƙarin jini a cikin watanni 3 da suka gabata, marasa lafiya masu ciki ko kwanan nan da aka haife su ko kuma suna fama da tabin hankali, marasa lafiya da aka yi musu tiyata ko zubar jini bisa kowane dalili, da marasa lafiyar da aka yi musu maganin parasite na hanji. .Koyi.
An ƙayyade girman samfurin ta hanyar amfani da tsarin rabo na yawan jama'a guda ɗaya kuma bisa ga zato masu zuwa: 95% tazarar amincewa, 5% kuskuren kuskure, da cutar anemia na masu ciwon sukari daga Asibitin Referral Dessie a arewa maso gabashin Habasha (p = 26.7)%).24 Bayan ƙara 10% ga waɗanda ba su amsa ba, girman samfurin ƙarshe shine 331.
660 marasa lafiya masu ciwon sukari an bi su a cikin asibitin ciwon sukari a GGH.Raba jimlar adadin masu ciwon sukari (660) da girman samfurin ƙarshe (331) don samun tazarar samfur guda biyu.Ta yin amfani da rajistar masu ciwon sukari waɗanda ke karɓar sabis na bin diddigin ciwon sukari a asibiti a matsayin ƙirar samfuri, mun yi amfani da dabarar ƙirar ƙira don haɗa duk sauran marasa lafiya a cikin binciken.Ba wa kowane ɗan takarar binciken lambar tantancewa ta musamman don guje wa kwafi, idan mai haƙuri ɗaya ya sake bayyana yayin binciken don wani bibiya.
Tattara bayanai kan sauye-sauye na zamantakewar al'umma, shan barasa, shan taba, da halaye na abinci ta hanyar yin amfani da ƙayyadaddun tambayoyin da aka daidaita daga matakin mataki-mataki na jagorar sa ido kan haɗarin cututtuka na yau da kullun na WHO.25 Shan shayi da kofi, amfani da bututun ruwa, tambayoyin taunawar Carter, amfani da maganin hana haihuwa, da tarihin haila an samu ta hanyar bitar littattafai daban-daban.Tambayoyin 26-30 an rubuta su cikin Ingilishi kuma an fassara su zuwa harshen gida (Afaan Oromoo), sannan masana harshe daban-daban suka fassara su zuwa Turanci don tabbatar da daidaito.Samun bayanan asibiti kamar tsawon lokacin ciwon sukari, nau'in ciwon sukari, rikice-rikice na ciwon sukari, da matakan glucose na jini na azumi daga bayanan likitan majiyyaci.Kwararrun ma’aikatan jinya biyu ne da wani kwararre na dakin gwaje-gwaje ne suka tattara bayanan, kuma wani babban jami’in da ya kammala karatunsa na kiwon lafiya ne ke kula da shi.
Auna hawan jini (BP) ta amfani da na'urar hawan jini na dijital (Heuer) wanda ake tantancewa akai-akai.Kafin auna hawan jini, batun bai sha wani abin sha mai zafi ba, kamar shayi, kofi ko taba taba, tauna Caterpillar, ko yin motsa jiki mai ƙarfi a cikin mintuna 30 na ƙarshe.Bayan batun ya huta na akalla mintuna biyar kuma ya rubuta matsakaicin karatun BP, an ɗauki ma'auni masu zaman kansu guda uku a hannun hagu.An dauki ma'auni na biyu da na uku bayan mintuna biyar da goma bayan ma'aunin farko da na biyu, bi da bi.An ayyana hauhawar jini azaman marasa lafiya tare da haɓakar BP (SBP≥140 ko DBP≥90mmHg) ko waɗanda a baya aka gano suna shan magungunan antihypertensive.31,32
Don ƙayyade matsayin abinci mai gina jiki ta hanyar ma'aunin jiki (BMI), mun auna tsayi da nauyin mai haƙuri.Lokacin da kowane mahalarta ya tsaya a tsaye a kan bango, diddige su sun taɓa bango tare, ba su sa takalma ba, suna riƙe kawunansu a tsaye, kuma suna auna tsayin su tare da mai mulki kuma sun rubuta mafi kusa 0.1 cm.Yi amfani da sikelin dijital mai alamar 0-130 kg don auna nauyin ku.Kafin kowane auna, daidaita ma'auni zuwa matakin sifili.Auna nauyin ɗan takara yayin sanye da tufafi masu haske kuma babu takalmi, kuma rikodin 0.1 kg mafi kusa.33,34 Ma'aunin Jiki (BMI) ana ƙididdige shi ta hanyar rarraba nauyin jiki (kg) da tsayi (m).Sannan an ayyana matsayin abinci mai gina jiki kamar: idan BMI <18.5, rashin nauyi;idan BMI = 18.5-24.9, rashin nauyi;idan BMI = 25-29.9, kiba;idan BMI ≥30.35,36, kiba
Kusa da tsakiyar tsakiya tsakanin gefen ƙasa na haƙarƙari mai laushi da saman ƙarshen, yi amfani da ma'aunin tef ɗin da ba na roba ba don auna kewayen kugu da yin rikodin zuwa mafi kusa 0.1 cm.An ayyana kiba ta tsakiya a matsayin madaidaicin kewayan kugu ga maza ≥ 94 cm, kuma madaidaicin kewayar ƙugu na mata ≥ 80 cm.30,36 A lokacin horon, 10 manya masu fama da ciwon sukari an fuskanci kuskuren ma'aunin fasaha na dangi (%TEM) don rage kuskuren auna anthropometric bazuwar.Kuskuren ma'aunin fasaha na dangi da aka gane a ciki da tsakanin masu sa ido bai wuce 1.5% da ƙasa da 2% ba, bi da bi.
Masu fasahar dakin gwaje-gwaje sun tattara kusan milliliters biyu (2 ml) na samfuran jini daga dukkan mahalarta kuma sun sanya su a cikin bututun gwaji mai dauke da tripotassium ethylenediaminetetraacetic acid (EDTA K3) anticoagulant don tantance haemoglobin.A haxa jinin da aka tattara daidai da kyau kuma a yi amfani da Sysmex XN-550 mai nazari na hematology don bincike.An daidaita ma'aunin haemoglobin ta hanyar rage tsayin duk mahalarta ta hanyar rage 0.8 g/dl da yanayin shan taba ta hanyar rage 0.03 g/dl.Sannan ayyana anemia a matsayin matakin haemoglobin mace <12g/dl da namiji <13g/dl.Girman anemia ya kasu kashi: Matsayin haemoglobin na maza da mata shine 11-12.9 g/dl da 11-11.9 g/dl, bi da bi, ƙananan anemia, yayin da matakan haemoglobin na matsakaici da matsananciyar anemia sun kasance 8-10.9. g/dl, bi da bi da kuma <8 mg/dl.Namiji da mace
Tattara milliliters biyar (5 ml) na jini mai jijiya a cikin bututun gwaji ba tare da maganin jijiyar jini ba don tantance creatinine da urea.Dukkan jinin ba tare da maganin jijiyoyi ba yana toshe tsawon mintuna 20-30 kuma an sanya shi a tsakiya a 3000 rpm na mintuna 5 don raba maganin.Sa'an nan, Mindray BS-200E (China Mindray Biomedical Electronics Co., Ltd.) da aka yi amfani da na'urar tantance sinadarai na asibiti don tantance sinadarin creatinine da urea ta hanyar acid picrine da hanyoyin enzymatic.37 Yi amfani da ƙimar izinin creatinine don kimanta ƙimar tacewar glomerular.Yi amfani da Raba Ratio na Cutar Koda (CKD) (GFR), wanda aka bayyana kamar yadda CKD-EPI Cockroft-Gault dabara da aka bayyana a kowace murabba'in mita 1.73.
Matakan glucose na jini na azumi (aƙalla awanni 8) ana auna su ta hanyar bugun yatsa ta amfani da mitar glucose na jini wanda aka daidaita don glucose na jini.38 Idan matakin glucose na jini mai azumi ya kasance <80 ko> 130mg/dl, to lambar ba ta da ikon sarrafa glucose na jini.Sarrafa lokacin da ƙimar glucose na jini mai azumi ke tsakanin 80-130mg/dl 39
An ba wa mahalarta binciken da itace mai tsaftataccen sandar applicator da kuma tsaftataccen, busasshiyar ƙoƙon filastik mai yuwuwa tare da lambar serial ɗin abin a kai don duba ƙwayar cuta.Umurci su kawo sabon samfurin stool na giram biyu (kimanin girman babban yatsan hannu).Bayan gano tsutsotsi (kwai da / ko tsutsa) ta amfani da dabarun hawan rigar kai tsaye, an duba samfurori a cikin minti 30 na tarin samfurin.Sauran samfuran an adana su a cikin bututun gwajin da ke ɗauke da 10 ml na 10% formalin don haɓaka ƙimar gano ƙwayoyin cuta, kuma bayan jiyya tare da fasahar tattara hazo na formalin-ether, an yi amfani da na'urar gani na Olympus don dubawa.
Yi amfani da lancet maras kyau don tattara samfuran jinin capillary daga yatsu don gano zazzabin cizon sauro.Shirya fim din jini na bakin ciki a kan gilashi mai tsabta iri ɗaya ba tare da man shafawa ba, sannan iska ta bushe.An lalata faifan nunin tare da 10% Giemsa na kusan mintuna 10, kuma an duba nau'ikan cututtukan zazzabin cizon sauro.Lokacin da aka bincika filaye masu ƙarfi 100 a ƙarƙashin makasudin nutsar da mai, an ɗauki zamewar mara kyau.40
An ba da horon kwanaki biyu kan kayan aikin tattara bayanai da hanyoyin tattara bayanai ga masu tattara bayanai da masu sa ido.Kafin Babban Asibitin Chiro ya tattara ainihin bayanan marasa lafiya 30 masu ciwon sukari, an riga an gwada takardar kuma an yi gyare-gyaren da suka dace.An daidaita ma'aunin jiki ta hanyar kuskuren fasaha na dangi na ma'aunin (%TEM).Bugu da ƙari, ana bin daidaitattun hanyoyin aiki a cikin duk tarin samfuran dakin gwaje-gwaje, ajiya, bincike da tsarin rikodi.
An samu izinin ɗabi'a daga Kwamitin Bitar Da'a na Lafiya ta Cibiyar (IHRERC) na tsohuwar Makarantar Kiwon Lafiya da Magunguna ta Jami'ar Am Valley (IHRERC 115/2020).Kwalejin ta ba da wasiƙar tallafi ga GGH kuma ta sami izini daga shugaban asibitin.Kafin tattara bayanai, sami sanarwa, na son rai, rubuce-rubuce da sa hannu a yarda daga kowane ɗan takarar binciken.An gaya wa mahalarta taron cewa duk bayanan da aka tattara daga gare su za a adana su ta hanyar amfani da lambobin, kuma ba za a yi amfani da abubuwan gano mutum ba, kuma za a yi amfani da su kawai don dalilai na bincike.An gudanar da wannan binciken bisa ga "Sanarwar Helsinki".
Bincika amincin bayanan da aka tattara, sanya code kuma shigar da nau'in EpiData 3.1, sannan fitarwa zuwa sigar STATA 16.0 don sarrafa bayanai da bincike.Yi amfani da kaso, ma'auni, matsakaita, da daidaitattun sabani don bayyana bayanai.Bayan daidaita matakin haemoglobin bisa ga yanayin shan taba na mahalarta da kuma tsayin yankin, an ƙayyade matsayin anemia bisa ga sabon ma'auni na WHO.Daidaita tsarin jujjuyawar dabaru guda biyu don gano masu canji don bincike na koma-bayan dabaru na ƙarshe.A cikin rikice-rikice na logistic bivariate, masu canji tare da p-darajar ≤ 0.25 ana ɗaukar su azaman 'yan takara don dawo da dabaru da yawa.Ƙirƙiri samfurin jujjuyawar dabaru don gano abubuwan da ba su da alaƙa da anemia.Yi amfani da rabon rashin daidaituwa da tazarar amincewa 95% don auna ƙarfin ƙungiya.An ayyana matakin mahimmancin ƙididdiga azaman p-darajar <0.05.
A cikin wannan binciken, jimlar 325 manya marasa lafiya na DM sun shiga cikin taron, kuma adadin amsa ya kasance 98.2%.Yawancin mahalarta;Maza daga yankunan karkara 203 (62.5%), 247 (76%), 204 (62.8%) da 279 (85.5%) mazan aure ne, kuma kabilarsu ta Oromo.Tsakanin shekarun mahalarta shine shekaru 40, kuma matsakaicin matsakaicin matsakaici (IQR) shine shekaru 20.Kimanin kashi 62% na mahalarta taron ba su taɓa samun ilimi na yau da kullun ba, kuma 52.6% na mahalarta ƙwararrun manoma ne (Table 1).
Table 1 Halayen zamantakewa-alummai na manya DM marasa lafiya da aka kula da su a babban asibiti a gabashin Habasha a cikin 2020 (N = 325)
Daga cikin mahalarta binciken, 74 (22.8%) sun ruwaito cewa sun sha taba a kalla sau ɗaya a rayuwarsu, idan aka kwatanta da 13 masu shan taba (4%).Bugu da kari, mutane 12 (3.7%) masu sha ne a halin yanzu, kuma 64.3% na mahalarta binciken baƙar fata ne.Fiye da kashi ɗaya bisa uku (68.3%) na mahalarta binciken sun ruwaito cewa suna sha kofi a koyaushe bayan cin abinci.Mahalarta ɗari da talatin da uku (96.3%) da 310 (95.4%) mahalarta suna cin 'ya'yan itatuwa da kayan marmari kasa da sau biyar a mako.Game da matsayinsu na abinci mai gina jiki, 92 (28.3%) da 164 (50.5%) mahalarta sun kasance masu kiba da kiba a tsakiya (Table 2).
Tebur 2 Halayen halaye da abinci mai gina jiki na manya DM marasa lafiya da aka yi wa magani a Babban Asibitin Gabashin Habasha a 2020 (N = 325)
Fiye da 170 (52.3%) marasa lafiya tare da nau'in II DM suna da matsakaicin tsawon DM na 4.5 (SD ± 4.0) shekaru.Kusan kashi 50% na marasa lafiya na DM suna shan magungunan hypoglycemic na baka (glibenclamide da/ko metformin), kuma kusan kashi uku cikin huɗu na mahalarta binciken ba su da ƙarancin sarrafa glucose na jini (Table 3).Game da cututtuka, 2% na mahalarta suna da cututtuka.80 (24.6%) da 173 (53.2%) marasa lafiya tare da DM ba tare da hauhawar jini ba sun kasance anemia da marasa anemia bi da bi.A gefe guda, a cikin marasa lafiya na DM da aka gano suna da hauhawar jini, 189 (5.5%) da 54 (16.6%) sun kasance anemia bi da bi.
Tebur 3 Halayen asibiti na manya DM marasa lafiya da ake kula da su a babban asibiti a gabashin Habasha a cikin 2020 (N = 325)
Matsayin anemia a cikin marasa lafiya masu ciwon sukari shine 30.2% (95% CI: 25.4-35.4%), kuma matsakaicin matakin haemoglobin shine 13.2 ± 2.3g / dl (maza: 13.4 ± 2.3g / dl, mata: 12.9 ± 1.7g/ dl).Game da tsananin anemia a cikin marasa lafiya na DM tare da anemia, akwai lokuta 64 na anemia mai sauƙi (65.3%), lokuta 26 na anemia matsakaici (26.5%), da kuma lokuta 8 na anemia mai tsanani (8.2%).Anemia a cikin maza (36.0%) ya fi girma fiye da na mata (20.5%) (p = 0.003) (Hoto 1).Mun sami kyakkyawar alaƙa mai mahimmanci tsakanin tsananin anemia da tsawon lokacin ciwon sukari (r = 0.1556, p = 0.0049).Wannan yana nufin cewa yayin da tsawon lokacin DM ya karu, tsananin anemia yana ƙara karuwa.
Hoto 1 Matsayin anemia ta jinsi a cikin manya DM marasa lafiya da aka yi wa magani a babban asibiti a gabashin Habasha a cikin 2020 (N = 325)
A cikin marasa lafiya na DM, 64% na maza da 79.5% na mata ba su da jini, yayin da 28.7% da 71.3% na masu cin Katin na yanzu suna fama da karancin jini.67% na manya DM marasa lafiya da suka yi amfani da kofi bayan cin abinci ba su da anemia, kuma 32.9% daga cikinsu an gano suna da anemia.Game da wanzuwar cututtuka, 72.2% na marasa lafiya tare da DM ba tare da cututtuka ba sun kasance anemia, kuma 36.3% na marasa lafiya tare da DM comorbidities sun kasance anemia.Marasa lafiya masu ciwon sukari tare da rikice-rikice na DM suna da anemia mafi girma (47.4%) fiye da waɗanda ba tare da rikitarwa na DM ba (24.9%) (Table 4).
Table 4 Abubuwan da ke da alaƙa da anemia tsakanin manya marasa lafiya na DM da aka kula da su a babban asibiti a gabashin Habasha a cikin 2020 (N = 325)
Daidaita nau'ikan jujjuyawar dabaru da nau'ikan nau'ikan nau'ikan dabaru don bincika alaƙa tsakanin anemia da masu canjin bayani.A cikin nazarin bivariate;shekaru, jinsi, matsayin aure, Cin Khat, kofi bayan cin abinci, cututtuka, rikice-rikice na ciwon sukari, tsawon lokaci na DM da yanayin abinci mai gina jiki (BMI) suna da alaƙa da anemia tare da p darajar <0.25, kuma su ne Multivariate logistic regression.
A cikin bincike na rikice-rikice masu yawa, maza da DM ≥ 5 shekaru na tsawon lokaci, kasancewar cututtuka da rikitarwa na DM suna da alaƙa da anemia.Maza maza masu girma na DM marasa lafiya suna da sau 2.1 mafi kusantar shan wahala daga anemia fiye da mata (AOR = 2.1, 95% CI: 1.2, 3.8).Idan aka kwatanta da marasa lafiya na DM ba tare da cututtuka ba, marasa lafiya na DM tare da cututtuka sun kasance sau 1.9 mafi kusantar anemia (AOR = 1.9, 95% CI: 1.0, 3.7).Idan aka kwatanta da marasa lafiya tare da tsawon lokaci na DM na shekaru 1-5, marasa lafiya na DM tare da tsawon lokaci na DM ≥ 5 shekaru suna 1.8 sau da yawa don bunkasa anemia (AOR = 1.8, 95% CI: 1.1, 3.3).Rashin haɗarin anemia a cikin marasa lafiya tare da matsalolin DM shine sau 2.3 na abokan aiki (AOR = 2.3, 95% CI: 1.3, 4.2) (Table 4).
Wannan binciken ya yi la'akari da tsananin cutar anemia da abubuwan da ke da alaƙa a cikin marasa lafiya na DM waɗanda aka bi su don ciwon sukari a Babban Asibitin Gelemso.Matsayin anemia a cikin binciken na yanzu shine 30.2%.Dangane da rarrabuwa na WHO game da mahimmancin lafiyar jama'a, a cikin yanayin bincike, anemia shine matsakaicin matsalar lafiyar jama'a tsakanin manya marasa lafiya da DM.Jinsi, tsawon lokacin DM, kasancewar matsalolin DM, da kuma maza da ke da DM comorbidities an gano su a matsayin abubuwan da suka shafi anemia.
Matsayin anemia a cikin wannan binciken ya yi daidai da na Asibitin Referral na Habasha na Dessie [24], amma ya fi na Habasha Fenote Selam Hospital [41] a cikin wani binciken gida da aka gudanar a China, 42 Australia, 43 da Indiya [44] ]., Wanda ya yi ƙasa da binciken da aka gudanar a Thailand [45], Saudi Arabia [46] da Kamaru [47].Wannan bambance-bambancen na iya kasancewa saboda bambancin shekaru na yawan mutanen binciken.Misali, sabanin binciken da ake yi a yanzu wanda bai hada da manya da suka haura shekaru 18 ba, wani binciken da aka gudanar a kasar Thailand ya hada da manya da suka haura shekaru 60, yayin da wani bincike a Kamaru ya hada da manya da suka haura shekaru 50.Bambancin na iya kasancewa saboda raguwar aikin koda, kumburi, danne kasusuwa, da rashin abinci mai gina jiki (ƙara da shekaru)17.
Mun yi mamakin cewa a cikin bincikenmu, anemia namiji ya fi mace yawa.Wannan binciken ya saba wa sauran rahotannin bincike [42,48], inda mata suka fi fama da cutar anemia fiye da maza masu ciwon sukari.Dalilin da zai iya haifar da wannan bambance-bambancen na iya kasancewa cewa mazan da ke cikin bincikenmu sun fi yawan halayen cin Khat, wanda hakan na iya haifar da asarar ci49, kuma Khat yana dauke da tannins-wani sinadari da ke rage yawan sinadarin iron wanda ba shi da heme a cikin abinci.50 Wani dalili mai yuwuwa shine yawan shan kofi da shayi a cikin maza a cikin wannan binciken ya hana ɗaukar ƙarfe daga hanji.51-54
Mun gano cewa marasa lafiya tare da DM ≥ 5 shekaru sun fi samun ciwon anemia fiye da marasa lafiya tare da DM tare da hanya na 1-5 shekaru.Wannan ya yi daidai da binciken da aka gudanar a asibitin Fenote Selam a Habasha, 41 Iraq 55 da kuma Burtaniya.17 Wannan na iya zama saboda tsawaita bayyanar da hyperglycemia, yana haifar da haɓakar cytokines masu kumburi tare da tasirin anti-erythropoietin, yana haifar da raguwar adadin.Rage ƙwayoyin jajayen jini masu yawo yana haifar da raguwar haemoglobin da ke zagayawa.35
Daidai da binciken da aka gudanar a kasar Sin, anemia 13 a cikin wannan binciken ya fi kowa a cikin marasa lafiya na DM tare da rikitarwa.A ilimin halitta, rikice-rikice masu ciwon sukari na iya yin mummunar illa ga tsarin tantanin halitta da tsarin jini na koda, kumburin tsari, da shigar da masu hana sakin erythropoietin na iya haifar da anemia mai ciwon sukari.56 Hypoxia na iya rinjayar maganganun kwayoyin halitta, metabolism, capillary permeability da kuma rayuwa ta cell 57. Ragewar ƙwayar jinin jini da kaddarorin antioxidant da ke hade da anemia na iya haifar da ƙarin rikitarwa a cikin masu ciwon sukari58.
Bugu da ƙari, marasa lafiya na DM tare da cututtuka sun fi dacewa da anemia fiye da marasa lafiya na DM ba tare da cututtuka ba.Wannan yana kwatanta da irin wannan binciken da ya gabata [35,59], wanda zai iya zama saboda tasirin cututtuka (kamar hauhawar jini) wanda ke haifar da rikice-rikice na zuciya da jijiyoyin jini, don haka yana kara haɗarin anemia.60
A matsayin daya daga cikin 'yan kadan na binciken da aka gudanar a Habasha, cututtuka na yau da kullum irin su DM sun zama ruwan dare, wanda ya zama ƙarfin wannan bincike.A gefe guda, wannan binciken bincike ne guda ɗaya bisa asibiti kuma bazai wakilci duk marasa lafiya tare da DM ko marasa lafiya waɗanda aka biyo baya a wasu cibiyoyin kiwon lafiya ba.Yanayin giciye na ƙirar binciken da muka yi amfani da shi ba ya ba da izinin kafa dangantakar ɗan lokaci tsakanin anemia da dalilai.Nazari na gaba na iya buƙatar yin amfani da abubuwan sarrafawa, nazarin ƙungiyar ko wasu ƙira na bincike don yin la'akari da alamun da alamun anemia, RBC morphology, iron serum iron, bitamin B12, da matakan folic acid.
A cikin yanayin bincike, anemia shine matsakaicin matsalar lafiyar jama'a tsakanin manya marasa lafiya na DM.Jinsi, tsawon lokaci na DM, kasancewar matsalolin DM, da cututtuka sun kasance maza kuma an gano su a matsayin abubuwan da suka shafi anemia.Sabili da haka, gwajin cutar anemia na yau da kullun da kulawa mai dacewa ga marasa lafiya na DM tare da tsawon lokacin DM, cututtuka da rikitarwa ya kamata a tsara su don inganta rayuwar marasa lafiya.Ganewar farko da saka idanu na DM na yau da kullun na iya taimakawa rage rikice-rikice.
Ana iya samun bayanan da ke goyan bayan sakamakon da aka ruwaito a cikin rubutun daga mawallafin da ya dace daidai da buƙatu masu ma'ana.
Muna mika godiya ga shugaban babban asibitin Gelemso, ma’aikatan asibitin ciwon suga, mahalarta nazari, masu tattara bayanai da mataimakan bincike.
Duk marubutan sun ba da gudummawa mai mahimmanci ga aikin rahoton, ko ta fuskar ra'ayi, ƙira bincike, aiwatarwa, samun bayanai, bincike da fassarar, ko kuma a cikin duk waɗannan fannoni;ya shiga cikin zayyanawa, bita ko nazari mai tsauri na wannan sashe;a karshe ya amince da sigar da za a buga;sun cimma yarjejeniya kan mujallar da aka mika labarin;kuma sun yarda su kasance masu alhakin duk wani abu na aikin.
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Lokacin aikawa: Fabrairu-19-2021