Inqaku lesiseko eliphambili lephandemikhi

**Iphandemikhi** (lo mxholo usuka kwisiGrike), kuxa kukho uqhambuko lwesifo esosulelayo "esihamba" siye kwilizwe elinye nangaphezulu okanye kwingingqi enye nangaphezulu. Ukusuleleka kwesifo ebantwini abaliqela kwingingqi enye kwixesha elifutshane kuthiwa yi-ephidemikhi. Isifo esisuleleka ngokubanzi kodwa esichaphazela abantu benani elizinzileyo kuthiwa "yi-endemikhi", hayi iphandemikhi. Usasazeko ngokubanzi lwezifo ezichaphazela abantu benani elizinzileyo, njengophindaphindo lomkhuhlane oluthi lufike ngamaxesha athile onyaka, alubandakanywa kuba luqhubekeka ngexesha elinye kwiingingqi ezinkulu elizweni, hayi ukuthi zisasazeka kwizwe lonke.

### Inkcazo kunye namanqanaba
Iphandemikhi yi-ephidemikhi eyenzeka kwinqanaba elikhulu ngaphesheya kwimida yamazwe. Isifo okanye isigulo asiyophandemikhi kuba sisasazeka ngokubanzi okanye kuba sibulala abantu abaninzi; kufuneka sisuleleke. Umzekelo, umhlaza ngunobangela wokusweleka kabantu abaninzi, kodwa awuyophandemikhi kuba awosuleleki.

Amazinga osuleleko kwii-ephidemikhi (kunye neephandemikhi) alandela inkqubo elandela umgca onomjikelo xa wakhelwe kwigrafu. Mgca lowo ubonisa inani labantu abosulelweyo kwixesha elithile. Umgca we-ephidemikhi ufana nomgca wephandemikhi ixesha elininzi xa isifo eso "sihamba sisasazeka". Izifo ezosulelayo zisasazeka ngezigaba ezintathu njengakule grafu ingezantsi.

**Isigaba sokuqala** senzeka ekuqaleni komgca onomjikelo. Ukuba umntu usebenzisa usasazeko lweCovid-19 njengomzekelo we-ephendemikhi, oku kungaphawula ukuqala kokusasazeka kwesifo, ngoku abantu abosulelekileyo bebambalwa.

**Isigaba sesibini** somgca we-ephidemikhi onomjikelo sibonisa "isigaba soluntu".  Oku kuxa inani lisanda labantu abatsha abosulelekayo.

**Isigaba sesithathu** somgca onomjikelo we-ephidemikhi sibonisa i-ephendemikhi iphantsi kolawulo okanye akukho suleleko lutsha.

### Ulawulo
Akhona amanyathelo angathathwa ngoorhulumente ukulawula usasazeko lwephandemikhi. Ngonyaka wama-2005, uMbutho wezeMpilo weHlabathi (iWorld Health Organisation) wamkela iMigaqo yezeMpilo yeHlabathi (International Health Regulations), inkqubo-sikhokelo esemthethweni ukuthintela, ukulawula nokuphendula kumngcipheko wempilo yoluntu olungasasazeka kumazwe amaninzi.  Ukongeza, uMbutho wezeMpilo weHlabathi (iWorld Health Organisation) uphuhlise incwadi yesikhokelo eneenkcukacha malunga nokusombulula iiphandemikhi zomkhuhlane. Le ncwadi yaqala yapapashwa ngowe-1999, yaze yahlaziywa ngowama-2005 nangowama-2009. Uninzi lwamanyathelo athathiweyo ukulwa iphandemikhi yeCovid-19 asuka kwiMigaqo yezeMpilo yeHlabathi (International Health Regulations) yangowama-2005 nakwizikhokelo zokulungiselela iphandemikhi yomkhuhlane zoMbutho wezeMpilo weHlabathi (zeWorld Health Organisation).

Zininzi iingxoxo ezikhoyo malunga nendlela ye3T (Uvavanyo, Unyango, Ulandelelo). Le ndlela ivumela amazwe achonge abantu abachaphazelekileyo nabosulelweyo ngokukhawuleza, phambi kokuba babekelwe bucala banyangwe. Le ndlela ibandakanya ukulandelela bonke abantu abadibene nomntu osulelekileyo, nabo babekelwe bucala. Le ndlela ikhuthazwe kukusebenza kwayo kumazwe afana neSouth Korea neSingapore, kodwa oorhulumente bala mazwe bebeyilungiselele ngcono le meko emva kokuphazamiseka okwenziwe nguSARS.

Ukuqelelana kwabantu yimpilo yoluntu yokuziqhelisana nendlela enenjongo yokuthoba isantya sosasazeko nohambo lwesi sifo, ngokuthi kuthintelwe abantu ukuba bangasondelelani ukuze kuncitshiswe amathuba osulelekho lwesi sifo sosulelayo. UMlawuli uGqirha Michael J Ryan woMbutho wezeMpilo weHlabathi (iWorld Health Organisation) uthe kwingcaciso yomshiceleli ngomhla we-19 kweyoKwindla kowama-2020, ukuqelelana kwabantu "lunyathelo lwexeshana ukuthoba isantya sosasazeko lwentsholongwane, nokususa uxinzelelo kwinkqubo yezempilo, hayi ukuxazulula udabi lwentsholongwane. Kuyindleko kwaye kufuneka kusetyenziswe amanye amanyathelo ukuze le ngxaki ixazululeke.". UGqirha Ryan wenze kwacaca ukuba ukuzibhekelisa kodwa akuzususa sifo.

## Iiphandemikhi zangoku
### INtsholongwane kaGawulayo
Nangona iWHO isebenzisa ibinzana elithi "i-ephidemikhi yehlabathi" ukuchaza iHIV, yiphandemikhi ngokulandela intsingiselo yegama kuphela. Ukusukela kowama-2018, izigidi zabantu behlabathi ezingama-37.9 zosuleleke yiHIV. . Ngowama-2018, kubhubhe abantu bamawaka asi-770,000 nguGawulayo (iAIDS).  Okwangoku, iSub-Sahara yeAfrika yeyona ngingqi ichaphazekileyo. 

### IiCorona Virus/ IiNtsholongwane zeCorona
Iintsholongwane zeCorona (iiCoV) zilusapho lweentsholongwane ezibangela izigulo eziqala kumkhuhlane wesiqhelo ukuyoqhina kwizifo ezifana nezifo zokuphefumla iMiddle East Respiratory Syndrome (MERS-CoV) kunye neSevere Acute Respiratory Syndrome (SARS-CoV). Uhlobo olutsha lwentsholongwane yecorona (SARS-CoV-2) lubangela isifo sentsholongwane yeCorana (seCoronavirus) yama-2019. Ezinye iintsholongwane zecorona zosuleleka kwabantu zibe zisuka kwizilwanyana. Uphando oluneenkcukacha lufumanise ukuba iSARS-CoV yosuleleke ebantwini ibe isuka kwiikati ezizii-civet. I-MERS-CoV yona isuka kwiinkamela ezizii-dromedary yaze yosuleleka ebantwini. Zininzi iintsholongwane zecorona ezisezilwanyaneni ezingekosuleleki ebantwini.

Udidi olutsha lwentsholongwane yecorona luqale eWuhan, kwiphondo leHubei, eChina, kwimihla yokugqibela kweyoMnga kowama-2019. Le ntsholongwane ibangele iqela lezifo zokuphefumla ezinzima, ekuthiwa sisifo sentsholongwane yecorona (okanye secoronavirus) sonyaka wama-2019 (iCOVID-19). NgokweDashboard yeYunivesithi iJohn Hopkins, amazwe achatshazelwe yiCOVID-19 angama-200. Awona mazwe abenosoluleleko oluninzi yiMelika, yiChina kwiingingqi ezisembini, yintshona eYurophu kunye neIran. Ngomhla we-11 kweyoKwindla kowama-2020, uMbutho wezeMpilo weHlabathi (iWorld Health Organisation) uphawule usasazeko lweCOVID-19 njengephandemikhi.  Ukusuka kumhla wama-23 kuTshazimpunzi kowama-2020, inani labantu abosuleleke yiCOVID-19 zizigidi ezi-2.63 kwihlabathi lilonke, ababhubhileyo beli-184,249 kwaye abanyangekileyo bengama-722,055.

## Usasazeko oluphawulekayo
### IMalariya
IMalariya idla ngokusasazeka kwiinginqi ezisondele kwi-ikhweyitha ezishushu ezifumileyo. Oku kubandakanya iingqingqi kwiiAmericas, eAsia naseAfrika. Nyaka ngamnye, kosuleleka abantu abazizigidi ezingama-350-500 yimalariya. Ukuxhathisa kwamayeza okunyanga imalariya yingxaki ekhulayo ekuyinyangeni imalariya ukusekela ekuqaleni kwenkulungwane yama-21, kuba ukuxhathisa kwamayeza okunyanga imalariya kuxhaphakile kuwo onke amayeza okunyanga imalariya, ngaphandle kwe-artemisinins.

IMalariya yayixhaphake eYurophu naseNtshona-Melika, apho ingasekhoyo ngoku. Kusenokwenzeka ukuba iMalariya ibinegalelo ekutshabalaleni kwesizwe samaRoma. Esi sifo saqale saziwa "njengomkhuhlane wamaRoma". I-Plasmodium falciparum yabasisoyikiso esikhulu kubahlali beekoloni nakubantu bemveli ukufika kwayo kwiiAmericas ngexesha lokuthengiswa kwamakhoboka.

### UMkhulhane weSpanish
Umkhulhane weSpanish (ngowe-1918 - 1920) wosulele abantu abazizigidi ezingama-500 kwihlabathi lilonke, oku kubandakanya abantu abakwiingingqi ezikude njengeziQithi zePacific nakwiArctic, lomkhuhlane waze wabulala abantu abazizigidi ezingama-200 ukuya kwezili-100.  Uninzi losasazeko lomkhuhlane lubulala ngokungakhethiyo abancinci kakhulu kunye nabadala kakhulu. Aba baphakathi ngabona banethuba lokusinda. Nangona, umkhuhlane weSpanish ubulale isikakhulu abaphakathi ngendlela engaqondakaliyo. Umkhuhlane weSpanish ubulale ukodlula iMfazwe yeHlabathi yoku-1 kwaye ubulale abantu abaninzi kwiiveki zawo zokuqala ezingama-25 ukodlula uGawulayo kwiminyaka yokuqala engama-25.   Intshukumo yabantu abaninzi kunye neendawo zokuhlala ezisondeleleneyo kubangele ukuba isasazeke ngokukhawuleza kwaye itshintshatshintshe iindidi ngesantya esiphezulu. Usuleleko olulula kwamajoni lungaba lubangelwe luxinzelelo, ukungondleki, kunye nokuhlaselwa ngemichiza. Uphuhliso lweenkqubo lwezithutho lwenze kwalula ukuba amajoni, oomatiloshe kunye nabantu basasaze esi sifo.

## Inkxalabo malunga neeNtsholongwane ezizayo
### Ukuxathisa kwezibulala-ntsholongwane
Iintsholongwane ezixhathisayo kwizibulala-ntsholongwane ziqhele ukubizwa "izinambuzane ezinamandla". Zinganegalelo ekuvukeni kwezifo eziphantsi kolawulo olulungileyo. Umzekelo, usuleleko lwesifo sephepha esixhathisayo kumayeza onyango aqhele ukusebenza luhlala liluxhala kubasebezi lwecandelo lezempilo. Inani losuleleko lwesifo sephepha esixhathisa kumayeza onyango (MDR-TB) kwihlabathi lonke nyaka ngamnye liphantse lafika kwama-500. IChina neIndiya ngawona mazwe ahambela phambili kusuleleko lweMDR-TB.. UMbutho wezeMpilo weHlabathi (iWorld Health Organisation/ iWHO) uxela ukuba inani labantu abosulelekileyo yiMDR-TB kwihlabathi lonke zizigidi ezingama-50. Iipersenti ezingama-79 kwabobantu bosulelekileyo abanyangeki kuba isifo sabo sixhathisile kwizibulala-ntsholongwane. Ngowama-2005, useleleko lweMDR-TB kubantu abali-124 lwenzeke eMelika. Usuleleko lwesifo sephepha esixhathisa kakhulu kunyango (XMDR-TB) luchongwe eAfrika ngowama-2006, kwaye kufunyaniswe ukuba lukhona kumazwe angama-49 - oku kubandakanya iMelika. I-WHO iqikelela ukuba kubakho usuleleko lweXMDR-TB olunani lingama-40 000 nyaka ngamnye.

Kwiminyaka engama-20 edlulileyo, iibhaktheriya eziqhelekileyo iStaphylococcus aureus, iSerratia marcescens kunye neEnterococcus ziphuhlule uxhathiso lwezibulala-ntsholongwane ezininzi ezifana ne-vancomcyn, i-aminoglycosides kunye ne-cephalosporins. Iintsholongwane ezixhathisayo kwizibulala-ntsholongwane zibangela usuleleko (HAI) oluninzi okunxulumene nokhathalelo lwempilo (nosocomial). Ngaphezulu, usuleleko olubangelwe ziindidi zeentsholongowane ezisuka eluntwini lwengingqi ze-methicillin-resistant Staphylococcus aureus (MRSA) kubantu abanempilo entle luye lwaxhaphaka kwiminyaka edlulileyo.

### Imikhuhlane yeViral hemorrhagic
Imikhuhlane yeViral hemorrhagic yosuleleka kakhulu kwaye iyabulala. Imizekelo ibandakanya intsholongwane yeEbola, umkhuhlane weLassa, umkhuhlane waseRift Valley, isifo sentsholongwane yeMarburg kunye nomkhuhlane weBolivian hemorrhagic. Imikhuhlane yeViral hemorrhagic inaso isakhono sokubayiphandemikhi. Isakhono sayo sokubangela iphandemikhi sithintelwe kuba usuleleko lwezi ntsholongwane ludinga ukusondela kakhulu emntwini osulelekileyo kwaye umntu osulelekileyo ugula ixesha elifutshane phambi kokuba abhubhe. Ixesha lifutshane sokuba umntu asisulele esi sifo kwaye ukukhawuleza lokuqala kweempawu luvumela oogqirha bakhawuleze bambeke ekhusini, bamthintele angakwazi ukuyisulela mntu intsholongwane.

### IZika Virus/ INtsholongwane yeZika
Amanqaku aphambili:2015–16 Zika virus epidemic, Zika virus, and Zika fever.

Usasazeko lwentsholongwanye yeZika luqale ekuqaleni lowama-2015 lwaze lwaqhina ekuqaleni lowama-2016, kusuleleke abantu abasisigidi esi-1.5 kumazwe angaphaya kwe-12 kwiiAmericas. UMbutho wezeMpilo weHlabathi ulumkise ukuba iZika inesakhono sokubayiphandemiki eza konakalisa ihlabathi ukuba ayilawulwanga.

## References