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Anemia mubantu bakuze barwaye diyabete bitabira ibitaro rusange muburasirazuba bwa Etiyopiya: ubushakashatsi bwibanze
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 bivuga kugabanuka k'umubare w'amaraso atukura azenguruka (RBC) na / cyangwa kugabanuka k'ubushobozi bwo gutwara ogisijeni kubera iyo mpamvu, bidahagije kugira ngo umubiri w'umuntu ukenera umubiri.1,2 Ifata ibihugu bikiri mu nzira y'amajyambere kandi byateye imbere, kubuzima bwabantu, iterambere ryimibereho nubukungu.3 Ku isi hari abantu bagera kuri miliyari 1.62 bafite ikibazo cyo kubura amaraso make, bangana na 24.8% by'abatuye isi.4
Indwara ya Diyabete (DM) ni indwara ya metabolike, igabanijwemo kabiri mu bwoko bwa I_juvenile cyangwa diyabete iterwa na insuline ndetse na diyabete yo mu bwoko bwa II_non-insuline.5 Ku barwayi ba diyabete, kubura amaraso biterwa ahanini no gutwika, ibiyobyabwenge, kubura imirire, indwara zimpyiko, biherekejwe n'indwara ziterwa na autoimmune, kugabanuka kwa 6,7 ugereranije no gutanga umusaruro wa erythropoietin, kubura fer byuzuye cyangwa gukora, no kubaho kwa selile itukura bigabanuka.8,9 Kubwibyo, kubura amaraso bikunze kugaragara kubarwayi ba diyabete.10,11 Ku bantu bakuru, ubwinshi bw'amaraso make ni 24% mu bagore bafite imyaka yo kubyara (15-49) na 15% mu bagabo bafite imyaka 15-49.12
Ku barwayi bafite DM, cyane cyane abafite uburwayi bwimpyiko bugaragara cyangwa badafite impyiko, ubwiyongere bwa anemia bukubye inshuro 2 kugeza kuri 3 ugereranije n’abarwayi badafite DM.13,14 Anemia na diyabete, nka nepropatique, retinopathie, neuropathie, gukira ibikomere nabi, n'indwara ya macrovasulaire [15,16], bigira ingaruka mbi ku mibereho y'abarwayi.17-19 Nubwo ibyo ari ukuri, raporo z’ubushakashatsi zerekana ko abagera kuri 25% b’abarwayi ba diyabete batagishoboye kumenya amaraso make.20,21
Kumenya hakiri kare no kuvura amaraso make kubarwayi ba DM birashobora gufasha kugabanya indwara nimpfu, no kuzamura imibereho yabo.22 Icyakora, muri rusange, gusuzuma ikibazo cyo kubura amaraso make ku barwayi ba diyabete muri Etiyopiya ni gito cyane, kandi kugeza ubu, nta bushakashatsi bufite akamaro.Ibi ni ukuri cyane mubice byo kwiga.Kubwibyo, ubu bushakashatsi bugamije kugereranya urugero rw’amaraso make ku barwayi ba diyabete mu bitaro bikuru bya Gramsoe mu burasirazuba bwa Etiyopiya no kumenya ibintu bifitanye isano nayo.
Ubushakashatsi bwakorewe mu bitaro bikuru bya Glymso (GGH) biherereye mu Mujyi wa Glymso, mu Karere ka Habro, muri Leta ya Oromiya, mu burasirazuba bwa Etiyopiya.Ibitaro biherereye mu birometero 390 mu burasirazuba bwa Addis Abeba, umurwa mukuru wa Etiyopiya.23 Raporo y’ibiro by’ubuzima bya Habro Woreda ivuga ko GGH ari ikigo cyohereza abantu bagera kuri miliyoni 1.4 mu gace kegeranye.Itanga serivisi z'ubuvuzi ku barwayi barenga 90.000 mu mashami yayo n'amavuriro atandukanye buri mwaka.Ivuriro rya Diyabete ni kimwe mu bice by'umwuga bitanga serivisi ku barwayi ba diyabete bagera kuri 660.Akarere ka Habro gaherereye ku butumburuke bwa metero 1800-2000.
Ubushakashatsi bwibanze ku bitaro bwakozwe kuva ku ya 9 Kamena 2020 kugeza ku ya 10 Kanama 2020. Abemerewe kwitabira ni abarwayi ba diyabete bakuze (years18) bakurikiranwa na GGH.Abarwayi ba diyabete bakuze bakiriye amaraso mu mezi 3 ashize, abarwayi batwite cyangwa baherutse kubyara cyangwa barwaye indwara zo mu mutwe, abarwayi babazwe cyangwa bava amaraso ku mpamvu iyo ari yo yose, ndetse n'abarwayi bakiriye parasite yo mu nda ntabwo barimo .Iga.
Ingano y'icyitegererezo yagenwe hakoreshejwe uburyo bumwe bw'imibare y'abaturage kandi hashingiwe ku bitekerezo bikurikira: 95% intera y'icyizere, igipimo cy'amakosa 5%, hamwe no kubura amaraso make y'abarwayi ba diyabete bo mu bitaro bya Dessie Referral byo mu majyaruguru y'uburasirazuba bwa Etiyopiya (p = 26.7)%).24 Nyuma yo kongeramo 10% kubadasubije, ingano yicyitegererezo ni 331.
Abarwayi ba diyabete 660 bakurikiranwe cyane mu ivuriro rya diyabete muri GGH.Kugabanya umubare w’abarwayi ba diyabete (660) ukurikije urugero rwanyuma (331) kugirango ubone intera ebyiri.Twifashishije igitabo cy’abarwayi ba diyabete bahabwa serivisi zo gukurikirana diyabete mu bitaro nk'ikitegererezo, twakoresheje uburyo bwa sisitemu yo gutoranya ibintu kugira ngo dushyire abandi barwayi bose mu bushakashatsi.Tanga buri wese mu bitabiriye kwiga numero yihariye iranga kugirango wirinde kwigana, mugihe umurwayi umwe yongeye kugaragara mugihe cyo kwiga kugirango akurikirane ikindi.
Kusanya amakuru ku mpinduka za sociodemografiya, kunywa inzoga, kunywa itabi, n'ibiranga imirire ukoresheje ibibazo byubatswe byahinduwe bivuye ku ntambwe ku yindi ku buryo bwa OMS ikurikirana indwara zidakira.25 Kunywa icyayi n'ikawa, gukoresha amazi, ikibazo cya cheweri ya Carter, gukoresha uburyo bwo kuringaniza imbyaro, n'amateka y'imihango byabonetse mugusuzuma ibitabo bitandukanye.Ikibazo cya 26-30 cyanditswe mucyongereza gihindurwa mu rurimi rwaho (Afaan Oromoo), hanyuma gihindurwa mu Cyongereza n’inzobere mu ndimi zitandukanye kugira ngo barebe niba bihuye.Shakisha amakuru y’amavuriro nkigihe igihe cya diyabete, ubwoko bwa diyabete, ingorane za diyabete, hamwe n’amaraso ya glucose yisonzesha bivuye mu gitabo cy’ubuvuzi cy’umurwayi.Aya makuru yakusanyijwe n'abaforomo babiri b'umwuga n'umutekinisiye wa laboratoire, akanagenzurwa na shebuja warangije ubuzima rusange.
Gupima umuvuduko wamaraso (BP) ukoresheje metero yumuvuduko wamaraso (Heuer) usuzumwa buri gihe.Mbere yo gupima umuvuduko w'amaraso, isomo ntiryigeze ryanywa ibinyobwa bishyushye nk'icyayi, ikawa cyangwa itabi ryanyweye, guhekenya Caterpillar, cyangwa gukora imyitozo ikomeye mu minota 30 ishize.Nyuma yuko isomo rimaze kuruhuka byibuze iminota itanu hanyuma ryandika impuzandengo yo gusoma BP, hafashwe ibipimo bitatu byigenga ku kuboko kwi bumoso.Ibipimo bya kabiri n'icya gatatu byafashwe nyuma yiminota itanu nicumi nyuma yo gupimwa kwambere nuwa kabiri.Hypertension isobanurwa nk'abarwayi bafite BP (SBP≥140 cyangwa DBP≥90mmHg) cyangwa abapimwe mbere ko bafata imiti igabanya ubukana.31,32
Kugirango tumenye imirire dukoresheje indangagaciro z'umubiri (BMI), twapimye uburebure n'uburemere bw'umurwayi.Iyo buri wese mu bitabiriye amahugurwa yahagaze neza ku rukuta, inkweto zabo zakoze ku rukuta hamwe, ntibambara inkweto, bagumisha imitwe yabo neza, kandi bapima uburebure bwabo n'umutegetsi maze bandika cm 0.1 hafi.Koresha igipimo cya digitale cyanditseho 0-130 kugirango upime ibiro byawe.Mbere ya buri gipimo, kora igipimo kugeza kurwego rwa zeru.Gupima uburemere bwabitabiriye mugihe wambaye imyenda yoroheje kandi nta nkweto, hanyuma wandike kg 0.1 hafi.33,34 Indangantego yumubiri (BMI) ibarwa mukugabanya uburemere bwumubiri (kg) kuburebure (m).Noneho imirire isobanuwe nk: niba BMI <18.5, ibiro bike;niba BMI = 18.5-24.9, ibiro bike;niba BMI = 25-29.9, umubyibuho ukabije;niba BMI ≥30.35,36, umubyibuho ukabije
Hafi yumwanya uri hagati yuruhande rwo hasi rwurubavu rworoshye no hejuru yimpera, koresha igipimo cya kaseti kitari elastike kugirango upime umuzenguruko wikibuno hanyuma wandike kuri cm 0.1 hafi.Umubyibuho ukabije wo hagati usobanurwa nk'urugero rw'umuzenguruko w'ikibuno ku bagabo cm 94 cm, n'umuzenguruko w'ikibuno ku bagore cm 80 cm.30,36 Mugihe cyamahugurwa, abarwayi 10 ba diyabete bakuze bakorewe ikosa ryo gupima tekinike (% TEM) kugirango bagabanye amakosa yo gupima antropometricique.Ikosa ryemewe rya tekiniki yo gupima imbere no hagati yindorerezi ntiri munsi ya 1.5% na munsi ya 2%.
Abatekinisiye ba laboratoire bakusanyije mililitiro ebyiri (2 mL) z'icyitegererezo cy'amaraso ku bitabiriye amahugurwa bose maze babashyira mu muyoboro wipimishije urimo aside yitwa tripotassium ethylenediaminetetraacetic aside (EDTA K3) anticoagulant kugirango hamenyekane hemoglobine.Kuvanga neza amaraso yose yakusanyijwe hanyuma ukoreshe isesengura rya Sysmex XN-550 kugirango ubisesengure.Ibipimo bya hemoglobine byahinduwe no kugabanya uburebure bwabitabiriye bose bakuramo 0.8 g / dl hamwe n’itabi bakuramo 0.03 g / dl.Noneho sobanura anemia nkurwego rwumugore hemoglobine <12g / dl numugabo <13g / dl.Uburemere bwa anemia bugabanyijemo: urugero rwa hemoglobine y'abagabo n'abagore ni 11-12.9 g / dl na 11–11.9 g / dl, ibyo bikaba ari anemia yoroheje, mu gihe urugero rwa hemoglobine yo kubura amaraso make kandi akomeye ni 8-10.9. g / dl, kimwe dl na <8 mg / dl.Umugabo n'umugore
Kusanya mililitiro eshanu (5 mL) z'amaraso y'amaraso mu muyoboro wipimishije udafite anticoagulant kugirango umenye creinine na urea.Amaraso yose adafite anticoagulant yambitswe iminota 20-30 hanyuma ashyirwa muri 3000 rpm muminota 5 kugirango atandukane serumu.Hanyuma, isesengura rya Mindray BS-200E (Ubushinwa Mindray Biomedical Electronics Co., Ltd.) ryasesenguye imiti y’ubuvuzi ryakoreshejwe kugirango hamenyekane serumu creatinine na urea ikoresheje aside picrine hamwe nuburyo bwa enzymatique.37 Koresha igipimo cya creinine kugirango ugereranye igipimo cyo kuyungurura isi.Koresha Indwara Yimpyiko Zidakira (CKD) Ikigereranyo (GFR), cyerekanwe nka formula ya CKD-EPI Cockroft-Gault yerekanwe kuri metero kare 1.73.
Kwiyiriza ubusa kwa glucose (byibuze amasaha 8) bipimwa no gukubita urutoki ukoresheje metero ya glucose yamaraso yahinduwe na glucose yamaraso.38 Niba igipimo cyamaraso glucose yisonzesha ari <80 cyangwa> 130mg / dl, noneho code ntigenzurwa na glucose yamaraso.Igenzura iyo glucose yamaraso yiyiriza ubusa iri hagati ya 80-130mg / dl 39
Abitabiriye ubushakashatsi bahawe inkoni isaba ibiti isukuye hamwe n’igikombe cya pulasitike gisukuye, cyumye, kidashobora kumeneka hamwe nimero yuruhererekane yacyo kugirango bagenzure parasite.Bategeke kuzana icyitegererezo gishya cya garama ebyiri (hafi yintoki).Nyuma yo kumenya inyo (amagi na / cyangwa livre) ukoresheje tekinoroji yo gushiraho neza, ibyitegererezo byagenzuwe muminota 30 yo gukusanya icyitegererezo.Ingero zisigaye zabitswe mu cyuma cyipimishije kirimo mL 10 ya 10% ya foromine kugira ngo hamenyekane igipimo cya parasite, hanyuma nyuma yo kuvurwa hakoreshejwe ikoranabuhanga ry’imvura ya forma-ether, Microscope ya Olympus yakoreshejwe mu kugenzura.
Koresha lancet sterile kugirango ukusanyirize hamwe amaraso ya capillary yintoki kugirango umenye malariya.Tegura firime yamaraso yoroheje kumirahuri imwe isukuye nta mavuta, hanyuma umwuka wumye.Amashusho yashizwemo na 10% Giemsa muminota igera ku 10, hanyuma hasuzumwa amoko ya parasite ya malariya.Iyo amashanyarazi 100 yo hejuru yasuzumwe hifashishijwe intego yo kwibiza amavuta, slide yafatwaga nabi.40
Amahugurwa yiminsi ibiri kubikoresho byo gukusanya amakuru nuburyo bwahawe abakusanya amakuru nabashinzwe kuyobora.Mbere yuko ibitaro bikuru bya Chiro bikusanya amakuru nyayo y’abarwayi ba diyabete 30, ikibazo cyabajijwe mbere kandi gihinduka gikenewe.Ibipimo bifatika byapimwe nikigereranyo cya tekiniki ugereranije yo gupima (% TEM).Mubyongeyeho, uburyo busanzwe bwo gukora bukurikizwa muri laboratoire zose zo gukusanya, kubika, gusesengura no gufata amajwi.
Uruhushya rwimyitwarire rwabonetse muri komite ishinzwe gusuzuma imyitwarire yubuzima bw’ikigo (IHRERC) y’icyahoze ari Ishuri ry’Ubuzima n’Ubuvuzi rya kaminuza ya Am Valley (IHRERC 115/2020).Ishuri rikuru ryahaye GGH ibaruwa isaba inkunga kandi ibona uruhushya n’umuyobozi wibitaro.Mbere yo gukusanya amakuru, banza ubimenyeshejwe, kubushake, byanditse kandi byashyizweho umukono na buri wese mu bitabiriye kwiga.Abitabiriye amahugurwa babwiwe ko amakuru yose yakusanyirijwe muri yo azabikwa ibanga hakoreshejwe kode, kandi nta ndangamuntu bwite yari gukoreshwa, kandi izakoreshwa gusa mu bushakashatsi.Ubu bushakashatsi bwakozwe hakurikijwe “Itangazo rya Helsinki”.
Reba ubunyangamugayo bwamakuru yakusanyijwe, kode hanyuma wandike EpiData verisiyo 3.1, hanyuma wohereze muri STATA verisiyo ya 16.0 yo gucunga no gusesengura amakuru.Koresha ijanisha, ibipimo, impuzandengo, hamwe no gutandukana bisanzwe kugirango usobanure amakuru.Nyuma yo guhindura urwego rwa hemoglobine ukurikije itabi ryabitabiriye ndetse nuburebure bwakarere, imiterere yamaraso yagenwe hakurikijwe amahame mashya ya OMS.Huza ibintu bibiri-bihindagurika byerekana uburyo bwo guhindura ibintu kugirango umenye impinduka zanyuma zo gusesengura ibintu byinshi.Muri bivariate logistic regression, impinduka zifite p-agaciro ≤ 0.25 zifatwa nkabakandida ba logistique itandukanye.Shiraho uburyo butandukanye bwo gusubira inyuma kugirango umenye ibintu bitajyanye no kubura amaraso.Koresha ikigereranyo kidasanzwe hamwe 95% intera yicyizere kugirango upime imbaraga zishyirahamwe.Urwego rusobanura imibare rwatangajwe nka p-agaciro <0.05.
Muri ubu bushakashatsi, abantu 325 bakuze DM bakuze bitabiriye iyo nama, naho igisubizo cyari 98.2%.Abenshi mu bitabiriye amahugurwa;abagabo bo mu cyaro ni 203 (62.5%), 247 (76%), 204 (62.8%) na 279 (85.5%) ni abagabo bubatse, kandi ubwoko bwabo ni Oromo.Imyaka yo hagati yabitabiriye yari imyaka 40, naho intera intera interaire (IQR) yari imyaka 20.Abagera kuri 62% bitabiriye amahugurwa ntabwo bigeze biga amashuri asanzwe, naho 52,6% byabitabiriye ni abahinzi babigize umwuga (Imbonerahamwe 1).
Imbonerahamwe 1 Ibiranga imibereho-demokarasi y’abarwayi ba DM bakuze bavuwe mu bitaro rusange byo mu burasirazuba bwa Etiyopiya mu 2020 (N = 325)
Mu bitabiriye ubushakashatsi, 74 (22.8%) bavuze ko banywa itabi byibuze rimwe mu buzima bwabo, ugereranije n’abanywa itabi 13 (4%).Byongeye kandi, abantu 12 (3,7%) ni abanywi b'ubu, naho 64.3% by'abitabiriye ubushakashatsi ni icyayi cy'umukara.Abarenga kimwe cya gatatu (68.3%) bitabiriye ubushakashatsi bavuze ko bahora banywa ikawa nyuma yo kurya.Ijana na mirongo itatu na gatatu (96.3%) na 310 (95.4%) bitabiriye kurya imbuto n'imboga bitarenze inshuro eshanu mu cyumweru.Ku bijyanye n'imirire yabo, 92 (28.3%) na 164 (50.5%) bitabiriye bari bafite umubyibuho ukabije kandi bafite umubyibuho ukabije (Imbonerahamwe 2).
Imbonerahamwe 2 Ibiranga imyitwarire nimirire yabarwayi ba DM bakuze bavuwe mubitaro bikuru bya Etiyopiya mu 2020 (N = 325)
Abarwayi barenga 170 (52.3%) bafite ubwoko bwa DM DM bafite impuzandengo ya DM igihe cyimyaka 4.5 (SD ± 4.0).Hafi ya 50% by'abarwayi ba DM bafata imiti ya hypoglycemic yo mu kanwa (glibenclamide na / cyangwa metformin), kandi hafi bitatu bya kane by'abitabiriye ubushakashatsi bafite glucose y'amaraso itagenzuwe (Imbonerahamwe 3).Kubijyanye n'ingaruka, 2% by'abitabiriye amahugurwa bari bafite ibibazo.Abarwayi 80 (24,6%) na 173 (53.2%) barwaye DM badafite hypertension ni anemia ndetse no kutagira amaraso make.Ku rundi ruhande, mu barwayi ba DM basuzumwe na hypertension, 189 (5.5%) na 54 (16,6%) bari bafite amaraso make.
Imbonerahamwe 3 Ibiranga ivuriro ry’abarwayi ba DM bakuze bavuwe mu bitaro rusange byo mu burasirazuba bwa Etiyopiya muri 2020 (N = 325)
Urwego rwo kubura amaraso mu barwayi ba diyabete ni 30.2% (95% CI: 25.4-35.4%), naho impuzandengo ya hemoglobine ni 13.2 ± 2.3g / dl (abagabo: 13.4 ± 2.3g / dl, igitsina gore: 12.9 ± 1.7g / dl).Ku bijyanye n'uburemere bw'amaraso make ku barwayi ba DM bafite ikibazo cyo kubura amaraso make, hari abantu 64 barwaye amaraso make (65.3%), 26 bafite ikibazo cyo kubura amaraso make (26.5%), na 8 barwaye amaraso make (8.2%).Anemia ku bagabo (36.0%) yari hejuru cyane ugereranije n'abagore (20.5%) (p = 0.003) (Ishusho 1).Twabonye isano iri hagati yuburemere bwa anemia nigihe cya diyabete (r = 0.1556, p = 0.0049).Ibi bivuze ko uko igihe DM yiyongera, ubukana bwa anemia bukunda kwiyongera.
Igicapo 1 Urwego rwo kubura amaraso kuburinganire kubarwayi ba DM bakuze bavuwe mubitaro bikuru byo muburasirazuba bwa Etiyopiya muri 2020 (N = 325)
Mu barwayi ba DM, 64% by'abagabo na 79.5% by'abagore ntabwo bafite amaraso make, mu gihe 28.7% na 71.3% by'abahekenya Khat ubu bafite amaraso make.67% by'abarwayi ba DM bakuze bakoresha ikawa nyuma yo kurya ntabwo bari bafite amaraso make, naho 32.9% muri bo wasangaga bafite amaraso make.Ku bijyanye no kubaho kw'ingaruka, 72.2% by'abarwayi bafite DM badafite ingaruka mbi ni anemia, naho 36.3% by'abarwayi bafite indwara ya DM bari bafite amaraso make.Abarwayi ba diyabete bafite ibibazo bya DM bafite ikibazo cyo kubura amaraso make (47.4%) kurusha abadafite ibibazo bya DM (24.9%) (Imbonerahamwe 4).
Imbonerahamwe 4 Ibintu bifitanye isano no kubura amaraso mu barwayi ba DM bakuze bavuwe mu bitaro rusange byo mu burasirazuba bwa Etiyopiya mu 2020 (N = 325)
Bikwiye bivariate na multivariate logistic regression moderi yo gusuzuma isano iri hagati yo kubura amaraso hamwe nibisobanuro bihinduka.Mu isesengura rya bivariate;imyaka, igitsina, uko abashakanye bameze, guhekenya Khat, ikawa nyuma yo kurya, ingaruka, indwara ya diyabete, igihe DM imeze nimirire (BMI) bifitanye isano cyane no kubura amaraso afite agaciro k <0.25, kandi ni abakandida ba Multivariate logistic regression.
Mu isesengura ryinshi rya logistique yo gusubira inyuma, abagabo bafite DM years imyaka 5 yamara, kuba hariho ingaruka hamwe nibibazo bya DM byari bifitanye isano no kubura amaraso.Abarwayi ba DM bakuze bafite amahirwe yo kuba bafite ikibazo cyo kubura amaraso make kurusha igitsina gore (AOR = 2.1, 95% CI: 1.2, 3.8).Ugereranije n’abarwayi ba DM badafite ingaruka, abarwayi ba DM bafite ibyago byikubye inshuro 1.9 kuba anemia (AOR = 1.9, 95% CI: 1.0, 3.7).Ugereranije n’abarwayi bafite DM igihe cyimyaka 1-5, abarwayi ba DM bafite DM igihe cyimyaka 5 years inshuro 1.8 bashobora kwandura amaraso make (AOR = 1.8, 95% CI: 1.1, 3.3).Ibyago byo kubura amaraso make kubarwayi bafite ibibazo bya DM bikubye inshuro 2,3 abo bakorana (AOR = 2.3, 95% CI: 1.3, 4.2) (Imbonerahamwe 4).
Ubu bushakashatsi bwasuzumye ubukana bwa anemia hamwe n’ibintu bifitanye isano n’abarwayi ba DM bakurikiranwe na diyabete mu bitaro bikuru bya Gelemso.Urwego rwo kubura amaraso mu bushakashatsi burimo ni 30.2%.Dukurikije uko OMS yashyize mu majwi akamaro k’ubuzima rusange, mu bushakashatsi bwakozwe, kubura amaraso ni ikibazo cy’ubuzima rusange mu barwayi bakuze bafite DM.Uburinganire, igihe DM yamara, kuba hari ibibazo bya DM, nabagabo bafite ibibazo bya DM byagaragaye nkibintu bifitanye isano no kubura amaraso.
Urwego rwo kubura amaraso muri ubu bushakashatsi rwagereranywa n’urw'ibitaro byoherejwe na Etiyopiya Dessie Referral [24], ariko birenze ibyo mu bitaro bya Etiyopiya Fenote Selam [41] mu bushakashatsi bwakozwe mu Bushinwa, 42 Ositaraliya, 43 n'Ubuhinde [44 ]., Bikaba biri munsi yubushakashatsi bwakorewe muri Tayilande [45], Arabiya Sawudite [46] na Kameruni [47].Iri tandukaniro rishobora guterwa no gutandukanya imyaka yabaturage biga.Kurugero, bitandukanye nubushakashatsi bugezweho butarimo abantu bakuru barengeje imyaka 18, ubushakashatsi bwakorewe muri Tayilande bwarimo abantu bakuru barengeje imyaka 60, mugihe ubushakashatsi bwakorewe muri Kameruni bwarimo abantu bakuru barengeje imyaka 50.Itandukaniro rishobora nanone guterwa no kugabanuka kwimikorere yimpyiko, gutwika, guhagarika amagufwa, hamwe nimirire mibi (kwiyongera hamwe nimyaka) 17.
Twatunguwe nuko mubushakashatsi bwacu, kubura amaraso yabagabo bikunze kugaragara kurusha igitsina gore.Ubu bushakashatsi bunyuranye n’izindi raporo z’ubushakashatsi [42,48], aho usanga abagore bakunze kurwara amaraso make kurusha abagabo barwaye diyabete.Impamvu ishoboka yo gutandukana irashobora kuba nuko abagabo mubushakashatsi bwacu bari bafite akamenyero kohejuru ka Khat, bishobora gutera kubura ubushake bwo kurya 49, kandi Khat irimo tannine-ibintu bigabanya bioavailable ya fer itari heme mumirire.50 Indi mpamvu ishoboka ni uko gufata ikawa n'icyayi cyane ku bagabo muri ubu bushakashatsi byabujije kwinjiza fer mu mara.51-54
Twasanze abarwayi bafite DM ≥ imyaka 5 bafite amahirwe yo kurwara amaraso make kurusha abarwayi bafite DM bafite amasomo yimyaka 1-5.Ibi bihuye nubushakashatsi bwakorewe mu bitaro bya Fenote Selam muri Etiyopiya, 41 Iraki 55 n'Ubwongereza.17 Ibi birashobora guterwa no kumara igihe kinini uhura na hyperglycemia, bigatuma kwiyongera kwa cytokine ikongora hamwe ningaruka zo kurwanya erythropoietin, bigatuma umubare ugabanuka.Kugabanuka kwingirabuzimafatizo zamaraso zitukura biganisha ku kugabanuka kwa hemoglobine.35
Ukurikije ubushakashatsi bwakorewe mu Bushinwa, anemia 13 muri ubu bushakashatsi yagaragaye cyane ku barwayi ba DM bafite ibibazo.Mu binyabuzima, ibibazo bya diyabete birashobora kwangiza cyane ingirabuzimafatizo n'imitsi y'amaraso y'impyiko, gutwika sisitemu, hamwe no kwinjiza erythropoietin irekura bishobora gutera amaraso make ya diyabete.56 Hypoxia irashobora kugira ingaruka kumagambo ya gene, metabolism, capillary permeability no kubaho kwingirangingo 57. Kugabanuka kwamaraso atukura hamwe na antioxydeant ya antioxydeant bifitanye isano no kubura amaraso nabyo bishobora gutera izindi ngorane kubarwayi ba diyabete 58.
Byongeye kandi, abarwayi ba DM bafite comorbidities bakunze kwibasirwa n'amaraso make kurusha abarwayi ba DM badafite ingaruka.Ibi biragereranywa nubushakashatsi bwabanje [35,59], bushobora guterwa ningaruka ziterwa na comorbidities (nka hypertension) zitera ibibazo byumutima nimiyoboro y'amaraso, bityo bikongera ibyago byo kubura amaraso.60
Nka bumwe mu bushakashatsi buke bushingiye kuri laboratoire bwakorewe muri Etiyopiya, indwara zidakira nka DM zimaze kuba nyinshi, ibyo bikaba ari imbaraga z’ubu bushakashatsi.Ku rundi ruhande, ubu bushakashatsi ni ubushakashatsi bumwe bushingiye ku bitaro kandi ntibushobora guhagararira abarwayi bose bafite DM cyangwa abarwayi bakurikiranwa mu bindi bigo by’ubuvuzi.Imiterere-karemano yuburyo bwubushakashatsi twakoresheje ntabwo yemerera gushiraho umubano wigihe gito hagati yo kubura amaraso nibintu.Inyigisho z'ejo hazaza zirashobora gukenera gukoresha igenzura, ubushakashatsi bwa cohort cyangwa ubundi bushakashatsi bwakozwe kugirango harebwe ibimenyetso nibimenyetso bya anemia, morfologiya ya RBC, serumu fer, vitamine B12, hamwe na aside folike.
Mubushakashatsi, anemia nikibazo cyubuzima rusange buringaniye mubarwayi ba DM bakuze.Uburinganire, igihe DM yamara, kuba hari ibibazo bya DM, hamwe nibibazo byari igitsina gabo kandi byagaragaye nkibintu bifitanye isano no kubura amaraso.Kubwibyo, kwisuzumisha bisanzwe bya anemia hamwe nubuyobozi bukwiye kubarwayi ba DM bafite igihe kirekire cya DM, ibiza nibibazo bigomba gutegurwa kugirango imibereho yabarwayi irusheho kuba myiza.Gusuzuma hakiri kare no gukurikirana buri gihe DM birashobora kandi gufasha kugabanya ibibazo.
Amakuru ashyigikira ibisubizo byavuzwe mu nyandiko yandikishijwe intoki arashobora kuboneka ku mwanditsi uhuye ukurikije ibisabwa bifatika.
Turashaka gushimira umuyobozi wibitaro bikuru bya Gelemso, abakozi b’ivuriro rya Diyabete, abitabiriye ubushakashatsi, abakusanya amakuru hamwe n’abafasha mu bushakashatsi.
Abanditsi bose bagize uruhare runini mu mirimo ya raporo, haba mu bitekerezo, igishushanyo mbonera, gukora, gushaka amakuru, gusesengura no gusobanura, cyangwa muri ibyo byose;yagize uruhare mu gutegura, gusubiramo cyangwa gusubiramo bikomeye iyi ngingo;amaherezo Yemeje verisiyo igomba gutangazwa;bumvikanye ku kinyamakuru ingingo yashyikirijwe;kandi yemeye gushingwa ibintu byose byakazi.
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Inuma yubuvuzi bwa Dove ni iyitsinda rya Taylor & Francis, nishami rishinzwe gutangaza amasomo ya Informa PLC, uburenganzira bwa 2017 Informa PLC.uburenganzira bwose burabitswe.Urubuga rufite kandi rukoreshwa na Informa PLC (aha bita "Informa"), kandi ibiro byayo byanditse ni 5 Howick Place, London SW1P 1WG.Yiyandikishije mu Bwongereza na Wales.Numero 3099067. Itsinda rya TVA y'Ubwongereza: GB 365 4626 36
Kugirango dutange serivise zakozwe kubasura urubuga hamwe nabakoresha biyandikishije, dukoresha kuki kugirango dusesengure urujya n'uruza rwabashyitsi no kwiharira ibirimo.Urashobora gusoma politiki yi banga kugirango wumve imikoreshereze ya kuki.Turabika kandi amakuru yerekeye abashyitsi n’abakoresha biyandikishije kugirango bakoreshe imbere kandi dusangire amakuru nabafatanyabikorwa mubucuruzi.Urashobora gusoma politiki yi banga kugirango wumve amakuru tubika, uko tuyifata, abo dusangiye nuburenganzira bwawe bwo gusiba amakuru.
Igihe cyoherejwe: Gashyantare-19-2021