An yi watsi da muhalli

**Environmental enteropathy** (EE ko na wurare masu zafi enteropathy ko muhalli dysfunction na ciki ko EED) ne samu kananan hanji cuta halin da kumburi da gut, rage absorptive surface yankin a cikin ƙananan hanji, da kuma rushewa na hanji aiki shingen. EE ya fi kowa a tsakanin yaran da ke zaune a cikin ƙananan saitunan albarkatu. M bayyanar cututtuka yawanci kadan ne ko ba a nan. EE na iya haifar da rashin abinci mai gina jiki, anemia (rashin baƙin ƙarfe anemia da anemia na kumburi na kullum), ci gaba da ci gaba, rashin ci gaban kwakwalwa, da rashin amsa ga allurar rigakafi.

Dalilin EE shine multifactorial. Gabaɗaya, fallasa gurɓataccen abinci da ruwa yana haifar da yanayin kumburin hanji gaba ɗaya. Amsa mai kumburi yana haifar da canje-canje masu yawa na cututtukan cututtuka zuwa ga gastrointestinal tract: Ƙananan villi, manyan crypts (wanda ake kira crypt hyperplasia), ƙara yawan haɓaka, da haɓakar ƙwayoyin kumburi a cikin hanji. Wadannan canje-canjen suna haifar da rashin cin abinci, bitamin da ma'adanai.

Daidaitacce, ƙa'idodin bincike na asibiti ba su wanzu. Mafi ingantaccen gwajin gano cutar shine biopsy na hanji. Koyaya, wannan gwajin cutarwa ne kuma ba dole ba ne ga yawancin marasa lafiya.

Rigakafi shine zaɓi mafi ƙarfi kuma mafi aminci don hana EE da tasirin sa. Don haka, rigakafi da maganin EE galibi ana tattaunawa tare.

## Alamomi da alamomi
An yi imani da ciwon daji na muhalli yana haifar da rashin abinci mai gina jiki na yau da kullum da kuma ci gaba da girma (ƙananan ma'auni na tsawon shekaru) da kuma sauran ƙarancin ci gaban yara.

### Alamun dogon lokaci
Tamowa

EE yana haifar da rashin abinci mai gina jiki ta hanyar duka malabsorption da ƙarancin abinci mai gina jiki.

Girma da ci gaban jiki

Shekaru biyu na farko (da watanni 9 na rayuwar tayin) suna da mahimmanci ga ci gaban layi. Tsanani abu ne mai sauƙi don auna alamar waɗannan gazawar ci gaban yara.

Neurocognitive (ci gaban kwakwalwa)

Tasiri akan allurar baki

Yawancin allurar rigakafi na baka, masu rai da marasa rai, sun tabbatar da cewa ba su da ƙarancin rigakafi ko ƙarancin kariya lokacin da aka yi wa jarirai, yara ko manya waɗanda ke rayuwa cikin ƙarancin yanayin tattalin arziƙin jama'a a ƙasashe masu tasowa fiye da yadda ake amfani da su a ƙasashe masu ci gaban masana'antu. Ana hasashen EE mai yaɗuwa don zama sanadin bayar da gudummawa ga wannan lura.

Cin abinci mai gina jiki da yanayin abinci mai gina jiki a cikin mahalli enteropathy

Dangantakar da ke tsakanin cin abinci da kamuwa da cuta yana da wahala a yi nazari tun da yake daidai da yanayin. Bugu da ari, naman hanji yana cinye abubuwan gina jiki da yake buƙata kafin wuce gona da iri zuwa sauran jiki. Amfanin da aka samu ta hanyar ingantaccen abinci mai gina jiki akan mahalli enteropathy na iya zama mai zaman kansa ba tare da yanayin abinci mai gina jiki ba. Yawan cin abinci mai gina jiki yayin kumburi yawanci yana raguwa.

Rahotanni na "ƙananan cin abinci" daga masu ba da kulawa a cikin LMICs, da ƙuntatawa na ƙarin abinci yayin rashin lafiya na kowa. Za a iya rage cin abinci duka biyu ta hanyar cytokines pro-inflammatory da leptin da ƙananan matsayi na zinc, kuma yana iya ci gaba da ci gaba a cikin yara masu ciwon daji. Samar da abinci mai gina jiki don haɓakawa a cikin mahallin mahalli yana da iyakancewa saboda raguwar farfajiyar hanji da asarar ayyukan enzymatic da ke haifar da malabsorption na abinci mai gina jiki da kuma, bayan jujjuyawar microbial, riƙe da abubuwan gina jiki masu rarraba (watau bitamin A, zinc da baƙin ƙarfe) a cikin kyallen jikin jiki don yunwar cututtuka. Ƙungiyoyin da ke tsakanin cin abinci mai gina jiki da masu amfani da kwayoyin halitta don matsayi na gina jiki da matsayi na gina jiki da girma don haka suna iya gurbatawa a cikin yara masu kumburi.

Kumburi na tsarin da ke haifar da jujjuyawar ƙwayoyin cuta zai ƙara yawan adadin kuzari na basal da bukatun abinci na tsarin rigakafi. A lokaci guda kuma asarar abubuwan gina jiki na karuwa saboda fitar hanji. Ƙungiyoyin sun kasance masu rikitarwa, kuma suna da rikitarwa ta hanyar hulɗar mai masaukin baki-pathogen-microbiome da kuma tasirin waɗannan hulɗar akan samuwa na gina jiki na hanji, inda ake buƙatar ƙarin bincike. A ƙarshe, shaidar ko ayyukan abinci mai gina jiki na iya yin nasara a cikin yara masu yawan kamuwa da cuta ko kuma cutar da ke ci gaba da kasancewa kaɗan. A halin yanzu, da alama an yi yarjejeniya da cewa nasarar da aka samu don inganta ayyukan ciyar da abinci na yau da kullun da kuma rage tsangwama dole ne ya ƙunshi dalilai na kai tsaye da na asali.

## Manazarta