Umgada

**Umgada** sisifo esijikelezayo esibangela uhlaselo lwe-lokukrala kobuchopho ebantwini nakwezinye izilwanyana ezinegazi elishushu. Iimpawu zakwangoko zingaquka umkhuhlane nokuntlontlozela kwindawo eyosulelweyo. Ezi mpawu zilandelwa lolunye okanye ezininzi kwezi mpawu zilandelayo: iintshukumo eziyingozi, imincili engalawulekiyo, i-uloyiko lwamanzi, ukungakwazi ukuhambisa amalungu omzimba, ukubhideka, kunye nokulahlekelwa yingqondo. Emva kokubonakala kweempawu, umgada udla ngokuphumela ekufeni. Isigaba sexesha eliphakathi kokosulelwa sisifo nokuqalisa kweempawu kudla ngokuba yinyanga enye ukuya kwezintathu. Nangona kunjalo, esi sigaba sexesha singashiyana ukusukela ngaphantsi kweveki enye ukuya ngaphezulu konyaka omnye. Isigaba sexesha sixhomekeke kumgama omelwe kukuhanjwa yintsholongwane ukuya kufikelela kwisixokelelwano semithambo-luvo. 

## Unobangela noxilongo
Umgada ugqithiselwa ebantwini usuka kwezinye izilwanyana. Umgada ungagqithiseleka xa isilwanyana esinawo sikrwempa okanye siluma esinye isilwanyana okanye umntu. Amathe asuka kwisilwanyana esosulelekileyo angawugqithisela umgada ukuba amathe adibana nonwebu lwesinye isilwanyana okanye umntu. Inkoliso yomgada osebantwini ubangelwa kukulunywa yinja. Zingaphaya kwama-99% iimeko zomgada emazweni apho izinja ezinomgada apho izinja ezinomgada ingunobangela wokulunywa yinja. EMelika, ukulunywa ngamalulwane kungowona mthombo mkhulu wokosulelwa koluntu ngumgada, kwaye ungaphantsi kwesi-5% iimeko apho uvela khona ezinjeni. Izikrekrethi azifane zosulelwe ngumgada. Intsholongwane yomgada ihamba iye engqondweni ngokulandela iperipheral nerves. Isifo singaxilongwa kuphela emva kokuqalisa kweempawu. 
## Uthintelo nonyango
Iinkqubo zolawulo nogonyo lwezilwanyana ziwunciphisile umngcipheko osuka ezinjeni kuthotho lwemimandla yehlabathi. Ukugonywa kwabantu phambi kokuba badandalaze kuyacetyiswa kwabo basemngciphekweni omkhulu. Iqela elisemngciphekweni omkhulu liquka abantu abasebenza ngamalulwane okanye abachitha ixesha elide kwiindawo zehlabathi apho mninzi khona umgada. Kubantu abadibene nomgada, ugonyo lomgada kwaye ngamanye amaxesha umgada oyi-immunoglobulin uyasebenza ekuthinteleni  isifo ukuba umntu lowo ufumana unyango phambi kokuba ziqalise iimpawu zomgada. Ukuhlamba ukulunywa nemikrwelo kangangemizuzu eli-15 ngamanzi anesepha, i-povidone iodine, okanye isicocisi njengoko oko kunokuyibulala intsholongwane kwakhona kubonakala kusebenza noko ekuthinteleni ukugqithiseleka komgada. Ngabantu abambalwa kuphela abaye basinda kusuleleko lomgada emva kokuba bebonise iimpawu.  Oku kube ngenxa yonyango olubanzi olwaziwa njenge-Milwaukee protocol.
### Ugonyo
U**gonyo lomgada** lugonyo olusetyenziselwa ukuthintela umgada. Kukho uthotho olufumanekayo olukhuselekileyo nolusebenzayo. Zingasetyenziselwa ukuthintela umgada kwangaphambili nakwixesha lasemva kokuba semngciphekweni wentsholongwane enjengokulunywa yinja okanye ilulwane. Ukukhuseleka kwizifo ezithile kuthatha ixesha elide emva kwamathamo amathathu. Adla ngokunikezwa ngokutofwa esikhumbeni okanye esihlunwini. Emva kokuba semngciphekweni ugonyo lusetyenziswa ndawonye ne-rabies immunoglobulin. Kucetyiswa ukuba abo bakumngcipheko omkhulu wokuwufumana mabagonywe kwangaphambi kokuba babe semngciphekweni. Ugonyo luyasebenza ebantwini nakwezinye izilwanyana. Ukugonywa kwezinja kusebenza kakhulu ekuthinteleni isifo sabantu.

#### Ukhuseleko
Zizigidi-gidi zabantu ehlabathini jikelele abathe bagonywa kwaye kuqikeleleka ukuba oku kusindise imiphefumlo yabantu engaphaya kwama-250,000 ngonyaka. Oku kungasetyenziswa ngokukhuselekileyo kuwo onke amaqela obudala babantu. Bamalunga neepesenti ezingama-35 ukuya kwezingama-45 abantu abaye bakhulelwa sisiqingatha sexesha elifutshane lebala elibomvu kunye nentlungu kwindawo abatofwe kuyo. Bamalunga neepesenti ezi-5 ukuya kwezili-15 abantu abanokuba nomkhuhlane, iintloko ezibuhlungu, okanye isicaphu-caphu. Emva kokuba semngciphekweni kumgada akukho zinto zithintela ukusetyenziswa kwayo. Inkoliso yogonyo ayinazo ii-thimerosal. Ugonyo olwenziwe kwizicwili zemithambo-luvo lusetyenziswa kumazwe ambalwa, ingakumbi eAsiya ne-Latin America, kodwa azisebenzi kakhulu kwaye zineziphumo ezikhulu ezibi. Ukusetyenziswa kwazo ngoko akucetyiswa yi-World Health Organization.  

Indleko yentengo iyonke iphakathi kwama-44 nama-78 edola yase-US ngexesha lonyango ukusukela ngo-2014. KumaZwe aManyeneyo aseMelika indleko zogonyo lomgada lingaphezulu kwama-750 edola yase-US.

## I-epidemiyoloji
Umgada ubangela ukufa okumalunga nama-26,000 ukuya kuma-55,000 ngonyaka ngamnye ehlabathini jikelele. Ngaphezu kwama-95% oku kufa kwenzeka eAsiya naseAfrika. Umgada ukhona nakumazwe angaphaya kwali-150 nakuwo onke amazwekazi kodwa eAntarctica. Bangaphezulu kweebhiliyoni ezi-3 abantu abahlala kwimimandla yehlabathi apho wenzeka khona umgada. Kwinkoliso yaseYurophu naseAustralia, umgada ufumaneka kumalulwane kuphela. Iintlanga ezininzi ezikwiziqithi ezincinci azinawo konke-konke umgada.

## Iireferensi