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Urukingo rwa SIDA na Kanseri, kumenya indwara uzarwara mu bihe biri imbere: Ikiganiro na Prof Mutesa

Yanditswe na J. Claude Mugenzi
Kuya 10 June 2024 saa 07:11
Yasuwe :

Prof. Mutesa Léon, ni umwarimu muri Kaminuza y’u Rwanda, akaba ari umushakashatsi, by’umwihariko ku turemangingo ndangasano bizwi nka "human genetics".

Ni ibintu yakoze igihe kirekire akurikiranira hafi uburyo ihungabana rihererekanywa cyane mu buryo umubyeyi arihererekanya n’uwo atwite, uwo abyaye n’ibindi.

Prof Mutesa yaganiriye na IGIHE, agaruka ku bijyanye n’indwara zihererakanywa zishingiye ku turemangingo ndangasano, impamvu inkingo za kanseri, SIDA n’ibindi zitaraboneka, uburyo bwo kwisuzumisha bugenda bugerwaho ku buryo umuntu yaza amenya indwara ashobora kuzahura nazo n’ibindi.

Watangira udufasha kumva neza uburyo umuntu yiga uturemangingo ndangasano n’icyo ari cyo?

Harimo ibintu nka bibiri navuga koko byatumye mbyiga. Icya mbere, ni uko ari agace k’ishami ry’ubuganga ushobora no gusanga mu bindi bya siyansi ariko njyewe nashakaga kumenya ; nkibaza nti ’ni ukubera iki ibi bintu bitari mu Rwanda ? Ese birashoboka ko twabyiga? Cyane cyane ko nari maze kwiga maze kubona ko mu Rwanda hari izindi ndwara z’uruhererekane mu muryango z’icyo gihe n’uyu munsi wa none zitari zizwi kandi zihari.

Icyo rero ni cyo gice cya mbere cyatumaga njya kubyiga nkavuga nti ‘icyo gice kitigeze kitabwaho ndashaka kukimenya’. Ayo yari amatsiko ya mbere. Amatsiko ya kabiri ahuza cyane n’iby’ihungabana, nahera y’uko muri Jenoside yakorewe Abatutsi harimo icyo gice koko cy’abantu bayirokotse b’ababyeyi bagize ihungabana rikabije muri icyo gihe, bamwe baba mu gice cya AVEGA, hari n’abatabasha kubamo ariko bari mu Rwanda, nkajya mbona abana babakomotseho bavutse icyo gihe.

Twatangiye kubibona tukiri muri za kaminuza, icyo gihe bari bakiri bato tukabona bamwe batangira kugira ikibazo cy’ihungabana. Cyane cyane natangiye kubibona ubwo byari bimaze imyaka 12, 13 abana bari barangije amashuri abanza batangiye ayisumbuye, ku buryo hari aho byanavugwaga ko abo bana igihe byagaragaraga cyane ko bagira ibimenyetso by’ihungabana mu gihe cyo kwibuka, mu kwezi kwa Mata kugera muri Nyakanga.

Ndibuka twari dufite itsinda rimwe ryari ririmo AERG, icyo gihe bari muri kaminuza. Twajyaga tujya kureba mu bigo by’amashuri yisumbuye bigagamo cyane cyane byari byegereye Kaminuza y’i Butare, za Save, ESPANYA tukabona abo bana bafite icyo kibazo.

Hari n’aho bamwe bavugaga ngo ni ibyo bigira, barigiza nkana ku buryo njyewe byanteye amatsiko.

IGIHE: Ko bigaragara cyane mu gihe cy’icyunamo?

Ababyeyi babo nabyita ko bo bahuye n’ihungabana mu buryo buziguye, abana bo nabyita ko bo basa nk’aho bahuye n’ihungabana mu buryo butaziguye.

Ni nk’ingabo basaga nk’aho bafite ariko ntabwo ari ko bimeze buriya kuko twabonye ko mu ihererekanywa n’iyo umwana yaba ari muri ya mazi umwana abamo mu nda ya nyina icyo gihe amutwite, byagaragaye ko umwana yakira utwo turemangingo ndangasano twahungabanye.

Muri 2011 na 2012 ni bwo twari dutangiye kubona ubushobozi bwo kuba twabipima-mbere twari tutarabubona buhagije hano mu Rwanda-dukorana n’abashakashatsi babaga hanze.

Muri icyo gihe rero bashoboraga kuba bapima muri utwo turemangingo ndangasano biturutse ku bimenyetso cyangwa se ku bipimo dufata by’amaraso, tugakuramo ka karemangingo ndangasano noneho bo bakagapima bagashakamo bya bindi twarebaga.

Icyo gihe nanone ikindi kiriho ni uko byari bitaramenyekana cyane ko ku muntu utwo turemangingo ndangasano tugira ikibazo cy’ihungabana, tugahererekanwa (utwo twa épigénétique) mu bantu bagize ihungabana.

Aho twabiheraga rero, muzi ko Jenoside yakorewe Abayahudi bari barakozweho ubushakashatsi cyane. Na bo bari barakoze ubushakashatsi ariko tukabona amakuru batangaje harimo gukeka ko byamera gutyo, bidutera amatsiko. Noneho icyo gihe ndimo gukorana na Prof Karege, hasohotse ikinyamakuru cyerekanye mu bice by’inyamaswa, mu bice by’imbeba bapimiraho muri laboratwari babiteye cya kibazo cy’ihungabana [...]

IGIHE: Icyo kirashoboka se ? Umuntu ashobora guhangayikisha inyamaswa?

Ntabwo uyitera ubwoba ko ugiye kuyica, hari imiti uyitera. Nubwo mvuga uturemangingo ndangasano, hari ibindi bintu mu mubiri by’ibipimo bihinduka. Urabona iyo ugiye kwa muganga ugatanga ikizami cy’umusarane, inkari cyangwa amaraso, hari ibyo dupimamo.

Buriya rero umuntu ugize ubwoba cyangwa ihungabana, hari ibindi bintu bizamuka bikorana n’ubwonko bigatanga imisemburo. Iyo misemburo rero, hari iyo bita “cortisol” akenshi iyo ugize ubwoba urazamuka cyane, bwashira cyangwa se ihungabana rishize ukamanuka ukaba waguma ku gice cy’abandi bantu badafite ikibazo.

Dr Mutesa yagize uruhare runini mu bushakashatsi ku ihungabana rihererekanwa mu gihugu nk'u Rwanda cyabayemo Jenoside

Byagaragaye ko kuri uwo musemburo witwa “cortisol“, ku bantu bagize ihungabana rikabije, rimaze igihe ; warazamutse urangije ugaruka ku gipimo cy’abandi urangije umanuka hasi. Imyaka 12 hafi 20 nyuma ya Jenoside tukabibona. Ubu imyaka 30 na bwo turabibona, tukabona ko ibipimo byawo byagumye biri hasi ugereranyije n’abantu badafite ikibazo cy’ihungabana.

Waduha urugero ku turemangingo dutera indwara iyi n’iyi abantu bazi ifatika?

Hari n’indwara muzi, abarwayi bameze gutyo turabafite kwa muganga barwaye indwara yitwa “Down syndrome”, cyangwa “Trisomie 21”.

Ubundi buri wese agira uturemangingo ndangasano 46. Icya kabiri cy’utwo turemangingo tuba twavuye ku mubyeyi umwe, ni ko inkomoko imeze. Iyo rero mbonye 23 tw’umubyeyi umwe n’undi akampa 23, tugomba kuba 46, utwo ni two bita “chromosomes”.

Utu ni uturemangingo tubonera mu bipimo dupima. Utu hari igihe noneho aho kugira ngo umubyeyi umwe atange 23 n’undi atange 23, hari igihe hamwe hava 24 ahandi 23 tukaba 47.

Iyo rero kiyongereyeho ibyo bita “trisomie”, ni ukuvuga aho twakagiye ari tubiri tubiri twabaye dutatu. Aho rero izikunze kwiganza ni ku ya 21 yiganje no mu Rwanda aho abana bavukana ibimenyetso by’idindira mu bwenge, kugenda, kuvuga, guhaguruka byose biba bidindiye.

Abo bana ni ko bakunze kumera bakagira n’ibindi bimenyetso ku mubiri bidasa n’iby’abandi, kugira agatwe gato, amaso mato, akananwa gatoya, umwana akanakura asa n’ugwingiye ku buryo n’iyo tutagize icyo dukora hakiri kare, umwana usanga azicara hafi ku mwaka aho abandi bicara ku mezi atandatu, agahaguruka ku myaka itatu aho abandi bahaguruka bakagenda ku mezi icyenda cyangwa umwaka bagatera intambwe, we bikaba nyuma.

Akenshi iyo tubibonye kare turabafasha, tukabashyira mu bugororangingo ari byo twakwita “physiothérapie” cyangwa “kinésithérapie” kugira ngo abana baveyo. Nk’ibyo ni indwara ifatika iturutse ku turemangingo ndangasano ariko dufatika tunaboneka.

Hari utundi rero dutoya turi muri twatundi duhererekanwa 23 ku mubyeyi umwe umwe, 46 twita “genes” tuba noneho muri ka karemangingo ndangasano k’ifatizo “DNA”. Kariya rero gafite utugera kuri genes zirenga ibihumbi 30 ku muntu umwe, kuri buri wese ku isi dukora neza.

Kariya rero na ko hari igihe ushobora kugira gutya kagahungabana umuntu akarwara indi ndwara. Nk’iyo natangaho urugero ni “drépanocytose” cyangwa se “sickle cell anemia” ni indwara igaragara abana bakivuka igakomeza ku bantu bakuru ariko baba barayivukanye, ituma bagira ikibazo cyo kugira amaraso make, bakagira ikibazo cyo guhora barwaragurika.

Wagaruka noneho kuri ha handi umuntu abona akaremangingo karaga umwana ihahamuka

Muri izo zirenga ibihumbi 30 tuzibona muri twa genes tugenda kuri ka karemangingo ndangasano k’ifatizo ari ko DNA gafite utundi turemangingo ndangasano twinshi. Noneho iyo ugarutse inyuma, iriya DNA cyangwa ka karemangengo ndangasano uburyo gakora, uburyo DNA y’umuntu ihererekanywa igakora cyangwa se fatizo mu muntu, hari igice cy’imbere nakwita “moteri”.

Imodoka iba ifite moteri, ikaba ifite n’igice cy’inyuma abantu bicaramo n’amatara n’amapine byose. Iyo Moteri ipfuye ntibivuze ko imodoka yose yapfuye. Iyo Moteri ipfuye, imodoka ntishobora kugenda. Wicayemo, amatara ashobora kwaka wenda n’amapine ariko birakora. Icyo gihe rero iyo moteri ipfuye ni yo bita ka karemangingo ndangasano fatizo moteri yako yapfiriyemo; ariho kapfiriye.

Buriya ni mu mutima. Aho rero ni ho twabonye ko n’ihungabana utu genes turimo hariya mu moteri twapfiriyemo, ni uko twagize ihungabana ni ho tubitse.

Iyo rero ugiye ugafata imodoka, moteri ikora, ibindi bice tuvuge ipine rigapfa nanone imodoka ntigenda neza ariko moteri irakora. Ririya pine rero turigereranya na twa turemangingo ndangasano tw’utu genes turi mu twa tundi fatizo.

Ubu bushakashatsi ukora wanabuherewe igihembo…

Ni igihembo cyitwa HUGO African Prize, ni ukuvuga Human Genome Organization, igihembo gihabwa umunyafurika umwe wakoze ubushakashatsi bw’indashyikirwa ku isi. Iki gihembo nubwo nagihawe ariko, nkibona nk’igihembo cy’ababugizemo uruhare ariko by’umwihariko ababukoreweho.

Ubwo bushakashatsi haba mu Rwanda n’ahandi ku isi, bwafashije abantu kumva no gusobanukirwa ihungabana n’ihererekanwa ryabwo mu buryo bw’uturemangingo ndangasano ari nabwo bwa mbere ku isi bwari bubaye. Ubwo buryo rero nibwo twishimiyemo icyo gihembo, ariko haracyari urugendo rurerure rwo kugira ngo tumenyeibindi bintu.

Ubushakashatsi bwacu bwibanze ku babyeyi bahungabanye n’abana babo babavutseho icyo gihe, n’abavutse nyuma ya Jenoside yakorewe Abatutsi. Ni ubushakashatsi bwakozwe ku bisekuru bibiri.

Ubu turashaka gukurikirana igisekuru cya gatatu kigizwe n’abana bavutse ku bana bavutse mu 1994, kuko ubu bamaze kugira imyaka 30. Ubu rero turashaka kumenya niba abana bazabyara nabo hazabaho iryo hererekanya ku buryo bagira ikibazo cy’ihungabana.

Ubwo se muracyabishidikanyaho kandi mwarabonye ko bishobora guhererekanwa mu turemangingo?

Yego. Nicyo cyiza cy’ubushakashatsi. Utangira ushidikanya nyine ubundi ugashakisha. Biramutse ari ibintu bizwi ntabwo wajya mu bushakashatsi. Dufite amatsiko yo kumenya.

Hari ibigenderwaho ku buryo ibyo bishobora gutuma habaho kugabanuka k’ubukana bw’ihungabana. Ibi harimo nk’aho umuntu aba, urugero nko mu Rwanda iyo urebye, nyuma ya jenoside ukuntu u Rwanda rugenda rwiyubaka, byabaye byiza ku bantu bagize icyo kibazo ku buryo usanga harabayeho ubudaheranwa. Ba bantu bagize ikibazo bagatangira kwiyubaka, bihangira imirimo bumva ko ubuzima bushobora gukomeza ariko ibyo mubyumve mu rwego rwa siyansi noneho.

Ni ukuvuga ko nta muti ushoboka uretse gufashwa na sosiyete umuntu abamo?

Aho niho ubushakashatsi buryoheye kuko ibigo bikora imiti byatangiye kugira amashyushyu yo kugira ngo bibikoreho. Hari imiti ibaho dusanzwe tunatanga kwa muganga, igabanya guhungabana; izwi nka “antidepressant”.

Ubu noneho rero barashaka gukora imiti ireba muri turiya turemangingo twangiritse twabonye muri iki gice cy’aba bantu bo mu Rwanda, kugira ngo barebe niba bashobora gukora imiti ituma mu bihe bizaza, hashobora kubaho ubwirinzi bikarwanywa amazi atararenga inkombe.

Hari izindi ndwara nka kanseri z’amoko atandukanye nazo zigira aho zihurira n’uturemangingo-ndangasano, kuki zo zisa n’izibagiranye?

Kanseri nazo zifite aho zihurira n’uturemangingo ndangasano, noneho two dufite utunyabugingo (cells) ari natwo tubamo ka karemangingo ndangasano k’umwimerere ; aka rero karibyara kandi niko twese tubayeho ; karibyara mu mubiri, ariko iyo kibyaye kagakwira hose mu buryo budashobora kugenzurwa, nibwo kanseri ivuka.

Akenshi usanga kanseri ivuka mu mubiri w’umuntu ntabimenye, akazabimenya imugeze kure, ariko ubu kubera ko ubuvuzi bugenda burushaho gutera imbere mu gupima kanseri, ububishobora kugaragara hakiri kare.

Ubu rero hari kanseri nyinshi zizwi zihari, ushobora gufata urutonde rw’eshanu za mbere zikabije, ndetse ukurikije ubushakashatsi buhari nko mu Rwanda kanseri y’igifu iza mbere, kanseri y’inkondo y’umura ku bagore na kanseri y’ibere, noneho ku bagabo hari kanseri ya prostate kimwe; na kanseri y’urura runini.

Sinavuga ko izo kanseri zibagiranye kuko zabayeho kera ariko uburyo zigenda ziyongera ndetse n’ibyago byo kwiyongera kwazo bikarushaho kuba byinshi, aho usanga uburyo bw’imirire bwarahindutse, imibereho y’abantu aho usanga batita ku gukora imyitozo ngororangingo, kwirirwa abantu bicaye bakibasirwa n’umubyibuho ukabije, kunywa itabi, n’ibindi.

Kwitabwaho kwa kanseri rero bijyana n’ubushobozi. U Rwanda rurubaka ubushobozi nk’uko mwagiye mubibona; usanga ubu noneho tunafite aho bazivurira nko mu bitaro bya gisirikare biri i Kanombe, hari ukwica twa tunyangingo twirema ntiturenge urugero (chemotherapy), hakaba hanakomeza kugenda hashakishwa ibisubizo by’umwihariko kuri kanseri zihererekanwa nk’iy’ibere aho usanga ababyeyi bashobora kuyihererekanya n’abana b’abakobwa babakomokaho. Ariko kandi burya kanseri y’ibere ijya ifata n’abahungu nubwo ari bakeya.

Abantu rero basabwa kwisuzumisha buri mwaka ariko habaho n’uburyo bwo kwikorakoraho ku ibere kugira ngo wumve niba nta kabuye gatangiye kuza. Ni bimwe mu bifasha kugira ngo kanseri ikumirwe itarasakara.

Ahantu ikibazo gikomerera ni igihe cyo gukumira yaramaze gufata ibice byinshi itagikumirika. Ugasanga yageze mu bihaha, mu magufwa no mu ruti rw’umugongo n’ahandi kandi yari kanseri y’ibere.

Kugorana no kuramba kwa kanseri ko muguhuriza he n’agakoko ka virusi itera SIDA ko nayo bisa n’aho itakigarukwaho by’umwihariko muri Afurika?

SIDA yo itandukanye gato na kanseri kuko SIDA yo irandura ariko kanseri hari uburyo ihererekanwa cyangwa se ikaza nta wundi muntu ikomotseho. Sida yo rero irandura mu maraso ariko cyane cyane biciye mu myanya ndangagitsina kandi nabwo ni uturaso tuba tuvuye ku wanduye tujya ku muntu utanduye.

Virusi yayo rero yamaze imyaka irenga 35 hakorwa ubushakashatsi bashaka kuvumbura imiti n’urukingo. Ku kijyanye n’imiti, twavuga ko babashije gutera intambwe ifatika ku isi kuko mu myaka ya 1980 na 1990 SIDA yahitanaga abantu benshi kugeza yewe no muri za 2000 n’uyu munsi hari ibihugu bagipfa cyane, ariko nk’u Rwanda usanga harashyizwemo ingufu ku buryo imiti yagiye iboneka.

Kugeza ubu rero imiti ihari myinshi yakozwe rero, ikora mu buryo irwanya ibimenyetso bya virusi; ariko imiti iyica igatuma ishwanyuka itarabasha kugira icyo ikora mu mubiri, ni yo akenshi dukunze kwita urukingo, ariko ibyo byo biracyari mu bushakashatsi ntabwo birabasha kugerwaho ku buryo n’aho byagiye bisa n’ibigerwaho, inkingo zikaboneka ntabwo zagiye zirandura virusi burundu, ahubwo yasaga n’igabanuka cyangwa igasinzira gato bwacya ukabona yazamutse.

Gusa ubu hariho icyizere kuko COVID-19 yasize amasomo menshi, aho hari inkingo zagiye zikorwa mu buryo bwihuse bitandukanye na ziriya nkingo zakorwaga mbere.

[…] Imiti yo rero yarakozwe myinshi ku isi kandi iranafasha ndetse u Rwanda ruri mu bihugu byabaye ibya mbere mu kurwanya SIDA neza ku buryo twavuye ku gipimo cya 13% mu 2000 tukagera munsi ya 3% uyu munsi mu baturage bose.

Aho ni ku gice cy’imiti, ariko ku gice cy’inkingo kugira ngo ya virusi noneho tuyikingire, aho niho harimo guterwa intambwe.

Mu Rwanda hamaze guterwa intambwe igaragara ku bijyanye n’ubuvuzi bushingiye ku buhanga buhambaye […] mu myaka iri imbere ni ibiki biri gukorwaho twakwitega ko bizaduteza intambwe zirenze ibyo tugezeho none ?

Mpereye muri ibi nkora, hari icyo bita “Human Genome Project” ari byo nakwita kwiga uturemangingo ndangasano tw’amakingirizo mu mubiri w’umuntu kugira ngo ubashe gukumira ya kanseri twavuze, witegure wa muvuduko w’amaraso ukabije ntuzabeho, isukari nyinshi na za diyabete byose ukabikumira.

Icyo gihe ni nk’uko wafata ishusho yose y’umuntu ukayipima kuko uyu munsi tubasha kubikora ; ukamenya aho hantu harimo utwo tuntu dushobora gutera izo ndwara mu myaka igiye kuzaza.

Bikunze kugaragara cyane ko umuntu arwara kanseri uko akura ari na yo mpamvu usanga ziganza mu bakuze kurusha abana. Abana nabo barazigira ariko ni bake. Ubu rero uvutse muri uwo muryango ariko ugakorerwa iryo shusho, ushobora kurindwa kuzazirwara.

Ibi byasakaye mu bindi bihugu aho hakorwa icyo cya Human Genome Project aho umuntu ashobora kumenya umuryango avukamo akamenya ko wenda abawukomokamo bakunda kwibasirwa na kanseri ya prostate cyangwa indi runaka, bikamufasha mu gukorerwa kimwe cyo gukumira.

Ibyo rero mvuye mu byo mbamo cyane, biraza bigahura na bimwe muri kubona ku isi by’ubwenge buhangano bizwi nka Artificial Intelligence aho iri koranabuhanga rigenda rifasha cyane mu igenamigambi ry’ahazaza nk’uko abantu bareba iteganyagihe ry’ibizabaho ejo bakakubwira bati mwitegure ejo hazagwa imvura nyinshi.

Ubu nabyo niho biri kugana aho dushobora kuvuga ngo SIDA ishobora kuba nyinshi muri iki gihe, ibyorezo bishobora kuba byinshi muri iki gihe kubera ubwo bwenge buhangano.

Ibyo rero ubihuza n’amakuru yizewe aho uyakomatanya ukavuga uti mu mwaka umwe cyangwa ibiri igiye kuza, mwitegure dushobora kugira ibyorezo byinshi by’ubu bwoko kuko hari ibimenyetso fatizo biri kubitwereka.

Ni ukuvuga ko mu gihe kiri mbere tugiye kujya duhendwa no kwisuzumisha kurusha kwivuza?

Ni nabyo byiza kuko bizaba bifasha umuntu kumenya uko yifata n’ibyo akwiye kwirinda, ahindure imirire niba yaryaga nabi cyangwa niba yaryaga ibishobora kumutera umubyibuho ukabije.

Ibi bizagabanya za kanseri n’ibindi byago byinshi nk’uko ubu dufite za camera zicunga umuvuduko bikagabanya impanuka, uko ni nako mu buvuzi hagiye kuba hariho ibimenyetso bikwereka ko niba mu mubiri wawe waravutse bimeze bitya, ufite ibyago byo kwibasirwa na kanseri, ihungabana noneho hatangwe inama y’icyo umuntu yakora kugira ngo yirinde guhura n’ibyo byago.


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